Tinnitus Flashcards
What is tinnitus?
A perception of sound typically in absence of auditory stimulation
Is tinnitus normal?
No - is often a symptom of an underlying abnormality
2/3 of those with tinnitus have what type of hearing loss?
Sensorineural hearing loss (SNHL)
1/3 have no identifiable cause
Ringing, hissing or buzzing suggests…
An inner ear or central cause
Popping or clicking suggests a problem with..
External or middle ear
Or the palate
How can it be classified?
Objective
Subjective
What does objective tinnitus mean?
Audible to examiner
What does subjective tinnitus mean?
Audible only to the patient
What can cause objective tinnitus?
Rare
Vascular disorders: pulsatile vibratory sounds from AV malformations, carotid pathology, glomus tumours
High output cardiac states: hyperthyroidism, anaemia, Paget’s
Myoclonus of palatal or stapedius/ tensor tympani muscles resulting in audible click
Patulous Eustachian tube: prolonged opening causing abnormal sound transmission to ear
What is subjective tinnitus most commonly associated with?
Disorders causing SNHL - presbyacusis, noise induced hearing loss, Ménière’s disease
Conductive deafness is less commonly associated e.g impacted wax, otosclerosis, otitis media with effusion
What type of tinnitus can ototoxic drugs cause?
Bilateral, subjective tinnitus with associated hearing loss
What examples of drugs can cause permanent hearing loss?
Cisplatin
Aminoglycosides
What drugs are associated with tinnitus and reversible hearing loss?
Aspirin NSAIDS Quinine Macrolides Loop diuretics
What other conditions (not specifically ear pathology) can cause tinnitus?
Hyper/hypothyroidism DM MS Acoustic schwannoma (unilateral) Trauma to head or neck Anxiety or depression
