Tinnitus

Question 1

Is tinnitus more associated with sensorineural or conductive hearing loss?

Answer 1

2/3 have sensorineural hearing loss, 1/3 have no identifiable cause.

Question 2

What are the different characteristics of tinnitus?

Answer 2

1. Unilateral/bilateral
2. Pulsatile/non-pulsatile
3. Ringing, hissing, buzzing, popping, clicking.

Question 3

Which sounds suggest an inner ear cause of tinnitus?

Answer 3

Ringing, hissing, or buzzing.

Question 4

Which sounds suggest an external or middle ear cause of tinnitus?

Answer 4

Popping or clicking

Question 5

What are the two types of tinnitus?

Answer 5

1. Objective - audible to examiner (rare)

2. Subjective - only audible to patient

Question 6

What are the causes of bilateral and unilateral subjective tinnitus?

Answer 6

1. Ototoxic drugs - bilateral

2. Acoustic neuroma - unilateral

Question 7

How is tinnitus investigated?

Answer 7

Audiometry, tympanogram, MRI if unilateral

Question 8

What is the management for tinnitus?

Answer 8

1. Treat underlying cause
2. Improves with time through habituation
3. Manage depression, anxiety, and insomnia
4. Sound therapy - background noise to mask
5. CBT