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Zumbido

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Last reviewed: 11 Dec 2025
Last updated: 15 Sep 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • história medicamentosa
  • história de exposição a ruído
  • sons episódicos
  • perda auditiva
  • vertigem
  • sons pulsáteis
  • sons de cliques
  • alterações visuais
  • presença de sopros ou zumbidos
  • paralisia de nervo craniano
  • cerume (cera de orelha)
  • otoscopia anormal
  • teste de Weber anormal
  • teste de Rinne anormal
Full details

Other diagnostic factors

  • perda auditiva progressiva de início lento
  • alta frequência
  • baixa frequência
  • unilateral
  • bilateral
  • piora durante a mastigação
  • poliúria/polidipsia
  • diarreia
  • palpitações
  • corpo estranho
Full details

Risk factors

  • idade avançada
  • perda auditiva
  • exposição a ruídos altos
  • schwannoma vestibular
  • medicamentos ototóxicos
  • exposição a metais pesados
  • História de doença cerebrovascular
  • história de esclerose múltipla
  • história de trauma cranioencefálico
  • história de depressão
  • história de ansiedade
Full details

Diagnostic tests

1st tests to order

  • audiometria
Full details

Tests to consider

  • Hemograma completo
  • testes da função tireoidiana
  • perfil lipídico
  • glicemia de jejum
  • teste de absorção do anticorpo treponêmico fluorescente
  • ressonância nuclear magnética (RNM) de crânio
  • tomografia computadorizada (TC) dos ossos temporais
  • Angiografia por RM ou Angiotomografia
  • angiografia carotídea
  • resposta auditiva evocada de tronco encefálico (BERA)
  • nível mínimo de mascaramento (MML)
  • inibição residual
  • sensação de intensidade e pitch-matching
  • exame do nível de desconforto para sensação de intensidade
Full details

Emerging tests

  • emissões otoacústicas
  • ressonância nuclear magnética (RNM) funcional
  • tomografia por emissão de pósitrons (PET)
  • magnetoencefalografia

Treatment algorithm

ACUTE

etiologia conhecida

zumbido problemático

ONGOING

perda auditiva no audiograma

audição normal

Contributors

Authors

Michael D. Seidman, MD, FACS

Medical Director Otologic/Neurotologic/Skull Base Surgery

Medical Director Wellness

Advent Health Medical Group

Professor of Otolaryngology-Head and Neck Surgery

University of Central Florida

Collaborative Prof of Oto-HNS University of South FLa

Past Board of Directors American Academy of Otolaryngology-Head and Neck Surgery

Celebration

FL

Disclosures

MDS is a consultant for Acclarent, the founder of PEAK 365 Nutrition and Body Language Vitamins, and is involved in post-market studies for Envoy (non-compensated) and research for MicroTransponder, Inc (non-compensated), Auris Medical, and the National Institutes of Health. He receives royalties from seven patents. MDS is the author of several references cited in this topic.

Acknowledgements

Dr Michael D. Seidman would like to gratefully acknowledge Dr Hamid Djalilian, Dr Alice Lee, Dr Vanessa Rothholtz, and Dr Sanaz Hamidi, the previous contributors to this topic.

Disclosures

HD, AL, VR, and SH declare that they have no competing interests.

Peer reviewers

Aaron Benson, MD

Clinical Adjunct Professor

Division of Neurotology

Department of Otolaryngology Head and Neck Surgery

University of Michigan

Ann Arbor

MI

Consulting Staff

Toledo ENT

Toledo

OH

Disclosures

AB declares that he has no competing interests.

Andrew McCombe, MD, FRCS(ORL)

Consultant ENT Surgeon

Frimley Park Hospital

Portsmouth Road

Frimley

Surrey

UK

Disclosures

AM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Henry JA, Dennis KC, Schechter MA. General review of tinnitus: prevalence, mechanisms, effects, and management. J Speech Lang Hear Res. 2005 Oct;48(5):1204-35. Abstract

Tyler RS. Tinnitus hand book of medicine. San Diego, CA: Singular Publishing Group; 2000.

Cima RF, Maes IH, Joore MA, et al. Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet. 2012 May 26;379(9830):1951-9. Abstract

Muehlmeier G, Biesinger E, Maier H. Safety of intratympanic injection of AM-101 in patients with acute inner ear tinnitus. Audiol Neurootol. 2011;16(6):388-97. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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