Tinnitus - Subjective (heard only by patient) - 90% - Differential Diagnosis Algorithm Unilateral On Audiogram - Perform MRI to rule out RC Lesion • Acoustic Neuroma • Lesion of Cochlear or Auditory Nerve • Brainstem Lesion • Multiple Sclerosis • Infarction • Méniére's Disease Bilateral - No Hearing Loss: • Metabolic Causes: Thyroid Dysfunction, Vitamin A, B, Zinc Deficiency. • Psychogenic, Anxiety, Depression • Drugs (Salicyclates, Quinidine, Indomethacin) • Idiopathic Bilateral - Conductive Hearing Loss: • Lesion of External or Middle Ear • Impacted Cerumen • Otitis Media • Otosclerosis Bilateral - Sensorineural Hearing Loss: • Noise Induced • Ototoxicity • Presbycusis • Drugs (Propranolol, Levodopa, Loop Diuretics) • Congenital Somatic: • TMJ • Bruxism • Whiplash • Skull Fracture • Closed Head Injury #Tinnitus #Ringing #hearing #subjective #Differential #Diagnosis #Algorithm #Causes
