- Published on 20 November 2018
Researchers from the Department of Otolaryngology–Head and Neck Surgery at the University of California San Francisco recently published an interesting review article on tinnitus. The article covers the pathophysiology of the disorder, diagnostic evaluation, classification, and treatment.
The authors point out that the pathophysiology of tinnitus is complex and remains poorly understood. Tinnitus may originate at any location along the auditory pathway from the external ear to the auditory cortex. According to a leading theory, cochlear abnormalities may be the initial source of tinnitus, but a subsequent cascade of neural changes may perpetuate the symptoms of this sometimes debilitating disorder.
In addition, the article proposes a diagnostic algorithm for the work-up of tinnitus, and provides a clear classification of subjective and objective tinnitus, with selected examples. In terms of treatment, the authors discuss psychological approaches such as counseling and psychoeducation, tinnitus retraining therapy, and cognitive behavioral therapy. Auditory stimulation as a possible treatment modality is also discussed.
The various pharmacologic treatments available or that have been studied and not retained are also reviewed. These include options that are not recommended such as tricyclic antidepressants and selective serotonin reuptake inhibitors, as well as anxiolytics and anticonvulsants. Herbal and dietary supplements are also mentioned.
Source: Chari DA, Limb CJ. Tinnitus. The Medical Clinics of North America. 2018 Nov;102(6):1081-1093