Tinnitus may present with the patient reporting perception of noises as varied as pure tones, music, speech or random white noise. The site of perception is ascribable to the head generally, or occasionally one ear. The association with intermittent bouts of vertigo and hearing loss direct one to a diagnosis of Meniere's disease.
Although tinnitus is not a psychological disorder, it may cause anxiety concerning its cause, prognosis and the patient may fear of its influence on lifestyle and work (1).
Tinnitus may also produce or exacerbate symptoms such as tension, frustration, loss of concentration, sleep disturbance and depression (1).
Otoscopy may disclose impacted wax, a tympanic membrane perforation or middle ear disease.
Patients with unilateral tinnitus should be referred to an ENT specialist to exclude an acoustic neuroma.
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