Tinnitus is defined as the perception of sound in absence of corresponding external sound.It can be unilateral or bilateral.it is not a disease by itself.but a symptom caused by various diseases.it is a disease which is subjective in nature hence it is very difficult to measure the intensity using audiometric tests.It is also objective in some rare conditions such as pulsatile paraganglioma.

Causes

Conductive hearing loss

• Impacted wax
• Middle ear effusion
• Acoustic shock
• Meniere syndrome.

 

Sensineural loss

• Loud noise
• Presbycusis
• Some medications such as aspirin,some diuretics such as bumetanide ethacrynic acid and some antimalarials such as quinine and chloroquine
• Antibiotics such as gentamicin,chloramphenicol
• Metabolic disorders such as thyroid disorders vitamin b 12 deficiency and hyperlipidaemia.

 

Pschiatric disorders

• Anxiety
• Depression.

 

Rare causes such as lyme disease,hypnogogia(before sleeping),sleep paaralysis.

Diagnostic procedures

• After a careful history including drug history hearing test ,
• Angiography(to study blood vessesls)
• X-ray
  
• MRI

 

Treatment

Cleaning the ear in case of ear wax.

Withdrawal of the drug causing it also stops tinnitus .

Reduction of alcohol intake is supposed to play a huge role in reducing tinnitus.

Niacin is recommended by many otolaryngologists to reduce tinnitus.but it has side effects of skin flushing

Middle ear effusion is treated with antibiotics and drainage