Tinnitus - Bradfordvts
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Transcript Tinnitus - Bradfordvts
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