tinnitus Flashcards
what is tinnitus ?
subjective perception of sound without external acoustic stimulation
what are the types of tinnitus ?
subjective and objective
what is the difference between subjective and objective tinnitus ?
subjective - can be heard by the patient only
objective - can be heard by the patient and the examiner
what are the subtypes of subjective tinnitus ?
conductive tinnitus
sensorineural tinnitus
wheere is the pathology in subjective conductive tinnitus ?
external and middle ear pathologies
where is the pathology in subjective sensorineural tinnitus ?
cochlear and auditory pathways
what are the subtypes of objective tinnitus ?
pulsatile tinnitus
non pulsatile tinnitus
what is the cause of pulsatile tinnitus ?
vascular causes
what are the vascular causes that can result in pulsatile tinnitus ?
AV malformation
Internal Carotid Artery atherosclerosis
Glomus tumors
high jugular bulb
anemia , hypertension, thyrotoxicosis
how is thyrotoxicosis related to pulsatile tinnitus ?
due to increased vascularity
where do glomus tumors arise from ?
chief cells of the paraganglia
what are the causes of non-pulsatile tinnitus ?
- myoclonus of the middle ear muscles or palatal muscles - recurrent clicking tinnitus
- TMJ arthritis - clicking sound on opening of mouth or during mastication
what muscles are affected causing non-pulsatile tinnitus ?
tensor tympani or stapedius muscle
which nerve is the jacobson’s nerve ?
the tympanic branch of the glossopharyngeal nerve
what is the nerve supply of tensor tympani and the stapedius muscle ?
tensor tympani - tensor tympani branch of the mandibular nerve of the trigeminal nerve
stapedius muscles - nerve to stapedius through the facial nerve
what are the required investigations for a case of tinnitus ?
pure tone audiometry and tympanometry if associated with hearing loss
MRI in unilateral SNHL to exclude acoustic neuroma
in pulsatile tinnitus - MR or CT angiography
Carotid duplex
what is the treatment for cases of tinnitus ?
treat the underlying cause
hearing aid in cases of hearing loss
hearing aid with tinnitus masker in selected cases
noise generator at night if it is causing sleep difficulty
Behavioural therapy can be provided by audiologist to reduce perception of tinnitus sound
what is harsh tinnitus an indication off ?
conductive heearing loss
what is sharp tinnitus and indication off ?
sensorineural hearing loss
