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Unusual Tinnitus Causes Should Not Be Forgotten

Unusual Tinnitus Cases: It’s Not All Primary Idiopathic
7:30 – 8:30 am
Room E451B

Have you been hunting zebras? Not real zebras, but the allegorical animals medical school professors warn students about when tracking down unusual types of tinnitus.

The session will reinforce your old professor’s message that hearing loud footsteps outside is like diagnosing tinnitus. Don’t assume the footsteps are from horses and don’t assume the tinnitus is idiopathic. Instead, remember that the footsteps could be from zebras and that the tinnitus could have other causes.

“More than 90 percent of tinnitus cases are primary idiopathic, but the remaining 10 percent can be made up of a host of different diagnoses. We want to touch on a few of those,” said session moderator Daniel Coelho, MD.

Daniel Coelho, MD

Among the out-of-the-ordinary conditions that will be discussed are somatosensory, typewriter/stacatto, and myoclonic tinnitus. The challenge with these unusual conditions is in the diagnosis, which will be explained by the panelists. One of the positives of diagnosing these conditions is that many of them are treatable or curable, perhaps more easily than primary idiopathic tinnitus.

Somatosensory tinnitus can be linked to musculoskeletal tension. Vascular or staccato tinnitus has a rapid tapping related to vascular compression of some of the cranial nerves. Myoclonic tinnitus produces a rhythmic tapping from muscle contractions.

“Each speaker will address a topic and review the pathophysiology, diagnosis, and treatment—all with actual case studies.” Dr. Coelho said. “This Miniseminar is designed to be useful to everyone, from trainees to general otolaryngologists, to experienced neurotologists, so when a patient presents with symptoms not consistent with primary idiopathic tinnitus, other conditions make it onto the differential diagnosis list.”

The goal is to remind otolaryngologists not to assume that the footsteps outside are always from horses.

“It is human nature to try to lump everyone into one nice, easy compartment,” Dr. Coelho said. “But the practice of medicine, and particularly otolaryngology, doesn’t work that way. Not everything is a horse. Remember that, and the zebras won’t come back to bite you!”

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