Tinnitus
SX â buzzing, ringing, roaring, whistling, or hissing. Worst at bedtime.
Unilateral or bilateral. Exacerbating or relieving factors (eg, swallowing, head position).
Associated symptoms include hearing loss, vertigo, ear pain, and ear discharge.
Hx: Exposure to loud noise, sudden pressure change (from diving or air travel), history of ear or CNS infections or trauma, radiation therapy to the head, and recent major weight loss.
Causes: cerumen impaction, otitis media, eustachian tube dysfunction.
PE â Ear, CN 8, Weber, Rinne, Carotid bruits.
Next Steps
DX â Refer to ENT. Neurology referral if nec. MRI/CT, Audiometry. ⢠Check med list (Eg. Aspirin, aminoglycosides Abx - streptomycin, loop diuretics - lasix).
Health Tips
TX â Treat underlying cause. ⢠Tinnitus masking device.