The following differential diagnoses refer to the causative diseases, not to the symptom of tinnitus. Blood, blood-forming organs – immune system (D50-D90).
- Anemia (anemia)
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Thyrotoxicosis – hyperthyroidism with excessive hormone production.
Cardiovascular system (I00-I99)
- Vascular diseases such as abnormalities of cerebral vessels: aneurysms, AV shunts, dural arteriovenous malformations (DAVF; mostly from external carotid artery, and intracranial venous sinuses or veins), etc. (pulse synchronous tinnitus)Note: Any shunt between an artery and vein can cause pulse synchronous tinnitus.
- Hypertension (high blood pressure)
- Hypotension (low blood pressure)
Infectious and parasitic diseases (A00-B99).
- Lyme disease
Musculoskeletal system and connective tissue (M00-M99)
- Cervical syndrome – syndrome of the cervical spine with nerve compression/damage.
Neoplasms – tumor diseases (C00-D48).
- Acoustic neuroma (AKN) – benign tumor arising from the Schwanńs cells of the vestibular portion of the VIII. Cranial nerve, the auditory and vestibular nerves (vestibulocochlear nerve), and is located in the cerebellopontine angle or in the internal auditory canal. Acoustic neuroma is the most common cerebellopontine angle tumor. More than 95% of all AKNs are unilateral. In contrast, in the presence of neurofibromatosis type 2, acoustic neuroma typically occurs bilaterally.
Ears – mastoid process (H60-H95).
- Chronic noise-induced hearing loss
- Ear canal obstruction due to cerumen obturans (cerumen; earwax) or foreign bodies (→ hearing loss)
- Hearing loss – acute hearing loss
- Bang trauma
- Meniere’s disease – inner ear disease with vertigo.
- Myoclonias (twitching) of the middle ear muscles.
- Open tuba auditiva – connection between the ear and nose, which is normally closed by mucosa.
- Otitis media (inflammation of the middle ear) – here especially the purulent and serous otitis media after chronic infections.
- Otosclerosis – increasing hearing loss due to bone remodeling processes.
- Pulse synchronous ringing in the ears (pulse synchronous tinnitus).
- Arterial causes (atherosclerosis/arteriosclerosis, dissection, fibromuscular dysplasia).
- Arteriovenous fistulas and vascular tumors at the skull base.
- Venous causes (intracranial hypertension and anatomic normovarian basal veins and sinuses).
- Presbycusis (age-related hearing loss).
- Tympanic membrane perforation – (tympanic membrane rupture; e.g., injury by foreign bodies, in about two-thirds of cases by cotton swabs (Q-tips); in adolescents between 13 and 18 years in about one-third of cases trauma during water sports (diving or water skiing)).
Psyche – nervous system (F00-F99; G00-G99).
- Depression
- Psychosomatic diseases
Injuries, poisonings and other consequences of external causes (S00-T98).
- Traumatic brain injury (TBI) – craniocerebral injuries.
Further
- Craniomandibular dysfunction (CMD) – such as congenital malocclusion, bruxism (teeth grinding), unilateral chewing; myoarthropathy of the temporomandibular joint.
- Chronic noise exposure (→ hearing loss).
Medication
- See “Causes” under medications
