greek.doctor

14. Tinnitus

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  • An auditory sensation that occurs in the absence of external acoustic or electrical stimulus
  • Nonspecific symptom of an auditory system abnormality
  • Types
    • Subjective tinnitus
      • Conductive tinnitus
        • Obstruction of the ear canal
        • Middle ear disease
      • Sensorineural tinnitus
        • Damage to cochlea
        • Damage to cochlear nerve
      • Central tinnitus
        • Damage to central auditory pathway
    • Objective tinnitus
      • Vascular tinnitus
        • Vascular malformations
        • AV fistulas
      • Myogenic tinnitus
        • Velopharyngeal myoclonus
        • Middle ear myoclonus
  • Compensated – if it doesn’t compromise life quality
  • Decompensated – if it causes disability or suffering
  • Worsening factors
    • Stress
    • Caffeine
    • Alcohol
    • Nicotine
    • Sleeping problems
  • Classification according to time
    • Acute – < 3 months
    • Subacute – 4 – 12 months
    • Chronic > 12 months
  • Diagnosis
    • Patient history
    • Audiometry
    • Neurological examination
    • MRi – if unilateral, asymmetric or pulsatile
  • Treatment
    • IV lidocaine (temporary)
    • Tinnitus retraining therapy
      • Break link between tinnitus and negative emotions
    • Masking with white noise