Tinnitus - Bradfordvts

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First found May 22, 2018

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Tinnitus
The sensation of sounds in the ears or head in the
absence of an external sound source
Pathophysiology
 Still poorly understood
 Almost every ear disease and cause of deafness can be
associated with tinnitus
 Useful web resource if RNID website
 Any area’s that want to discuss?
 Current pathways:
 Manage in primary care – the majority
 Referral to ENT – who to refer and when?
History
 Description of the sound
 Pulse, ringing, whoosh
 Unilateral, Bilateral
 Intrusive (sleep interrupted?)
 Persistent or intermittent
 Associated symptoms
 Hearing loss
 Vertigo
Examination and Investigation
 TM’s
 EAM’s
 Cranial, Carotid, Cardiac bruit – especially if pulsatile
 Consider FBC, TFT
Management
 Treat any underlying cause if found
 Bilateral +/- symmetrical hearing loss, No other symptoms,
not intrusive –advice
 Unilateral < 3/12. No worrying feature. Manage primary
care
 Objective tinnitus - refer
 Unilateral tinnitus > 3/12 refer - ?CPA lesion
 Intrusive tinnitus – refer
 Bilateral + asymmetrical hearing loss > 3/12 – refer
Management
 Advice
 Sound therapy
 Tinnitus councelling
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