Medical Significance of Tinnitus.
The medical significance of a symptom or disease process in a patient is defined as a clinical manifestation of abnormal function of a living cell, tissue, organ or organ system(s). Tinnitus, an aberrant perception of sound unrelated to an external source of sound, has been identified to have a medical significance. The medical significance of tinnitus has been identified with a Medical Audiologic Tinnitus Patient Protocol since 1979. The highlights of this clinical experience include for diagnosis: tinnitus not to be a unitary symptom; the identification of clinical type and subtypes of tinnitus and a Final Common Pathway for Tinnitus of all clinical types particularly of the severe disabling type. For treatment a multidisciplinary approach has evolved including neurology, otology and psychiatry; a combined treatment protocol of drug therapy and instrumentation, based on differentiation between the components of the symptom of tinnitus i.e. sensory, affect, and psychomotor. Two diagnostic categories are identified: otologic/neurotologic and neurologic. The application of SPECT Imaging of Brain which has identified a Final Common Pathway for tinnitus and provides an increased diagnostic accuracy for tinnitus and a basis for selection of a neuropharmacology for tinnitus is discussed.
Shulman
A
Martha Entenmann Tinnitus Research Center, Health Sciences Center at Brooklyn, State University of New York, Brooklyn, New York.
Goldstein
B