H.I. is a 51 year old veteran who reports that he has had constant tinnitus for the past 29 years, worsening in the last two years, and greater in the right ear.  The tinnitus is high pitched, but now is increasingly soundling like a “pounding sound”, again, more pronounced in the right ear.  The tinnitus is interfering with sleep and is irritating to the patient.

He reports that he is having some difficulty hearing; he notices he has to ask for repetitions more often.  He also has problems using the telephone (he typically uses his left ear.) He has never used hearing aids and does not believe he is a candidate for amplification.

He reported military noise exposure but no significant exposure subsequently or recreationally.

He denies vertigo, his otologic history is unremarkable.  He is in good health other than having controlled hypertension.  He suffered a head injury as a child, but did not lose consciousness.

Otoscopic inspection is within normal limits.

Case Credit: Teri Hamill, PhD, Nova Southeastern University