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Tinnitus

Donna I. Meltzer, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Tinnitus is a perceived sensation of sound in the absence of an external acoustic stimulus; often described as a ringing, hissing, buzzing, or whooshing

  • Derived from the Latin word ti...

DIAGNOSIS

HISTORY

  • Onset gradual (presbycusis) or abrupt (following loud noise exposure)

  • Timing: can be continuous (hearing loss) or intermittent (Ménière disease)

  • Pattern: nonpulsatile > pulsatile (of...

TREATMENT

GENERAL MEASURES

  • Individualize treatment based on the severity of tinnitus and impact on function.

  • Reassure patient.

  • Manage treatable pathology.

  • Education, relaxation therapy, cognitive-behavior...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Audiologist: for hearing evaluation and therapy

  • Counseling as needed for psychological distress

  • Family physician: as needed for support and guidance

PATIENT EDUCATION

REFERENCES

1
Yew KS. Diagnostic approach to patients with tinnitus. Am Fam Physician.  2014;89(2):106–113. [View Abstract on OvidMedline]
2
Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guid...

ADDITIONAL READING

CODES

ICD10

  • H93.19 Tinnitus, unspecified ear

  • H93.11 Tinnitus, right ear

  • H93.12 Tinnitus, left ear

  • H93.13 Tinnitus, bilateral

ICD9

  • 388.30 Tinnitus, unspecified

  • 388.31 Subjective tinnitus

  • 388.32 Objective tinni...

CLINICAL PEARLS

  • People have different levels of tolerance to tinnitus. It may affect sleep, concentration, and emotional state. Many patients with chronic tinnitus have depression.

  • To keep tinnitus fro...

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