Tinnitus diagnosis

Tinnitus examination

In order to determine whether or not you have tinnitus, your health care provider will conduct a physical examination and possibly opt for further testing^[12] before providing a diagnosis^[13]. Trained audiologists and specialists have a variety of tools to help evaluate hearing and provide a diagnosis of tinnitus, when necessary. Generally, a comprehensive audiological evaluation that measures your overall hearing abilities will be administered in order to determine whether your symptoms are caused by underlying hearing loss. Some tests used to diagnose tinnitus include:

• Audiological (hearing) exams take place in a soundproof room. You will be asked to wear headphones that play specific sounds into one ear at a time. You will indicate when each sound is heard, and your results are compared to what is normal for your age range. These exams can help to rule out or identify possible causes of tinnitus.
• Movement: Your provider or audiologist may ask you to clench your jaw or move your eyes, legs, arms, and neck. If your tinnitus is affected by any of these movements, it may help identify the underlying disorder that needs treatment.
• Imaging tests such as MRIs or CT scans may be used depending on the suspected cause of your tinnitus symptoms.
• A speech recognition test, sometimes called speech audiometry, measures how well you hear and can repeat specific words.
• A pure tone audiogram is a subjective test that measures your hearing across multiple frequencies (which are measured in Hertz) and volumes (which are measured in decibels). The sounds you are able to hear may help a provider identify the cause of your symptoms.
• A tympanogram is an objective test that measures the functioning of the middle ear—specifically, the mobility of the tympanic membrane^[14] and conduction bones^[15].
• Acoustic reflex testing is objective testing that measures the contraction of the middle ear muscles in response to loud sounds.
• Otoacoustic emission testing uses highly sensitive microphones to objectively measure the movement of the tiny hair cells within the middle ear.
• Tinnitus sound matching: Common tinnitus sounds are presented back to the patient in order to help them identify their specific phantom sounds. The provider conducting the test may adjust the pitch or layer multiple sounds to achieve an audio recreation of the tinnitus sounds experienced. This examination provides a baseline for customized tinnitus treatments and therapies.
• Minimum masking level: Determining the volume at which an external narrowband noise masks tinnitus sounds helps provide an approximate measurement of how loud a patient perceives his or her tinnitus sounds. This information can be applied to future tinnitus masking and sound therapies.
• Loudness discomfort level: A provider can determine the volume at which external sounds become uncomfortable or painful for tinnitus patients. This measurement can help determine the feasibility of sound therapy, making, and hearing aids as potential treatment options.

While in many cases the cause of tinnitus is never determined, a provider or specialist can determine treatment options that will help improve your symptoms and allow you to cope with tinnitus. Always inform your provider of any new or worsening symptoms.

Hearing loss and hearing aids

Because tinnitus is overwhelmingly associated with some form of hearing loss, hearing aids^[16] and other sound amplification devices may provide relief from tinnitus symptoms. Hearing aids—small electronic devices worn in or behind the ear—amplify external sound and increase the intensity of auditory stimuli received and processed by the body’s auditory system. Hearing aids have proven successful in easing the symptoms of tinnitus: in a 2007 survey^[17] of auditory health professionals, respondents reported that about 60% of their tinnitus patients experienced at least some degree of relief while wearing hearing aids, while roughly 22% of patients reported experiencing significant relief.

Benefits of hearing aids for tinnitus

Hearing aids can provide relief of tinnitus symptoms in a number of ways. One of these benefits is the masking of tinnitus sounds. Hearing aids can increase the volume of outside noises to the point of covering phantom tinnitus sounds, bringing the wearer’s focus away from these sounds and onto external ambient noise. Noise masking is particularly successful in patients whose hearing loss is in the same frequency range as their tinnitus. Hearing aids may also help improve communications and concentration in patients with tinnitus. Tinnitus can make normal communication difficult, or even impossible, when it is loud enough to severely impair hearing. As hearing aids increase the volume of external sounds, they make it easier to hear and engage in conversations. While hearing aids do not eliminate phantom tinnitus noises, they make them less noticeable in comparison to augmented external sound.

Should I get a hearing aid?

There are a number of factors you should consider before deciding whether to get a hearing aid. You can consult with a specialist in order to determine whether a hearing aid is right for you (and, if so, what particular hearing aid would be best suited for your needs). Generally, price, lifestyle and comfort, sound sensitivity, and age are taken into account when choosing a hearing aid.