Tinnitus Ringing In The Ears

Overview

Tinnitus is a symptom that can be defined as any sound perceived by the patient when no external source of sound exists. From a clinical perspective, there are two types of tinnitus that demands careful investigation: Pulsatile tinnitus, which may indicate the presence of a vascular abnormality or tumor and unilateral tinnitus, in which a space occupying lesion within the cerebellopontine angle or petrous apex must be excluded.

Signs and Symptoms

ringing in the ear: hissing, buzzing, roaring, clicking, humming

Common Causes

Inner ear damage and hearing loss (leading to auditory cortex hyper-excitability), Ear wax, temporomandibular joint disease, Head injury, Otitis media, Post-stapedectomy, Meniere's disease, Carotid artery stenosis, AV fistula, Glomus jugulare tumor, Cerebellopontine angle tumour, depression

Risk Factors

Smoking, Reduced sleep (≤ 6 h), Stress, Hyperlipidemia, Osteoarthritis, Rheumatoid arthritis, Asthma, Depression, Thyroid disease, Loud noise exposure from earphones, Workplace hazards, Hypertension

Investigation Techniques

Audiometry, Full blood count including autoimmune panel, Lipid profile, Thyroid function test, Blood glucose,Functional MRI, Ct temporal bone

Treatment and Prevention

Nortriptyline, Selective serotonin reuptake inhibitors such as Paroxetine, Cognitive therapy, Drugs, Masking, Hearing aids, Cochlear nerve section, Alternative such as gingko biloba consumption, Surgical if conductive hearing loss, tumor, AV malformation