2/3 of tinnitus patients have a somatic trigger

Red Flags:

  • Acoustic Neuroma
  • Lesion of Cochlear or Auditory Nerve
  • Brainstem Lesion
  • MS
  • Infarction
  • Skull Fracture

TINNITUS: Subjective Unilateral On Audiogram Perform MRI to rule out RC Lesion TMJ Bruxism Whiplash Skull Fracture Closed Head Injury No Hearing Loss Bilateral On Audiogram Lesion of External or Middle Ear Impacted Cerumen Otitis Media Otosclerosis Acoustic Neuroma Lesion of Cochlear or Auditory NerveBrainstem Lesion Multiple Sclerosis Infarction Ménière's Disease Somatic Hearing Loss Metabolic Causes: Thyroid Dysfunction, Vitamin A, B, Zinc Deficiency.Psychogenic, Anxiety, Depression Drugs (Salicyclates, Quinidine, Indomethacin) IdiopathicConductive Hearing Loss Sensorineural Hearing LossNoise Induced Ototoxicity Presbycusis Drugs (Propranolol, Levodopa, Loop Diuretics) Congenital Tinnitus Subjective Heard only by patient (Common) Objective Heard by others (Rare)

Related resources

Calgary Guide