Tinnitus Flowchart: Types of Tinnitus and the Corresponding Causes of It

I found this chart interesting. It shows the types of tinnitus, medical exams done to diagnose and possible causes to be treated:



Check out the interactive flowchart:
http://www.tinnitusresearch.org/index.php/for-clinicians/diagnostic-flowchart

 

Nice chart and a lot of information on the link. Do you see one common thread with all this information? No matter what the cause or symptoms they all lead to the same battery of treatments. So does it really matter what the cause is? Maybe for research, but for treatment I'm not sure.

 

wow.. this is very helpful. I am pretty sure the doctors I have been too don't even know this much! I will use this as a guide to ask questions and pester my doctor until she sends me to have the appropriate tests done.

 

All roads less to 1 destination. My point exactly.....but still does beat 'go live with it'

 

Thanks for the post, Fish. I can pretty much follow my own T path on it.
Re. Richard's comment: I do think the chart is helpful for those who are new to tinnitus, as it can help them be their own advocate and get all the testing that would be helpful.

But at the end of the day: Yes, in most cases, the battery of treatments will be the same (although, as the chart shows, those that develop or who already had psychiatric complications like anxiety and depression need to treat those disorders as well if they were previously asymptomatic). This is why I think at some point, and I speak from personal experience, one needs to stop running to specialists and chasing the "what caused it, can you fix it?" question and move on to "how can I manage it?" Only then can you move from objection to acceptance. And acceptance, as CBT therapists will tell you, is critical to habituation and regaining your life.

 

Though I'm broadly in agreement that most approaches for chronic sufferers are going to end up with symptomatic treatment, what I missed in my experience is encountering any conventional medical professional who knew how to proceed. I had to advise my ENT that an MRI might be a good idea, had to insist that my dentist check my bite. All my GP could say was that he has it too from years playing in a band and he just lives with it. It's like I said, "Hey, doctor, my finger fell off and I ate it. Anything you can do?"

I'm now considering seeking a consultation with a neuro-otologist. My symptoms are hard to correlate with the chart, but it certainly does suggest some additional questions I would like to ask.

 

I saw two and they were equally useless. But you should go anyway and rule out any fixable possibilities.

I do like this chart. New therapies need to developed that address the different tinnitus etiologies. The Tinnitus Research Initiative (TRI) has long held this position.

Right now, your best option might be AM-101, which, if efficacious, should help with most tinnitus types--regardless of their origin. Some middle ear issues may be fixed with surgery. But with any ear surgery you risk worsening your tinnitus. It happens regardless of your surgeon's skill. The ear is delicate.

Good luck and keep us posted!

 

If you don't know where to begin to narrow down your T, you may find that this flow chart helps.

 

What does everyone think of this?

 

In what sense?
Have you looked at this diagnostic flowchart?

 

oh, wow, much more detailed. I just found the one I linked in some medical article

Actually, I stand corrected. This is an amazing article. Thank you so much

 

You might also consider getting a Fasting Glucose Tolerance Test together with an Insulin Assay. The glucose tolerance by itself is not indicative and the doctor ordering may not connect the dots on insulin. If the insulin level is not back at 30 or below by 2 hours then hyperinsulinemia may be indicated and Tinnitus has been mentioned in my research as a potential indicator, i.e. there may be a link. Deal with the insulin issue (with diet/lifestyle/exercise) and it just might fix the Tinnitus as well. I am looking further into this issue.

Further to the above on Fasting Glucose Tolerance test with Insulin Assay, the test is the 100-G-H one which is not the one recommended by the ADA now (its the older one).

 

The chart is interesting. But I'm not sure if I'm reading it right... I've been to the ENT a handful of times now and he says that my ears look good, my hearing test was positive. The Allergist says I'm good, I don't have crazy allergies, just regular house hold stuff. I just got ear tubes put in my ear drums, hoping that was going to help with the pressure and lessen the ringing.. no luck! So now I'm wondering if I should get an MRI to rule out tumors? anyone have this experience?

 

A great interactive chart (follow the link, don't just watch the OP's image of it). I don't understand however why it assumes that any non-pulsatile, constant tinnitus has necessarily to be accompanied by some other symptom (be it vertigo, headache, hearing loss, etc.). Sometimes a constant T is the only symptom.

 

By the way, the URL in the first post seems not to work anymore. This URL does work though.

Plus, in case the authors read this:
- One of the links in the chart points to a blank page (Prevention -> page 70).
- I think bruxism is missing from the chart --several sources mention it as another possible cause for T.

 

It is to be hoped that all doctors who treat tinnitus patients know this flowchart

 

No mention of hidden hearing loss?

 

I agree, but I have yet to meet a doctor that will go through the flowchart with you and help narrow things down for you, but I'm still trying.

 

but what about MRI being too loud? I am reading many got worse hearing loss/T due to MRI.

I mean all the ENTs I visited said: “if you are in a noisy place, just put a piece of tissue in each ear”.
Yet they say nothing about the noises of MRI.

 

I wish they could make a chart that completely excludes pulsatile tinnitus and pyschosis/hallucinations.

I'm not sure what they mean by psychiatric induced tinnitus.

 

Why would they do that? Those also need to be diagnosed.