Straightforward Information About Tinnitus
If you're seeing a specialist for your tinnitus for the first time, knowing what to expect can help reduce anxiety. A thorough tinnitus evaluation typically includes several components.
Your audiologist or ENT will start by asking detailed questions about your tinnitus: when it started, what it sounds like, whether it's constant or intermittent, which ear or ears are affected, and what makes it better or worse. They will also ask about your noise exposure history, medications, general health, and family history of hearing problems.
A physical exam of your ears, head, and neck is standard. The doctor will use an otoscope to look into your ear canals and check for earwax, infection, or structural abnormalities. They may also evaluate your jaw (TMJ), neck movement, and blood vessels near the ears, especially if pulsatile tinnitus is suspected.
A pure-tone audiogram is the most common hearing test. You will sit in a soundproof booth wearing headphones and respond to tones at different frequencies and volumes. The results are plotted on a chart called an audiogram. This test reveals whether you have hearing loss and at which frequencies. For a guide to reading results, see Understanding Your Audiogram.
In some evaluations, the audiologist will try to match your tinnitus. This involves playing tones at different pitches and volumes until you identify the one that most closely resembles your tinnitus. While not always perfectly accurate (tinnitus can be hard to match), this information can be useful for treatment planning and for tracking changes over time.
OAE testing measures sounds produced by the outer hair cells of the cochlea. A small probe is placed in the ear canal and plays sounds; healthy outer hair cells produce a faint echo in response. Reduced or absent OAEs suggest outer hair cell damage. This test is quick, painless, and does not require your active participation.
You will likely be asked to fill out one or more standardized questionnaires that measure the impact of tinnitus on your life. The two most common are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). These provide a numerical severity score that helps guide treatment decisions. See Tinnitus Severity: How It's Measured.
Not everyone with tinnitus needs imaging, but your doctor may order an MRI or CT scan if there are red flags such as unilateral tinnitus, pulsatile tinnitus, or accompanying neurological symptoms. MRI is commonly used to rule out acoustic neuroma.
In some cases, blood tests may be ordered to check for conditions that can contribute to tinnitus, such as thyroid disorders, anemia, or vitamin deficiencies.