Tinnitus Diagnosis: Audiometry, EMG, and Screening for Otological Causes and Hearing Loss

Tinnitus, or tinnitus, is an auditory perception without an external sound source, affecting a significant number of patients who seek otolaryngology services. The diagnosis of tinnitus is a complex process that requires a thorough evaluation to identify its underlying causes, which may be of otological or neurological origin. Audiometry and otoneurological evaluation are fundamental tools in this process, allowing for hearing loss screening and the identification of possible otological causes.

Diving Deeper into Tinnitus Diagnosis

Audiometry is an essential test in the evaluation of tinnitus, as it determines the patient's auditory threshold and detects any associated hearing loss. Studies have shown that audiometry, along with tests such as electrococheography and vestibular evoked myogenic potentials (VEMP), are useful for assessing cochlear and vestibular function, respectively.

The otoneurological evaluation is complemented by vestibular tests, as the cochleovestibular system functions as a unit. Research has shown that many patients with tinnitus exhibit abnormalities in vestibular tests, even in the absence of evident vestibular symptoms. This suggests that a comprehensive evaluation, including both audiological and vestibular tests, is crucial for an accurate etiological diagnosis of tinnitus (see study).

Additionally, conditions such as Meniere's disease and Fabry disease can manifest with tinnitus and sensorineural hearing loss, highlighting the importance of a comprehensive diagnostic approach that considers both auditory and neurological factors.

Conclusions

The diagnosis of tinnitus requires a multidisciplinary approach that combines audiometry with a detailed otoneurological evaluation. Identifying the underlying otological and neurological causes is essential for the effective management of this condition. The integration of tests such as tonal audiometry and vestibular assessments can significantly enhance diagnostic accuracy and ultimately improve the quality of life for patients affected by tinnitus.

Referencias

• [1] The contribution of otoneurological evaluation to tinnitus diagnosis.
• [2] Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of Ménière's disease.
• [3] Prevalence of Fabry disease in men with tinnitus and sensorineural hearing loss.
• [4] Translabyrinthine vestibular neurectomy and simultaneous cochlear implant for Ménière's disease.
• [5] Hearing impairment and tinnitus pitch in patients with unilateral tinnitus: comparison of sudden hearing loss and chronic tinnitus.

Created 6/1/2025