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J Head Trauma Rehabil. 2014 Sep-Oct;29(5):432-42. doi: 10.1097/HTR.0b013e31829d3129.

Trauma-associated tinnitus.

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Departments of Psychiatry and Psychotherapy (Drs Kreuzer, Landgrebe, and Langguth) and Otolaryngology (Dr Vielsmeier), University of Regensburg, Regensburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg, Germany (Dr Landgrebe); Department of Otolaryngology, University of Zurich, Zurich, Switzerland (Dr Kleinjung); Brain Research Center Antwerp for Innovative & Interdisciplinary Neuromodulation, Antwerp, Belgium; and Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Dr De Ridder).



Up to 53% of individuals suffering from traumatic brain injuries develop tinnitus.


To review the current literature on trauma-associated tinnitus in order to provide orientation for the clinical management of patients with trauma-associated tinnitus.


A systematic literature search has been conducted in PubMed database applying the search terms posttraumatic tinnitus and trauma-associated tinnitus. Results have been complemented by related studies, book chapters, and the authors' clinical experience.


Not only mechanical, pressure-related, or noise-related head traumata but also neck injuries and emotional trauma can cause tinnitus. Exact diagnosis is essential. Disorders such as ossicular chain disruption, traumatic eardrum perforation, or perilymphatic fistula can be surgically treated. It should also be considered that pulsatile tinnitus can be a sign of life-threatening disorders such as carotid cavernous fistulas, arteriovenous malformations, and carotid dissections. Also, posttraumatic stress disorder should be taken into consideration as a potential contributing factor.


There is an evident mismatch between the high incidence of trauma-associated tinnitus and scarce literature on the topic. A consistent and-at best-standardized assessment of tinnitus- and hearing-related sequelae of trauma is recommended both for the improvement of clinical care and for a deeper understanding of the various pathophysiological mechanisms of trauma-associated tinnitus.

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