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Tinnitus is a condition where the patient hears ringing, buzzing, or other sounds without an external cause. Patients may experience tinnitus in one or both ears or in the head.
Tinnitus affects as many as 40 million adults in the United States. It is defined as either objective or subjective. In objective tinnitus, the doctor can hear the sounds as well as the patient. Objective tinnitus is typically caused by tumors, turbulent blood flow through malformed vessels, or by rhythmic muscular spasms. Most cases of tinnitus are subjective, which means that only the patient can hear the sounds.
Subjective tinnitus is frequently associated with hearing loss and damage to the cochlea, or the inner ear. About 90% of patients have sensorineural hearing loss; 5% suffer from conductive hearing loss; and 5% have normal hearing.
The causes of subjective tinnitus include:
Diagnosis of tinnitus includes a physical examination of the patient's head and neck. The doctor will use an instrument called an otoscope to examine the ears for wax, infection, or structural changes. He or she will also use a stethoscope to listen to the blood vessels in the neck.
The patient's doctor may also refer him or her to an audiologist, who is a health care professional trained to perform diagnostic testing of hearing problems.
In some cases, tinnitus is a symptom of temporomandibular joint disorder, or TMJ, which is caused by dysfunction of the temporomandibular joint in the jaw. The muscles and nerves in the jaw are located very close to the nerves that control hearing, which is why TMJ can cause tinnitus. Patients with tinnitus may be referred to a dentist or orthodontist for assessment of their jaw muscles or a misaligned bite.
Additional tests may include the following:
Author Info: Paula Ford-Martin, Rebecca J. Frey PhD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005
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