Q. What causes tinnitus?

Answered by
Dr. Syed Tehmid
and medically reviewed by Dr. Nithila A
Published on Aug 05, 2019

Hello doctor,

I have been diagnosed with tinnitus, and it is driving me crazy for the past 5.5 months. In my CTA examination, my upper cervical spine demonstrates some moderate facet arthritis primarily at c2 and c3. It also shows an incomplete fusion of the posterior arch of c1 and mild cervical spondylosis. Also, I have a deformity of the right zygomatic arch related to prior depressed fracture, and I have a small screw in the right lateral zygoma due to the previous injury. Also a mild deformity at the tip of the nasal bone from a prior injury.

The paranasal sinuses demonstrate a minimal dependent mucosal thickening in the maxillary antra. This surrounds some roots of some maxillary teeth which extend into the base of the maxillary sinuses bilaterally. Also, mild swelling if the middle turbinate and moderate swelling of the inferior turbinates. Also moderate bowing of the nasal septum. With your knowledge, could any of the above be causing my tinnitus? I do not know who else to turn to or if I am missing something. I am under, 20 mg Prozac per day and 900 mg of Propafenone.

Dr. Syed Tehmid

Otolaryngology (E.N.T)
#

Hello,

Welcome to icliniq.com.

Cervical spine abnormalities can cause vertigo but not tinnitus. A zygomatic bone fracture can be a cause of tinnitus if it is impinging on the mandible. But that would be more due to chewing and movements of the lower jaw, and sinusitis can also cause tinnitus if it causes otitis media, but then the hearing is also impaired. Have you done a pure tone audiometry?

Thank you doctor,

I consulted an audiologist who took a test and noted snhl at @ 8 kHz notch pattern noted asymmetry @ 4 to 6 kHz. The tone is low in the right ear and intermittent in the left ear. What can I do?

Dr. Syed Tehmid

Otolaryngology (E.N.T)
#

Hello,

Welcome back to icliniq.com.

The audiogram shows high-frequency snhl (sensorineural hearing loss) at 8 kHz, which is outside the range of speech frequency as such I guess you do not have any hearing impairment or do you have any? Since you are on Propafenone and Prozac (Fluoxetine), these medications have been known to cause or worsen tinnitus. Tinnitus can be, at times, is very difficult to treat. Specific agents like Ginkgo Biloba are beneficial. Then there are options like behavioral therapy and tinnitus retraining therapy, which can be helpful.

Thank you doctor,

I am not sure if it is snhl. What about the incomplete fusion of c1?

Dr. Syed Tehmid

Otolaryngology (E.N.T)
#

Hello,

Welcome back to icliniq.com.

Well in 80 % of cases anomalies of the atlas are asymptomatic or have symptoms of neck pain or spasm. In severe cases, there may be symptoms of nerve weakness like paraplegia. However, tinnitus is very unlikely in the absence of neurological symptoms.

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