Tinnitus... an overview
Two Types of  Tinnitus Subjective Tinnitus Objective Tinnitus
Two Types of  Tinnitus Subjective Tinnitus The experience of sound not originating  from a source outside the body. Needs ...
What are Somatosounds? Sounds that  are  internally-generated in the body or head and perceived by the patient  Pulsatile:...
Two Types of  Tinnitus Subjective Tinnitus The experience of sound not originating  from a source outside the body Needs t...
Two Levels of  Tinnitus Acute Tinnitus Chronic Tinnitus
Two Levels of  Tinnitus Acute Tinnitus <ul><li>Lasts days or weeks </li></ul><ul><li>With appropriate evaluation, many und...
Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1-  No known etiology or event (~ 40%) 2- Noise r...
Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1-  No known etiology or event (~ 40%) 2- Noise r...
Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1-  No known etiology or event (~ 40%) 2- Noise r...
Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1-  No known etiology or event (~ 40%) 2- Noise r...
Factors That Exacerbate Tinnitus Caffeine Alcohol Sodium Fatigue Stress  (excercise) Noise exposure
Characteristics of Tinnitus according to the Oregon Tinnitus Data Registry (2000) <ul><li>Sudden or gradual onset </li></u...
Whom Does Tinnitus Impact? Patient <ul><li>Spouse / partner </li></ul><ul><li>Family members </li></ul><ul><li>Friends </l...
Symptoms Associated with Tinnitus Confusion Fear Isolated Stress Fatigue Inattentive Anxiety DEPRESSION
Individuals With Tinnitus  Have Lost Their Quality of Life Silence &
Needs of the Tinnitus Patient Attention Information Education Compassion
The Tinnitus Patient Should See? Audiologist Otolaryngologist Neurologist Psychologist Psychiatrist Nutrionist TMJ Special...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul>Pure tone A...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul>Pure tone A...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul>Pure tone A...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul>Pure tone A...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul>Pure tone A...
Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological  Evaluation </li></ul><ul><li>Tin...
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AUD733 Tinnitus Overview

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AUD733 Tinnitus Overview

  1. 1. Tinnitus... an overview
  2. 2. Two Types of Tinnitus Subjective Tinnitus Objective Tinnitus
  3. 3. Two Types of Tinnitus Subjective Tinnitus The experience of sound not originating from a source outside the body. Needs to be differentiated from internally-generated somatosounds and from objective tinnitus
  4. 4. What are Somatosounds? Sounds that are internally-generated in the body or head and perceived by the patient Pulsatile: caused by perception of bloodflow can be rhythmic with heartbeat Ex: venous hum or vascular noise Pulsatile and non-pulsatile Non-pulsatile: Ex: patulous eustachian tube, tensor tympani muscle spasms, TMJ Somatosounds can be objective or subjective Somatosounds require medical evaluation
  5. 5. Two Types of Tinnitus Subjective Tinnitus The experience of sound not originating from a source outside the body Needs to be differentiated from internally-generated somatosounds and from objective tinnitus Objective Tinnitus Also known as - “audible” tinnitus The person’s tinnitus can be heard by others (infant) Relatively rare
  6. 6. Two Levels of Tinnitus Acute Tinnitus Chronic Tinnitus
  7. 7. Two Levels of Tinnitus Acute Tinnitus <ul><li>Lasts days or weeks </li></ul><ul><li>With appropriate evaluation, many underlying conditions can usually be identified and treated -sometimes resulting in resolution of tinnitus </li></ul>Chronic Tinnitus <ul><li>Persistent for 6 months or more </li></ul><ul><li>Today there is no true CURE for tinnitus - there are effective tinnitus management programs available that helps patients get relief from tinnitus </li></ul>
  8. 8. Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1- No known etiology or event (~ 40%) 2- Noise related <ul><li>Noise of long duration </li></ul><ul><li>Explosion </li></ul><ul><li>Noise of brief intensity </li></ul>
  9. 9. Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1- No known etiology or event (~ 40%) 2- Noise related 3- Head and neck trauma <ul><li>Head injury </li></ul><ul><li>Cervical trauma or whiplash </li></ul><ul><li>Skull fracture </li></ul><ul><li>Concussion </li></ul>
  10. 10. Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1- No known etiology or event (~ 40%) 2- Noise related 3- Head and neck trauma 4- Head and neck illness <ul><li>Sinus infection </li></ul><ul><li>Ear infection or inflammation </li></ul><ul><li>Other ear problems </li></ul><ul><li>Sudden hearing loss </li></ul>
  11. 11. Causes of Tinnitus according to the Oregon Tinnitus Data Registry (2000) 1- No known etiology or event (~ 40%) 2- Noise related 3- Head and neck trauma 4- Head and neck illness 5- Other medical conditions <ul><li>Medications, drugs </li></ul><ul><li>Surgery </li></ul><ul><li>Barotrauma </li></ul>
  12. 12. Factors That Exacerbate Tinnitus Caffeine Alcohol Sodium Fatigue Stress (excercise) Noise exposure
  13. 13. Characteristics of Tinnitus according to the Oregon Tinnitus Data Registry (2000) <ul><li>Sudden or gradual onset </li></ul><ul><li>Variety of sounds reported </li></ul><ul><li>Constant or intermittent </li></ul><ul><li>Vary in pitch, loudness and quality </li></ul><ul><li>Perceived in one ear, both ears or in </li></ul><ul><li>the head </li></ul>
  14. 14. Whom Does Tinnitus Impact? Patient <ul><li>Spouse / partner </li></ul><ul><li>Family members </li></ul><ul><li>Friends </li></ul><ul><li>Colleagues / co-workers </li></ul>
  15. 15. Symptoms Associated with Tinnitus Confusion Fear Isolated Stress Fatigue Inattentive Anxiety DEPRESSION
  16. 16. Individuals With Tinnitus Have Lost Their Quality of Life Silence &
  17. 17. Needs of the Tinnitus Patient Attention Information Education Compassion
  18. 18. The Tinnitus Patient Should See? Audiologist Otolaryngologist Neurologist Psychologist Psychiatrist Nutrionist TMJ Specialist Biofeedback Specialist Primary Team
  19. 19. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul>Pure tone AC/BC High frequency: 9KHz – 20KHz (ideally) SRT / SDS Most Comfortable Loudness Level (MCL)
  20. 20. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul>Pure tone AC/BC High frequency: 9KHz – 20KHz (ideally) SRT / SDS Most Comfortable Loudness Level (MCL) Loudness discomfort levels (LDL)* <ul><li>5dB increments – no hyperacusis reported </li></ul><ul><li>2dB increments – hyperacusis reported </li></ul><ul><li>repeat twice </li></ul>
  21. 21. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul>Pure tone AC/BC High frequency: 9KHz – 20KHz (ideally) SRT / SDS Most Comfortable Loudness Level (MCL) Loudness discomfort levels (LDL)* Immitance testing Tympanometry Acoustic reflex thresholds** Acoustic reflex decay**
  22. 22. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul>Pure tone AC/BC High frequency: 9KHz – 20KHz (ideally) SRT / SDS Most Comfortable Loudness Level (MCL) Loudness discomfort levels (LDL)* Immitance testing Otoacoustic emissions – distortion product (DPOAE) Invaluable tool in counseling session
  23. 23. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul>Pure tone AC/BC High frequency: 9KHz – 20KHz (ideally) SRT / SDS Most Comfortable Loudness Level (MCL) Loudness discomfort levels (LDL)* Immitance testing Otoacoustic emissions – distortion product (DPOAE) ABR – if necessary
  24. 24. Audiologist’s Role <ul><li>Complete History </li></ul><ul><li>Comprehensive Audiological Evaluation </li></ul><ul><li>Tinnitus Assessment </li></ul>Pitch match Loudness match Minimum masking level (MML)
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