Tinnitus: Medical History

The medical history (case history) represents an important component in the diagnosis of tinnitus (ringing in the ears). Family history

• Does your family have frequent tinnitus (buzzing, hissing, or ringing in one or both ears)?

Social history

• What is your profession?
• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• How long have the ringing in the ears been present?
• Do the ringing in the ears exist unilaterally or bilaterally?
• How loud is the noise?
• What kind of sound is it? Is it hissing, buzzing, hissing or ringing?
• Does the sound have a pulsatile (“pulse-like”) character?
• How has the tinnitus developed – from onset to now?
• Have you noticed any accompanying hearing loss?
• Do you feel dizzy?
• Have you noticed any fluctuations in blood pressure?

Vegetative anamnesis incl. nutritional anamnesis

Self anamnesis incl. medication anamnesis

• Pre-existing conditions (ear disease, cardiovascular disease; comorbidities (concomitant conditions): hearing and balance disorders?, affective disorders (e.g., adjustment disorder; depressive episode)?, anxiety disorders?, and reactions to severe stress and adjustment disorder? (post-traumatic stress disorder (PTSD); insomnia/sleep disorder)).
• Operations
• Allergies

If applicable, record health-related quality of life (HR-Qol) using established disorder-specific instruments:

• THI (Tinnitus Handicap Inventory).
• THQ (Tinnitus Handicap Questionnaire)
• TQ (Tinnitus Questionnaire); engl. TF (Tinnitus Questionnaire).
• TRQ (Tinnitus Reaction Questionnaire).
• TSI (Tinnitus Severity Index)
• TSQ (Tinnitus Severity Questionnaire)

Medication history

• Antiarrhythmic drugs
  • Class Ib antiarrhythmics (quinidine, lidocaine, mexiletine (1-10%)).
  • Class Ic antiarrhythmics (flecainide, propafenone).
  • Unclassified (adenosine).
• Antibiotics
  • Aminoglycosides (gentamycin (gentamicin), streptomycin).
  • Cephalosporins (cefepime, cefpodoxime).
  • Gyrase inhibitors
    • Fluoroquinolones (ciprofloxacin, moxifloxacin).
  • Macrolide antibiotics / macrolides (roxithromycin).
  • Monobactams (aztreonam)
• Antidepressants
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs) – bupropion
  • Selective serotonin reuptake inhibitors (SSRIs) – citalopram, paroxetine, sertraline (1-10%).
  • Tetracyclic antidepressants (maprotiline).
  • Tricyclic antidepressants (amitriptyline, clomipramine, imipramine).
• Antihistamines (cetirizine, loratadine).
• Antihypertensives
  • ACE inhibitors (captopril, enalapril, quinapril, ramipril).
  • AT1 antagonists (valsartan).
  • Calcium anatgonists (amlodipine, verapamil)
• Antimalarials (artesunate, chloroquine, quinine).
• Antifungal agent (posaconazole, voriconazole).
• Anticoagulants
  • Platelet aggregation inhibitors (ticlopidine).
• Antirheumatic drugs, nonsteroidal (NSAIDs) – acetylsalicylic acid (ASA), ibuprofen, indometacin (> 10%), meloxicam, piroxicam (1-10%).
• Antidementives (galantamine)
• Antiepileptic drugs
  • Functionalized amino acid (lacosamide).
  • Gabapentin
  • Classical antiepileptic drugs (valproic acid).
• Anxiolytics (buspirone, 1-10%).
• Beta-blockersBetablockers, systemic.
  • Nonselective beta blockers (e.g., carvedilol, pindolol, propranolol, soltalol).
  • Selective beta blockers (e.g., atenolol, acebutolol, betaxolol, bisoprolol, celiprolol, nebivolol, metoprolol).
• Bisphosphonates – risedronic acid.
• Codeine
• COX inhibitors – celecoxib, naproxen (1-10%).
• Diuretics
  • Loop diuretics (furosemide, etacrine acid).
• HCV protease inhibitors – boceprevir
• Hormones
  • Corticosteroids (loteprednoletabonate).
  • GnRH analogues (buserelin, triptorelin).
  • Oral contraceptives
  • Prostaglandin E1 (misoprostol)
• Immunosuppressants (tacrolimus).
• Interferons (interferon alfa 2b, peginterferon alfa-2b).
• Intestinal anti-inflammatory (sulfasalazine (INN))
• Contrast agent (gadobenic acid)
• Lipid-lowering agent
  • Statins (atorvastatin
• Local anesthetics (articaine, lidocaine).
• Monoclonal antibodies (adalimumab, alemtuzumab)
• Parasympatholytics (oxybutynin).
• Parkinson’s drugs (Budipin)
• Protease inhibitors (lopinavir)
• Proton pump inhibitors
• Sympathomimetics
• Triptans (frovatriptan)
• Antivirals (imiquimod)
• Cytostatic drugs (anagrelide, bortezomib, cisplatin, imatinib, temozolomide (1-10%)).