Tinnitus is perceived sound in absence of acoustic stimulus external to the head. It may be unilateral, bilateral, or lateral dominant. It is commonly described as ringing, buzzing, roaring, hissing, whistling, humming, cricket-like, and pulsing. The sound may be internal and perceived only by the patient, called subjective or tonal tinnitus, or it may be heard by both patient and examiner, called objective or nontonal tinnitus. DIFFERENTIAL DIAGNOSIS • Subjective/tonal tinnitus: > Otologic: tympanic membrane disorder, inner ear disorder (hair cells, organ of Corti), Meniere’s disease > Ototoxic medications (inflammatory?) >Neurologic: multiple sclerosis, head trauma, cochlear nerve lesion, acoustic schwannoma, neurofibroma, meningioma > Metabolic: thyroid disorder, hyperlipidemia (leading to plaque formation), vitamin B12 deficiency >Psychogenic: depression, anxiety, fibromyalgia > Infectious: otitis media, Lyme disease, meningitis, syphilis • Objective/nontonal tinnitus: > Vascular: arterial bruit, venous hum, arteriovenous malformation, vascular tumors > Neurologic: contraction of muscles of eustachian tube, contraction of stapedius muscle, contraction of tensor tympani muscles, palatal myoclonus, glomus jugulare tumor > Conductive: patulous (wide-open) eustachian tube info @DrSudeepKC
Posted on: Fri, 22 Nov 2013 08:56:42 +0000
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