Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about tinnitus.

And you can find written notes on this topic at zero definals.com slash tinnitus

or in the ear, nose and throat section of the zero to finals surgery book.

So let's get straight into it.

Tinnitus refers to a persistent additional sound that is heard but is not present in the

surrounding environment. It may be described as a ringing in the ears, but it can also be a buzzing, hissing or humming noise.

The additional noise experienced with tinnitus is thought to result from a background sensory signal produced by the cochlear that's not effectively filtered out by the central auditory system.

In a quiet enough environment, almost everyone will

experience some background noise or tinnitus. This becomes more prominent the more attention it's given.

Let's talk about the causes. Primary tinnitus has no identifiable cause and often occurs with

sensory neural hearing loss. So in someone occurs with sensory neural hearing loss.

So in someone who has sensory neural hearing loss, they may experience primary tinnitus.

Secondary tinnitus refers to tinnitus with an identifiable cause.

And the causes include impacted ear wax, and ear infection, many airs disease, noise exposure, medications,

for example loop diuretics, gentomysin and chemotherapy drugs such as cisplatin,

acoustic neuromas, multiple sclerosis, trauma and depression.

Sinitus may also be associated with systemic conditions such as anemia, diabetes,

hypothyroidism or hyperthyroidism and hyperlipidemia with raised blood lipid levels.

Objective tinnitus refers to when a patient can objectively hear an extra sound within their head.

This sound can also be observable on examination by auscultating with a stethoscope around their ear.

In patients with objective tinnitus, actual additional sounds may be caused by carotid artery stenosis,

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