Tinnitus

As tinnitus (ringing in the ears) we refer to auditory sensations for which there is no sound source in the external environment.

Subjective Tinnitus
Auditory perception is not linked to real physical sound, it is perceived only by the patient.
 * Usually pure tones, noises or sounds:
 * Conductive hearing loss is usally accompanied by humming and buzzing.
 * Perceptual hearing loss is most often accompanied by whistling, buzzing, ringing or hissing.
 * (Sometimes also in lesions of the middle ear otosclerosis, tympansclerosis).
 * Tinnitus may be the first symptom of a vestibular schwannoma.

Objective Tinnitus
Objective tinnitus is less common and is caused by an actual sound source near the auditory system, the sound is not only heard by the patient.
 * Blood flow in a vascular malformation (arteriovenous shunts), stenosis, aneurysm or in a tumor can be influenced by compressing the supply artery.
 * More rarely, the contraction of the musles of the middle ear has the character of peeling or humming.

Anamnesis
We describe symmetry/lateralization, intensity, character, pitch, duration and affectability.