3.  SUBJECTIVE- WHICH CAN OLY BE HEARD BY THE PATIENT  OBJECTIVE-CAN EVEN BE HEARD BY THE EXAMINER WITH THE USE OF STEHOSCOPE

4. CAUSES OF TINNITUS SUBJECTIVE-ORIGINATE FROM EXTERNAL EAR,MIDDLE EAR, INNER EAR, VIIITH NERVE OR CNS. OBJECTIVE –MOSTLY VASCULAR LESIONS LIKE GLOMUS TUMOUR OR CAROTID ARTERY ANEURYSM.

5. TINNITUS SYNCHRONOUS WITH RESPIRATION MAY OCCUR DUE TO ABNORMALLY PATENT EUSTACHIAN TUBE. SOMETIME TINNITUS IS PSYCHOGENIC AND NO CAUSE CAN BE FOUND IN THE EAR OR CNS.

6. CAUSES OF TINNITUS 1.SUBJECTIVE CAUSES-  OTOLOGIC-  IMPACTED WAX  FLUID IN THE MIDDLE EAR  ACUTE AND CHRONIC OTITIS MEDIA  ABNORMALLY PATENT EUSTACHIAN TUBE  MENIERE’S DISEASE  OTOSCLEROSIS  PRESBYACUSIS  NOISE TRAUMA  OTOTOXIC DRUGS  TUMOURS OF VIII TH NERVE

7. » NON OTOLOGIC DISEASE OF CNS ANAEMIA ARTERIOSCLEROSIS HYPERTENSION HYPOTENSION HYPOGLYCAEMIA EPILEPSY MIGRAINE

8. 2.OBJECTIVES VASCULAR TUMOURS OF MIDDLE EAR(GLOMUS TUMOUR) ANEURYSM OF CAROTID ARTERY PALATAL MYOCLONUS TINNITUS SHOULD BE DIFFERENTIATED FROM AUDITORY HALLUCINATION 3.PSYCHOGENIC

9. TREATMENT TREATMENT SHOULD BE DIRECTED TOWARDS THE CAUSE IF NO CAUSE FOUND THEN 1.REASSURANCE AND PSYCHOTHERAPY 2.TECHNIQUES OF RELAXATION AND BIOFEEDBACK 3.SEDATION AND TRANQUILIZERS 4.MASKING OF TINNITUS

10. TINNITUS MASKERS CAN BE USED IN PATIENTS WHO HAVE NO HEARING LOSS. THEY ARE WORN LIKE A HEARING AID USE OF TINNITUS MASKER FOR A SHORT TIME MAY PROVIDE, IN SOME INDIVIDUALS, A SYMPTOM FREE PERIOD FOR SEVERAL HOURS DUE TO THE PHENOMENON OF RESIDUAL INHIBITION