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Tends to be high frequency (hissing, crickets) and may be caused by barotrauma, head trauma, valsalva (plugging the nose and forcefully blowing out to make the ears "pop"), and erosion to the bony labyrinth caused by inflammatory or neoplastic processes or following middle ear surgery (stapedectomy)

Patients should report any severe or persistent side effects, as dose adjustments or temporary treatment interruption may be necessary

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However, before deciding whether to start any of these treatments, patients must be fully informed about the potential benefits, risks, and limitations