A 45-year-old patient presents with constant, high-pitched, unilateral right tinnitus of 6 months duration. Audiometry shows a notch at 4 kHz bilaterally with predominantly right-sided loss. Tinnitus matching localizes it to 4 kHz. Residual inhibition testing shows complete suppression of tinnitus lasting 30 seconds after masking tone presentation. This residual inhibition finding indicates:
- A The tinnitus is psychogenic in origin
- B Sound therapy / masking is likely to provide symptomatic benefit ✓
- C The tinnitus is of central origin and will not respond to peripheral treatments
- D Cochlear implantation is the only effective treatment
Explanation
Residual inhibition is the temporary suppression or reduction of tinnitus that follows the cessation of a masking tone. The presence of complete residual inhibition (especially lasting >10–30 seconds) predicts that the patient's auditory system is responsive to acoustic modulation — a positive prognostic indicator for sound-based therapies including tinnitus maskers, Tinnitus Retraining Therapy (TRT), and hearing aids. Absent or brief residual inhibition suggests less auditory plasticity and poorer response to sound therapy. It does not indicate psychogenic or central origin.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.