HISTORY:
Tinnitus for
Type: ,
Severity: , / 10
Pattern:
Worsening factors:
Alleviating factors: ,
Other elements:
EXAM:
General appearance:
Ears: -R: , -L:
Neurologic: cranial nerves , strength , sensation , reflexes , cerebellar function , gait
Mental status: , , speech , mood , thought process , , judgment
ASSESSMENT:
DDx:
PLAN:
- Audiogram
- MRI of the brain and internal auditory canals if unilateral with hearing loss
- CT scan of the temporal bones
- Reassured that most cases are benign
- Sound therapy
- Cognitive behavioral therapy
- Avoidance of loud noises
- Limit caffeine and alcohol
- Hearing aids
-
- Referral to otolaryngologist if sudden onset, pulsatile, unilateral, hearing loss, or if persistent
- Referral to audiologist
- Referral to psychologist
- Referral to tinnitus support group
- Follow-up in
- Return if tinnitus worsens, if new symptoms develop such as hearing loss, dizziness, or if symptoms do not improve with treatment