Non-specific tinnitus in a helicopter pilot: Aeromedical perspective

Tinnitus is the perception of noise in the absence of any external sounds. High intensity noise exposure of aircrew increases the incidents of hearing loss and tinnitus. It can be associated with hyperacusis or hearing loss. Tinnitus may interfere with the cockpit communication and have flight safety implications. This paper presents a case of a military helicopter aircrew having non-specific tinnitus with emphasis on aeromedical assessment & disposal. The case is of a 52-year-old male helicopter pilot, who is a known case of primary hypertension (on medication) and pre-diabetes developed bilateral progressive tinnitus. His magnetic resonance imaging brain, serial pure tone audiometry and brainstem evoked response audiometry (BERA) showed normal reports. He was gradually upgraded to unrestricted flying category after sufficient ground observation and aeromedical evaluation. Though there is significant prevalence of tinnitus in aircrew, a standard guideline for evaluation & disposal have not been described in any military/civil aeromedical literatures. This paper aims to discuss about aeromedical concerns & a proposed guideline for evaluation & disposal of tinnitus. Objective assessment of tinnitus, psychological assessment and rehabilitation holds significant relevance in aeromedical disposal of a case of tinnitus in an aircrew. Specific guidelines and policies may be formulated for implementation of the same.