Etiology and diagnosis of tinnitus
- Elizabeth A Dinces, MD
Elizabeth A Dinces, MD
- Associate Professor of Clinical Otolaryngology
- Albert Einstein College of Medicine
Tinnitus is a perception of sound in proximity to the head in the absence of an external source. It can be perceived as being within one or both ears, within or around the head, or as an outside distant noise. The sound is often a buzzing, ringing, or hissing, although it can also sound like other noises.
Tinnitus can be continuous (a never ending sound) or occur intermittently. Although both may have a significant impact on the patient, the latter is not usually related to a serious underlying medical problem. The sound may be pulsatile or non-pulsatile. Pulsatile tinnitus raises more concern for underlying significant pathology, though non-pulsatile tinnitus may also be associated with underlying disease.
The epidemiology, pathogenesis, and diagnosis of tinnitus will be reviewed here. The treatment of tinnitus is discussed separately. (See "Treatment of tinnitus".)
According to the American Tinnitus Association, an estimated 50 million people in the United States have chronic tinnitus, persisting for greater than six months . For 12 million, it is severe enough to interfere with daily activities. These people are effectively disabled by their tinnitus to varying degrees.
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- CLINICAL IMPACT
- Vascular disorders
- - Arterial bruits
- - Arteriovenous shunts
- - Paraganglioma
- - Venous hums
- Neurologic disorders
- Eustachian tube dysfunction
- Other somatic disorders
- Tinnitus originating from the auditory system
- - Ototoxic medications
- - Presbycusis
- - Otosclerosis
- - Vestibular schwannoma
- - Chiari malformations
- - Other etiologies
- Physical examination
- Specialized testing
- - Suspected vascular tinnitus
- - Suspected auditory system tinnitus
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS