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Perception of abnormal ear or head noises
Persistent tinnitus often, though not always, indicates the presence of sensory hearing loss
Intermittent periods of mild, high-pitched tinnitus lasting seconds to minutes are common in normal-hearing persons
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For nonpulsatile tinnitus: Audiometry to rule out associated hearing loss
For unilateral tinnitus: MRI should be done to rule out retrocochlear lesion (eg, vestibular schwannoma)
For pulsatile tinnitus: Consider MR angiography and venography and temporal bone CT when vascular abnormality or sigmoid sinus abnormality is suspected
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Avoid exposure to excessive noise, ototoxic agents, and other factors that may cause cochlear damage
Masking the tinnitus with music or through amplification of normal sounds with a hearing aid may bring relief
Oral antidepressants (eg, nortriptyline at an initial dosage of 50 mg at bedtime) often impact tinnitus-induced sleep disorder and depression
Habituation techniques, such as tinnitus retraining therapy, may prove beneficial in those with refractory symptoms
Transcranial magnetic stimulation of the central auditory system may improve symptoms
Progress is being made toward implantable brain stimulators as treatment option