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Tinnitus: Characteristics and Management
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Unilateral tinnitus (one ear only)
Etiologies: Acoustic neuroma, Meniere's disease, ear injury. Management: Treat specific underlying cause, surgery if tumor is present, steroids if inflammation is a factor.
Age-related worsening
Etiologies: Age-associated hearing loss, degeneration of ear structures. Management: Hearing aids, coping strategies, avoiding ototoxic medications.
Synchronized with heartbeat (pulsatile tinnitus)
Etiologies: High blood pressure, vascular disorders, tumor. Management: Treat underlying vascular condition, surgery if needed, managing blood pressure.
A ringing, buzzing, or hissing sound in the ears
Etiologies: Hearing loss, ear infection, noise exposure. Management: Hearing aids, white noise machines, behavioral therapy.
Can be associated with a sense of fullness in the ear
Etiologies: Earwax buildup, Eustachian tube dysfunction, Meniere's disease. Management: Earwax removal, Eustachian tube exercises, diuretics.
Objective tinnitus audible to an examiner
Etiologies: Muscle contractions, vascular abnormalities, patulous Eustachian tube. Management: Surgical or medical treatment for the cause, sound therapy.
Subjective phenomenon not audible to others
Etiologies: Most common type of tinnitus, often idiopathic. Management: Counseling, sound therapy, stress reduction.
Fluctuation in intensity of tinnitus
Etiologies: Changes in hearing, stress levels, medication use. Management: Hearing aids, stress management, review of medications.
Impact on sleep and concentration
Etiologies: Stress, insomnia, auditory system malfunction. Management: Sleep hygiene, sound masking at night, cognitive behavioral therapy.
Aggravated by certain medications (ototoxic drugs)
Etiologies: NSAIDs, antibiotics, chemotherapy agents. Management: Discontinuing or replacing medication, monitoring drug levels, using alternative treatments.
Associated with temporomandibular joint (TMJ) disorders
Etiologies: TMJ dysfunction, dental issues, clenching or grinding teeth. Management: Dental consultation, mouth guards or splints, TMJ exercises.
Worsened by exposure to loud noises
Etiologies: Noise-induced hearing loss, acoustic trauma. Management: Protecting ears from further noise exposure, using earplugs, avoiding loud environments.
Ringing that increases with stress or fatigue
Etiologies: Elevated stress hormones, lack of sleep, poor diet. Management: Stress reduction techniques, improved sleep hygiene, relaxation exercises.
Tinnitus associated with dizziness or vertigo
Etiologies: Meniere's disease, vestibular schwannoma, labyrinthitis. Management: Vestibular rehabilitation, medications like antihistamines or diuretics, occasionally surgery.
Hearing tinnitus when in quiet environments
Etiologies: Normal auditory processing, heightened awareness in silence. Management: Background noise, sound generators, cognitive-behavioral therapy.
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