Question
I have a 90 year old client with tinnitus in the right ear which she says she can stop for a few minutes by rubbing the bottom of her front teeth with her finger or by pressing behind her right ear. What could be a possible explanation for this? She thinks it is dental related.
Answer
At 90 years of age there is usually a fair amount of arteriosclerosis or hardening of the arteries so that the circulation becomes ''louder'' or there may be some sort of aneurism formed. Most likely this is objective in that she is hearing her own circulation. Might be objectified by spontaneous OAE, see if circulation is prominent. You can do an arterial flow study but this is a ''high risk'' procedure. Her physician may be interested in doing a study to evaluate for ''clogged arteries'' and subsequent surgery to unclog them. For this study, ultra sound is quite useful and is non invasive.
The best course is to document as much as you can here, and forward information to her physician regarding the possibility that it reflects a circulatory situation, i.e. sclerosis. Whether he decides to check it out or ignore it depends on ''the whole picture''.
BIO: Murray Grossan, MD, is Board certified in Otolaryngology. His practice is in Los Angeles at Tower ENT. His c.v. includes several papers on Tinnitus. For further information, refer to the following web sites:
1https://www.audiologyonline.com/audiology-ceus/course/tinnitus-activities-treatment-33539Tinnitus Activities TreatmentThe course will provide clinicians with a framework for evaluating and treating tinnitus patients, including counseling for Thoughts and Emotions, Hearing, Sleep and Concentration difficulties. It will include the application of hearing aids, and wearable and non-wearable sound therapy devices.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comTinnitus Activities TreatmentThe course will provide clinicians with a framework for evaluating and treating tinnitus patients, including counseling for Thoughts and Emotions, Hearing, Sleep and Concentration difficulties. It will include the application of hearing aids, and wearable and non-wearable sound therapy devices.33539OnlinePT60M
The course will provide clinicians with a framework for evaluating and treating tinnitus patients, including counseling for Thoughts and Emotions, Hearing, Sleep and Concentration difficulties. It will include the application of hearing aids, and wearable and non-wearable sound therapy devices.
2https://www.audiologyonline.com/audiology-ceus/course/teenagers-with-tinnitus-38668Teenagers with TinnitusThis course describes the prevalence of tinnitus in teenagers from all causes, and discusses the primary complaints associated with bothersome tinnitus. Specific interventions the audiologist can provide are described in detail.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comTeenagers with TinnitusThis course describes the prevalence of tinnitus in teenagers from all causes, and discusses the primary complaints associated with bothersome tinnitus. Specific interventions the audiologist can provide are described in detail.38668OnlinePT60M
This course describes the prevalence of tinnitus in teenagers from all causes, and discusses the primary complaints associated with bothersome tinnitus. Specific interventions the audiologist can provide are described in detail.
3https://www.audiologyonline.com/audiology-ceus/course/hyperacusis-misophobia-35597Hyperacusis and My MisophobiaHyperacusis comes in many different forms (loudness, avoidance, fear and pain) and patients need our help. There are effective counseling, sound therapy and hearing aid approaches that many find helpful.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comHyperacusis and My MisophobiaHyperacusis comes in many different forms (loudness, avoidance, fear and pain) and patients need our help. There are effective counseling, sound therapy and hearing aid approaches that many find helpful.35597OnlinePT60M
Hyperacusis comes in many different forms (loudness, avoidance, fear and pain) and patients need our help. There are effective counseling, sound therapy and hearing aid approaches that many find helpful.
4https://www.audiologyonline.com/audiology-ceus/course/clinical-assessment-hyperacusis-in-children-35599Clinical Assessment of Hyperacusis in Children and AdultsMeasuring hyperacusis in children is an important skill for the audiologist. Using an adapted Loudness Discomfort Level (LDL) assessment protocol provides valuable information and treatment progress data points. Hyperacusis is an unusual condition that can be present in pediatric populations and deserves attention and professional assessment.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comClinical Assessment of Hyperacusis in Children and AdultsMeasuring hyperacusis in children is an important skill for the audiologist. Using an adapted Loudness Discomfort Level (LDL) assessment protocol provides valuable information and treatment progress data points. Hyperacusis is an unusual condition that can be present in pediatric populations and deserves attention and professional assessment.35599OnlinePT60M
Measuring hyperacusis in children is an important skill for the audiologist. Using an adapted Loudness Discomfort Level (LDL) assessment protocol provides valuable information and treatment progress data points. Hyperacusis is an unusual condition that can be present in pediatric populations and deserves attention and professional assessment.
5https://www.audiologyonline.com/audiology-ceus/course/modern-technologies-for-management-tinnitus-38415Modern Technologies for the Management of Tinnitus: The Colorado Model of CareTinnitus is a leading chronic condition from which millions of Americans suffer. Patients with annoying or debilitating tinnitus often seek the help of hearing care professionals. This podcast provides evidence-based, real world insights from the University of Colorado Medical School’s Audiology Department and how to more effectively manage patients with tinnitus through counseling and the provision of various modern technologies.auditory129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comModern Technologies for the Management of Tinnitus: The Colorado Model of CareTinnitus is a leading chronic condition from which millions of Americans suffer. Patients with annoying or debilitating tinnitus often seek the help of hearing care professionals. This podcast provides evidence-based, real world insights from the University of Colorado Medical School’s Audiology Department and how to more effectively manage patients with tinnitus through counseling and the provision of various modern technologies.38415OnlinePT30M
Tinnitus is a leading chronic condition from which millions of Americans suffer. Patients with annoying or debilitating tinnitus often seek the help of hearing care professionals. This podcast provides evidence-based, real world insights from the University of Colorado Medical School’s Audiology Department and how to more effectively manage patients with tinnitus through counseling and the provision of various modern technologies.
