Definition: perception of sound in the head or the ears.
Usually ringing, buzzing, might be various noise.
Auditory nerve anbnormality
Sudden onset tinnitus with / without hearing loss. Early referral to prevent hearing loss.
Subjective tinnitus vs objective tinnitus
Subjective is common. Only the patient can hear
Objective : if we listen closely, sometimes we also can hear it.
Objective usually cause by:
⁃ Muscle problem e.g: Tensor tympani myoclonus, Palatine myoclonus
⁃ Joint problem (TMJ)
⁃ Vascular: carotid, jugular.
*Cause & Prevention*
⁃ Prevent prolong noise trauma. Rule of earphone/headphone use: 60% volume for only 60 minute (60/60 rule)
⁃ Cautious with Ototoxicity drug: Gentamycin,TB drug, Aminoglycoside
⁃ CMC ear drop, TM ruptured? Don’t prescribed CMC drop. Counsel the side effect. Stop if any after first.
Tinnitus have treatment depend on aetiology.
25% resolve, 50% decrease, 25% persist.
Objective of treatment is to treat the tinnitus and address the emotional part.
Refer ENT & audiologist
• surgery, depend on aetiology
• Medication: epileptic drug for myoclonus
• Sound theraphy, hearing aids etc
• Oto-psychiatric theraphy
• electrical stimulation
• Biofeedback process
• Acoustic neuromodulation
• Repetitive transcranial magnetic stimulation
• Alternative (efficacy is depent on individual)
• ginko biloba
• Mediterranean diet
• Zinc supplement
• Vit B
Abnormal behaviour child might have tinnitus too causing the abnormal behaviour mimicking ADHD or Autism. Thorough assessment is needed to prevent misdiagnosed and left the tinnitus untreated.