TINNITUS

© Bruce Black MD

TINNITUS Patterns

Innate Ambient “Tone burst” Tensor Tympani / Stapedius

Pathological Inner Ear, VIII origins

Extraneous Pulsatile, Palatal myoclonus

© Bruce Black MD

© Bruce Black MD

Tinnitus patterns: 1 Innate “crickets”, 2 Sporadic “tone burst” sounds, 3 Pulsatile patterns, 4 Tensor tympani /

Stapedius twitch, 5 Palatal myoclonic sound. © Bruce Black MD

Mild middle ear conditions such as OME may enhance innate tinnitus by excluding other sound.

© Bruce Black MD

Mild conductive loss (e.g. OME), often accompanied by increased perception of innate tinnitus.

© Bruce Black MD

Tensor Tympani / Stapedius spasm: Twitching of the small intra-auricular muscles produces a characteristic rustling or irregular staccato sensation. Cause uncertain. Prolonged

Valsalva positive pressure may help to dispel. © Bruce Black MD

Advancing presbyacusis. Increased tinnitus due to cellular damage and exclusion of exterior sounds.

© Bruce Black MD

Noise trauma. Increased high pitched tinnitus secondary to hair cell pathology.

© Bruce Black MD

Transverse fracture of the temporal bone. Severe tinnitus due to otic capsule transection or VIII nerve damage.

© Bruce Black MD

Low frequency SND due to endolymphatic hydrops. Episodic tinnitus with the hydrops attacks and at other

times. © Bruce Black MD

Tinnitus, unsteadiness, unilateral SND. Beware VIII nerve tumour.

© Bruce Black MD

VIII nerve tumour in a young adult with concurrent tinnitus and SND.

© Bruce Black MD

© Bruce Black MD

AOM: marked pulsatile tinnitus due to the inflammatory process and exclusion of other sound.

© Bruce Black MD

Pulsatile tinnitus due to a glomus tympanicum tumour.

© Bruce Black MD

Partial conductive deafness due to a glomus tumour, causing enhanced perception of pulsatile tinnitus.

© Bruce Black MD

Palatal myoclonus may produce audible click pattern tinnitus, audible to external observers.

© Bruce Black MD

TINNITUS Management Strategies

Cause: Treat origin, e.g. OME Distraction: Radio, music Medication: Sleep, irritation Tinnitus treatment:

masking, other techniques Support: Carers, websites

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

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© Bruce Black MD

TINNITUSTINNITUS�PatternsSlide Number 3Tinnitus patterns: 1 Innate “crickets”, 2 Sporadic “tone burst” sounds, 3 Pulsatile patterns, 4 Tensor tympani / Stapedius twitch, 5 Palatal myoclonic sound.Mild middle ear conditions such as OME may enhance innate tinnitus by excluding other sound.Mild conductive loss (e.g. OME), often accompanied by increased perception of innate tinnitus.Tensor Tympani / Stapedius spasm: Twitching of the small intra-auricular muscles produces a characteristic rustling or irregular staccato sensation. Cause uncertain. Prolonged Valsalva positive pressure may help to dispel.Advancing presbyacusis. Increased tinnitus due to cellular damage and exclusion of exterior sounds.Noise trauma. Increased high pitched tinnitus secondary to hair cell pathology.Transverse fracture of the temporal bone. Severe tinnitus due to otic capsule transection or VIII nerve damage.Low frequency SND due to endolymphatic hydrops. Episodic tinnitus with the hydrops attacks and at other times.Tinnitus, unsteadiness, unilateral SND. Beware VIII nerve tumour.VIII nerve tumour in a young adult with concurrent tinnitus and SND.Slide Number 14AOM: marked pulsatile tinnitus due to the inflammatory process and exclusion of other sound.Pulsatile tinnitus due to a glomus tympanicum tumour.Partial conductive deafness due to a glomus tumour, causing enhanced perception of pulsatile tinnitus.Palatal myoclonus may produce audible click pattern tinnitus, audible to external observers.TINNITUS�Management StrategiesSlide Number 20Slide Number 21Slide Number 22Slide Number 23Slide Number 24Slide Number 25Slide Number 26Slide Number 27Slide Number 28Slide Number 29Slide Number 30Slide Number 31Slide Number 32Slide Number 33Slide Number 34Slide Number 35Slide Number 36Slide Number 37Slide Number 38Slide Number 39Slide Number 40Slide Number 41Slide Number 42Slide Number 43Slide Number 44Slide Number 45Slide Number 46Slide Number 47Slide Number 48Slide Number 49Slide Number 50Slide Number 51Slide Number 52Slide Number 53Slide Number 54Slide Number 55Slide Number 56Slide Number 57Slide Number 58Slide Number 59Slide Number 60Slide Number 61