Tinnitus is a symptom of an underlying disease or a disorder.

Sometimes it may be without any specific cause. In these cases it is termed “idiopathic tinnitus”.

In most people tinnitus means hearing low pitched background noises or sounds even when there is no such sound in the environment.

When does diagnosis of Tinnitus occur?

If the symptom does not cause annoyance or difficulty in concentration or sleep, most sufferers do not visit the physician.

However, help of a health care provider maybe sought if the symptoms cause disturbance of daily activities or if the symptoms point towards a disease deeper than apparent.

Who carries out diagnosis of Tinnitus?

Diagnosis and treatment is usually under the care of an ENT surgeon or otolaryngologist (dealing with Ear, nose and throat diseases) (1)

Initial assessment of Tinnitus

Initial assessment includes a complete history assessment of the patient. The health care provider will ask questions like (1) –

• What type of noise is heard?
• Is it in one or both ears?
• Is the noise rhythmic or throbbing?
• Are there any other symptoms?

Physical examination

A detailed physical examination will be performed.

Some causes such as hypertension, anemia and so forth may be detected on physical examination.

Tests for detection of underlying causes of Tinnitus

Some tests may be prescribed to detect underlying causes of tinnitus.

These tests includes (1, 2, 3, 4) –

• Tests to assess hearing loss. These tests are called audiology or audiometry.
• CT scan images of the brain. This is done to assess the disease process in the brain
• An MRI scan of the brain also shows in detail the disease process, tumor or aneurysm that may be causing the tinnitus
• An angiography is a blood vessel study that looks for aneurysms or blood vessel abnormalities.
• An X-ray of the head may also be prescribed if a CT scan or MRI is not possible.

  Tinnitus may also be caused due to abnormality of the jaw joint or Temporomandibular joint. This may be examined on an X ray.

• Balance tests may be performed to check the performance and functions of the cochlea in the inner ear. Cochlea is responsible for maintenance of the balance.
• A spinal tap or lumbar puncture may be performed to assess the cerebrospinal fluid or CSF. The CSF bathes the brain and the spine.

  If tinnitus is caused due to a brain tumor or other brain pathology, a spinal tap of CSF may provide clues to the diagnosis.

• An Auditory Brain Stem Response or ABR is sometimes prescribed. This is a computerized test that looks at the nerve pathways that connects the brain with the ear.