Differential Diagnosis for Tinnitus
Single most likely diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): Given the recent fall, BPPV is a likely cause of tinnitus. It is a condition related to the inner ear where small crystals become dislodged and cause vertigo, tinnitus, and other symptoms.
Other Likely diagnoses
- Middle Ear Injury: A recent fall could result in a middle ear injury, such as a perforated eardrum, leading to tinnitus.
- Cerumen Impaction: The fall might have caused earwax to become impacted, leading to tinnitus.
- Labyrinthine Concussion: This is a condition that affects the inner ear after a head injury, which could explain the tinnitus.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid Hemorrhage: Although less likely, a subarachnoid hemorrhage could present with tinnitus after a fall, especially if there was significant head trauma. This is a medical emergency.
- Temporal Bone Fracture: A fracture in the temporal bone could cause tinnitus and is a serious condition that requires immediate medical attention.
Rare diagnoses
- Meniere's Disease: An inner ear disorder that affects balance and hearing, causing tinnitus. While possible, it's less directly related to a recent fall.
- Ototoxicity: If the patient was treated with certain medications after the fall (e.g., antibiotics), ototoxicity could be a rare cause of tinnitus.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which could cause tinnitus. This is a rare condition and less likely to be directly related to a fall.