TINNITUS MAY BE DEFINED as conscious awareness of a sound in the absence of an external auditory stimulus. At least two-thirds of Australians have reported suffering from noticeable tinnitus at some point in their lives. 1 Clinical care examples are given in Cases 1-3. Definitions Tinnitus may be categorised as subjective, objective, primary or secondary (Table 1). Tinnitus is further classified according to duration. One must also differentiate between bothersome tinnitus and nonbothersome tinnitus because this will influence how active the treating general practitioner (GP) needs to be about management. Causes Almost any insult to the auditory pathway can result in tinnitus. Several non-auditory conditions can also lead to tinnitus. Therefore, many organic states can lead to the experience of tinnitus. The most common and potentially reversible causes are outlined in Table 2. Assessment A directed history and examination is required when a patient presents with tinnitus. History • Timeline: When did the experience of tinnitus begin? Duration will determine whether tinnitus is in the acute or chronic state.

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