Tinnitus Assessment & Management Flashcards

What is hyperacusis and how does it differ from tinnitus?

Answer: Hyperacusis is an abnormal hypersensitivity to ordinary environmental sounds (associated with reduced loudness discomfort levels); tinnitus is a phantom sound perception without an external source

Hyperacusis involves abnormally low tolerance to ordinary sounds (sounds that are comfortable for most people cause discomfort or pain), while tinnitus is a phantom sound perceived without an external acoustic stimulus—both frequently co-occur.

What is the role of sleep hygiene education in tinnitus management?

Answer: Poor sleep worsens tinnitus distress, and sleep hygiene strategies (regular sleep schedule, avoiding caffeine and screens before bed, using background sound) reduce the sleep disruption that amplifies tinnitus annoyance

Sleep disturbance is one of the most common and debilitating effects of tinnitus; addressing sleep hygiene reduces the bidirectional negative relationship between tinnitus and insomnia, as poor sleep lowers tinnitus tolerance and increased tinnitus awareness disrupts sleep.

A patient presents with tinnitus that began one day after attending a loud concert. Their audiogram is normal. What is the most likely diagnosis and management?

Answer: Temporary threshold shift (TTS) with associated tinnitus; typically resolves within hours to days, managed by counseling, rest, and noise avoidance—medical referral if persistent beyond 2 weeks

After intense noise exposure, temporary threshold shift and tinnitus are common and usually resolve within 16-48 hours. Counseling about noise avoidance, reassurance, and follow-up monitoring are appropriate; persistence beyond 2 weeks requires ENT referral.

What is somatosensory tinnitus and which patient history finding might suggest this type?

Answer: Tinnitus modulated by head, neck, or jaw movements, suggesting trigeminal or cervical somatosensory input is influencing the dorsal cochlear nucleus; often associated with neck injury or TMJ disorder

Somatosensory tinnitus is tinnitus that changes in pitch or loudness with head, neck, jaw, or eye movements, suggesting aberrant somatosensory input from the trigeminal or cervical systems is modulating dorsal cochlear nucleus activity.

What is the relationship between tinnitus and ototoxic medications, and which drug class is most commonly implicated?

Answer: Ototoxic medications including platinum-based chemotherapy agents (cisplatin), aminoglycoside antibiotics, loop diuretics, and high-dose salicylates (aspirin) can cause or worsen tinnitus by damaging cochlear hair cells or altering neural firing patterns

Several drug classes cause ototoxicity including tinnitus: cisplatin (chemotherapy), aminoglycosides (antibiotics), loop diuretics (furosemide), and high-dose salicylates (aspirin at 6-8 g/day or more)—effects range from reversible to permanent depending on the drug, dose, and duration.

A patient with severe tinnitus and comorbid anxiety disorders is referred for management. Which interprofessional team member should be included in their care?

Answer: Psychologist or psychiatrist specializing in CBT and anxiety disorders, coordinated with the audiological tinnitus management plan

For patients with severe tinnitus and comorbid anxiety or depression, psychological expertise (psychologist or psychiatrist) is essential for CBT delivery and mental health treatment, coordinated with audiological sound therapy and counseling.