Neurootological differentiations in endogenous tinnitus

Vertigo and tinnitus are very frequent complaints. Often, we find multisensory syndromes combined with tinnitus, hearing impairment, vertigo, and nausea. From more than 10,000 cases, we evaluated 757 randomly selected neurootological patients suffering from endogenous tinnitus. First, we classified the 10,000 patients into those suffering from the basic tetrad of tinnitus forms: bruits, endogenous (maskable) tinnitus, exogenous (nonmaskable) tinnitus, and other syndromes such as the slow brainstem syndrome. Then, of all the endogenous tinnitus patients, we randomly selected our study sample (n = 757), and those patients underwent a complex neurosensory investigation, including neurootological history; classic audiometry; acoustic brainstem-evoked potentials; acoustic cortically evoked potentials; visually evoked potentials; electronystagmography of spontaneous, caloric, rotatory, and optokinetic nystagmus; and craniocorpography with several vestibulospinal tests. For this study, we primarily examined the historical findings. The statistical results demonstrate that tinnitus is interconnected to a multifactorial disease background with a broad spectrum of individual complaints. Finally, the topodiagnostics of the functional neurootometric analysis shows that this type of endogenous tinnitus constitutes decidedly more central than peripheral statoacoustic pathology.