BN, a 57-year-old female, was referred to the tinnitus management clinic (TMC) at an audiology clinic. The TMC provides a comprehensive approach to the evaluation and management of patients with tinnitus through a multidisciplinary team (audiology, dentistry, neurology, physical therapy, and psychology) focused on counseling/education and the provision of individualized management recommendations following screenings (not comprehensive evaluations) conducted by each specialist.
Prior to attending the TMC, BN was seen by an otolaryngologist to rule out any underlying health-threatening condition requiring medical or surgical intervention. BN presented to the otolaryngologist with complaints of increased left-sided unilateral tinnitus over the past 2 weeks accompanied by left ear otalgia, which BN rated 5 on a 10-point pain scale (1 = no pain; 10 = worst imaginable pain). BN further reported that the ear pain increased when she used a cotton swab in her ear canal or the surrounding area—specifically the temporomandibular joint (TMJ) area. She also reported neck and upper back discomfort as well as previous episodes of vertigo. Physical examination and magnetic resonance imaging (MRI) findings were all within normal limits. Due to reported increased tinnitus and anxiety, the patient was prescribed 0.5 mg of alprazolam, to be taken by mouth at bedtime as needed for her tinnitus.