Tinnitus

Question 1

Tinnitus:

What if tinnitus is associated with an effusion?

Answer 1

If there is effusion in middle ear - monitor to resolution (if persist in 6 weeks refer to ENT for post nasal space lesion exclusion with FNE)

Question 2

Tinnitus:

If there is hearing loss with tinnitus what can help?

Answer 2

Hearing aids. They increased volume of natural noise and assist in masking the tinnitus. As well as reducing hearing difficulties which can be associated with frustration and communication difficulties.
*All these factors can increase the awareness of ones tinnitus

Question 3

Tinnitus:

Other factors to consider?

Answer 3

• TMJ dysfunction (dental input required)

- manage mental health comorbidities (exacerbate tinnitus)

Question 4

Tinnitus:

Instant referral to ENT specialist indicated by?

Answer 4

• unilateral, debilitating or pulsatile tinnitus
• sudden onset hearing loss (within 72 hours)
• cranial nerve/cerebellar signs

Question 5

Tinnitus:

Most effective treatments?

Answer 5

• hearing aids
• masking noise (50% effective)
• diet adjustment (reduce or eliminate tinnitogenic foods if possible - salt, sweets, caffeine, alcohol, fast food; include other foods that may reduce or assist - banana, papaya, pears, mangoes (all high in potassium and reduce BP), garlic and zinc)
• ensure not deficient in zinc, B12 and magnesium
• hypnotherapy (by indirectly aiding relaxation)
• tinnitus retraining therapy (https://tinnitustreatment.com.au/)
• habituation (getting used to the tinnitus as a stimuli that is present but not important eg like the background traffic noise or feel of clothes on your skin)

Question 6

Tinnitus:

Medications implicated in tinnitus?

Answer 6

• aminoglycosides
• macrolides
• glycopeptides (vancomycin)
• chemotherapy
• TCA’s
• Quinine based
• loop diuretics
• NSAIDs