Still poorly understood

Still poorly understood

• Still poorly understood

• Almost every ear disease and cause of deafness can be associated with tinnitus

• Useful web resource if RNID website

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 and reassurance
• RNID website useful

Advice

• Advice

• Sound therapy

• Tinnitus councelling