Still poorly understood



Yüklə 445 b.
tarix25.03.2017
ölçüsü445 b.
#12556



Still poorly understood



Any area’s that want to discuss?

  • Any area’s that want to discuss?

  • Current pathways:

  • Manage in primary care – the majority

  • Referral to ENT – who to refer and when?



Description of the sound

  • Description of the sound

      • Pulse, ringing, whoosh
      • Unilateral, Bilateral
      • Intrusive (sleep interrupted?)
      • Persistent or intermittent
  • Associated symptoms

      • Hearing loss
      • Vertigo


TM’s

  • TM’s

  • EAM’s

  • Cranial, Carotid, Cardiac bruit – especially if pulsatile

  • Consider FBC, TFT



Treat any underlying cause if found

  • Treat any underlying cause if found

  • Bilateral +/- symmetrical hearing loss, No other symptoms, not intrusive –advice

  • Unilateral < 3/12. No worrying feature. Manage primary care

  • Objective tinnitus - refer

  • Unilateral tinnitus > 3/12 refer - ?CPA lesion

  • Intrusive tinnitus – refer

  • Bilateral + asymmetrical hearing loss > 3/12 – refer

  • Tinnitus therapy

  • Masking with white noise therapy

  • Pillow radio

  • Bilateral, none intrusive tinnitus – Ok to manage in primary care



Advice

  • Advice

  • Sound therapy

  • Tinnitus councelling



Yüklə 445 b.

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