Fast Five Quiz: Tinnitus

Arlen D. Meyers, MD, MBA

Disclosures

April 07, 2021

Tinnitus is either objective (ie, audible to anyone in addition to the affected individual) or subjective (ie, audible only to the affected individual). Even though this classification system is used quite frequently, focusing on the etiology of tinnitus is often more useful.

Objective tinnitus is relatively rare. It is sound created somewhere in the body, usually in the ear, head, or neck, and is typically caused by carotid artery or jugular venous system abnormalities. Muscular tinnitus is observed in several degenerative diseases of the head and neck, including amyotrophic lateral sclerosis. In this entity, the neuromuscular control over the muscles in the ear occasionally deteriorates in an individual with perfect sensory perception. Occasionally, the loss of control results in a repetitive flutter or myoclonus of either the stapedius or tensor tympani muscles. The result is an observable and audible flutter coming from the ear.

Hearing loss is the most common causes of subjective tinnitus. Subjective tinnitus may also be caused by metabolic, neurologic, or psychogenic disorders. Unilateral hearing loss in patients with subjective tinnitus should prompt investigation for an acoustic neuroma. Fluctuating subjective tinnitus, tinnitus accompanied by dizziness, or dizziness and hearing loss may suggest Ménière disease. A low-pitched rumbling pattern also suggests Ménière disease, whereas a high-pitched pattern suggests sensorineural hearing loss.

Read more about objective and subjective tinnitus.

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