Tinnitus
Age: years old
Gender:
HISTORY:
Presents with a - history of tinnitus
Described as
Rated at / 10
Pattern
Worsening factors:
Alleviating factors: ,
Associated symptoms: *Try using right-click for negatives*
, , , ,
Contributing factors:
no history of: , , , , , , , , ,
no use of: , ,
EXAM:
General appearance: ,
Ears: tympanic membranes , auditory canal on , hearing
Neurologic: cranial nerves , strength , sensation , reflexes , cerebellar function , gait
Mental status: , , speech , mood , thought , , judgment
ASSESSMENT:
DDx: sensorineural hearing loss, Meniere's disease, acoustic neuroma, earwax impaction, ototoxic medications, eustachian tube dysfunction, temporomandibular joint disorder, head or neck injuries, hypertension, neck artery stenosis, aortic valve stenosis, anemia, hyperthyroidism, anxiety, depression, sleep disorders, benign intracranial hypertension, foreign body in the ear, vestibular schwannoma, neurological disorders
PLAN:
Investigations:
- Audiogram
- MRI of the brain and internal auditory canals if unilateral with hearing loss
- CT scan of the temporal bones
Treatments:
- Reassured that most cases are benign
- Sound therapy
- Cognitive behavioral therapy
- Avoidance of loud noises
- Limit caffeine and alcohol
- Hearing aids
-
Further care:
- Referral to otolaryngologist if sudden onset, pulsatile, unilateral, hearing loss, or if persistent
- Referral to audiologist
- Referral to psychologist
- Referral to tinnitus support group
- Follow-up in
- Return if tinnitus worsens, if new symptoms develop such as hearing loss, dizziness, or if symptoms do not improve with treatment
HISTORY: Associated symptoms: EXAM: ASSESSMENT: PLAN: