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

Discussion in 'Treatments' started by Fish, Jul 22, 2012.

    1. Fish
      Balanced

      Fish Member Benefactor

      Location:
      Poland
      Tinnitus Since:
      July 2012
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    2. Karen
      Talkative

      Karen Manager Staff Benefactor Ambassador Hall of Fame

      Location:
      U.S.
      Tinnitus Since:
      05/2010
      Cause of Tinnitus:
      First time: Noise 2nd Time: Ototoxic drug
      Great find, Fish! Thank you for this information. This will help a lot of people in seeking the appropriate treatment and tests. Let's hope the doctors we contact are understanding and patient in diagnosing the cause and providing the appropriate treatment. (I notice that my own situation doesn't fit neatly into one category!) Best wishes; hope you are doing OK.
       
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    3. Markku
      Inspired

      Markku Director Staff Benefactor Hall of Fame Advocate

      Tinnitus Since:
      04/2010
      Cause of Tinnitus:
      Syringing
    4. Richard Cristdahl

      Richard Cristdahl Member

      Tinnitus Since:
      10/1990
      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.
       
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    5. heartbroken

      heartbroken Member

      Tinnitus Since:
      march 2013
      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.
       
    6. Dhaval
      Buzzed

      Dhaval Member

      Tinnitus Since:
      4 months
      All roads less to 1 destination. My point exactly.....but still does beat 'go live with it'
       
    7. LadyDi
      Busy

      LadyDi Member Benefactor

      Location:
      Florida, USA
      Tinnitus Since:
      06/2013
      Cause of Tinnitus:
      Barotrauma/airplane
      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.
       
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    8. Karen
      Talkative

      Karen Manager Staff Benefactor Ambassador Hall of Fame

      Location:
      U.S.
      Tinnitus Since:
      05/2010
      Cause of Tinnitus:
      First time: Noise 2nd Time: Ototoxic drug
      Well said, Lady Di! I agree with getting past the "what caused it, can you fix it?" mindset, and getting on with finding ways to manage our condition. Unless there is some physical problem that a doctor can find and fix, the next step, although difficult, is acceptance. Once you've done that, the habituation process can begin.
       
    9. rtwombly
      Bookworm

      rtwombly Member

      Location:
      Southeast USA
      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Unknown
      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.
       
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    10. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      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!:)
       
    11. GregCA
      Jaded

      GregCA Member

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      If you don't know where to begin to narrow down your T, you may find that this flow chart helps.
       
      • Like Like x 1
    12. eom

      eom Member

      Tinnitus Since:
      12/27/2016
      Cause of Tinnitus:
      ear infection/wax??
      What does everyone think of this? afp20040101p120-f1.gif
       
      • Helpful Helpful x 1
    13. GregCA
      Jaded

      GregCA Member

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      In what sense?
      Have you looked at this diagnostic flowchart?
       
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      • Informative Informative x 1
    14. eom

      eom Member

      Tinnitus Since:
      12/27/2016
      Cause of Tinnitus:
      ear infection/wax??
      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
       
    15. Peter the Pilot

      Peter the Pilot Member

      Tinnitus Since:
      1996
      Cause of Tinnitus:
      unknown
      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).
       
    16. JannyBanany1
      Gloomy

      JannyBanany1 Member

      Tinnitus Since:
      July 2017
      Cause of Tinnitus:
      double ear infection
      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?
       
    17. Danig

      Danig Member

      Location:
      Spain
      Tinnitus Since:
      10/2017
      Cause of Tinnitus:
      Unknown
      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.
       
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    18. Danig

      Danig Member

      Location:
      Spain
      Tinnitus Since:
      10/2017
      Cause of Tinnitus:
      Unknown
      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.
       
    19. Tinniger

      Tinniger Member Benefactor

      Location:
      Germany
      Tinnitus Since:
      06/2017
      Cause of Tinnitus:
      unsure, maybe noise (MRI, smoke detector alarm) + somatic??
      It is to be hoped that all doctors who treat tinnitus patients know this flowchart
       
    20. Jontrast
      Mischievious

      Jontrast Member Benefactor Hall of Fame

      Tinnitus Since:
      11/2017 (Late November 2017)
      Cause of Tinnitus:
      Extremely loud noise preceived from headphones
      No mention of hidden hearing loss?
       
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      • Good Question Good Question x 1

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