Diagnostic Approach to Tinnitus – A Basic Overview

In my brief article, “What is the diagnostic approach to Tinnitus?” I explained that a medical doctor can look at the pulsatile (or vascular) tinnitus, the characteristic ear-ringing sound you hear when you have exposure to loud noises or experience hearing loss over the years. In this, a physician can look for the following: earwax buildup, fluid in the ears or ear canal, a cochlea that doesn’t operate properly, or tumors on the eardrum or in the nose. The physician can also order audiometry or MRI testing to see where the problem originates. Based on the result of these tests, your physician may recommend a treatment plan including non-pulsatile anti-depressants (anti-depressants), neck or head supports, and even surgery to remove the tumor.

Diagnostic Approach To Tinnitus

The diagnostic approach to tinnitus works with the premise that tinnitus is actually a symptom of an underlying disorder. As such, the approach attempts to find the underlying cause of the problem and then provide treatment within that framework. This means that instead of examining the individual ear (as would be done in a Traditional Medical approach), the doctor looks into the ears of both the patient and their family and their friends. The result is a more encompassing examination that provides better overall results than a single year or a single case of tinnitus treatment.

Diagnostic Approach to Tinnitus

In addition to this approach, the physician also performs a physiological examination. The purpose of this exam is to ensure that the ear ringing is not being caused by an underlying problem, such as high blood pressure, diabetes, or circulatory problems. Oftentimes, only a visit to the otolaryngologist (ear specialist) is required. However, if there is further concern that the ear ringing is being caused by a medical condition, such as Meniere’s Disease.

How does this work?

During a routine appointment, your doctor will ask you a series of questions about your ear ringing. He or she will then perform a physical examination to assess your health. From here, the doctor can determine whether or not there is a possible underlying cause. Which in turn determines the best tinnitus relief option. This diagnostic approach is much more effective than other methods of assessing the severity of tinnitus, which tend to fail on a subjective basis.

If the doctor determines that you do have some sort of medical issue causing the tinnitus. Your treatment options will become narrowed down. For instance, if the underlying issue is something as simple as a sinus infection or the growth of bone tumors, surgical removal of the tumor is often an option. In less severe cases, pharmaceutical medications may be prescribed for you to take orally, or your doctor may recommend that you try over-the-counter noise maskers or other treatments such as therapy, counseling, or biofeedback. No matter what medication or treatments recommended, the ultimate goal of relief from tinnitus is the same. You want to get rid of the sounds you hear in your head.

Physical Examination

The diagnostic Approach to Tinnitus starts with a thorough physical examination. This includes a thorough examination of the ears. Which may include a speculum or audiogram to rule out the presence of ear wax or fluid build-up. Or checking the inner ear with an audiogram. The doctor will also look inside the ears, to check for infections, wax build-up, or other possible conditions. Sometimes, a hearing test is all that needed to rule out tinnitus.

Neurological Exam

The next diagnostic step is a neurological exam, usually performed by a trained professional, to check for neurological conditions. One of the most common neurological conditions is sensorineural hearing loss. Which can cause loss of sensation or difficulty with the nerves controlling hearing. There are several other causes of tinnitus such as noise damage, high blood pressure, Meniere’s disease, tumors in the ear, and more. Sometimes, even a serious injury can result in tinnitus. For this reason, a specialist may perform a neurological exam to rule out any serious underlying issues.

Blood Flow Within The Sinuses

The third step is testing the blood flow within the sinuses. Often, people suffering from rhythmic tinnitus report that they hear pulsing sounds within the ear or head. However, there may be nothing wrong with the blood vessels, if the blood vessels themselves are healthy. Sinus openings and infections can also result in pulsating sounds. So a physician may order a nasal examination to rule out any infections. In some cases, the pulsing sound may not originate from the sinuses at all, but from the ear. To detect this, the physician may use an audiogram to detect any abnormalities in the flow of sound through the ear.

The last diagnostic step is determining whether or not the tinnitus came from sinusitis or other problem. The most common tinnitus-causing problem is a nonpulsatile (non-tearing) vasculitis. Patients with this type of problem have hearing loss due to their inability to drain abnormally narrowed sinus passages. Sinusitis that does not cause hearing loss is classified as either a nonpulsatile (NVP) or a pulsatile (PVP).


One of the primary benefits of using the diagnostic approach to tinnitus is that it gives patients a way to know what’s causing their tinnitus in the first place. This will help them better treat it when it arises. Plus, it allows them to take steps to eliminate the tinnitus before it gets out of control and becomes very debilitating. Unfortunately, not all cases of tinnitus respond favorably to standard treatments. So it’s important to continue to follow your doctor’s orders and to always follow your hearing test results closely.

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