Tinnitus Testing: How It Works

Two pieces of hearing assessment equipment hanging on the wall of a doctors office.

Most people experience some sort of ringing sensation in their ears from time to time. If this ear ringing is only occasional, does not last long, and does not impede your normal activities, it is probably nothing to worry about. However, when the sound is present all the time, you may be experiencing tinnitus. Not only is tinnitus disruptive enough to interfere with your normal activities, but it could also be a symptom of a potentially serious underlying condition.

A hearing test to measure tinnitus and determine the cause is the first step in an effective treatment plan.

Testing for Tinnitus

It is important to know tinnitus is not something that you just have to live with. It may be possible to manage or treat it. If experiencing tinnitus, the first thing you should do is talk with your doctor. Your primary care physician will often refer you to an audiologist, a doctor who specializes in treating conditions of the ears. Tinnitus often happens in the setting of hearing loss, although this is not always the case. Therefore, the audiologist will probably perform a pure-tone hearing test to confirm or rule out any loss of function.

The test takes place in a soundproof room. You will wear earphones that play sounds into one ear first and then the other. The sounds are different frequencies and volumes, and you indicate to the audiologist when you can hear them by raising a hand. Your results are compared with normal results for your age group, which determines whether you have hearing loss and to what degree.

Depending on what is causing your tinnitus, the audiologist may be able to hear it too. For example, if you hear a rushing sound due to a vascular deformity or a clicking sound from muscle contractions resulting from TMJ disorder, your audiologist may be able to perceive these during your physical examination. Usually, however, tinnitus is a subjective sensation that only you can hear.

However, that does not mean that tinnitus is not measurable. An audiologist can perform specific assessments, both subjective and objective, to determine how your tinnitus affects your hearing and your life in general.

  • Primary Functions Questionnaire: Measures how tinnitus affects areas of your life such as hearing, thoughts and emotions, concentration, and sleep
  • Speech Audiometry: Also called a speech recognition test, this test measures how well you understand spoken words
  • Otoacoustic Emission Testing: Measures the movement of hair cells within the inner ear using very sensitive microphones. Damage to the hair cells can cause them to send signals to the brain when no sound is present, causing tinnitus.
  • Acoustic Reflex Testing: Involves exposing you to loud noises and measuring the contraction of the muscles in your inner ear.

Treatment for Tinnitus

Sound Masking

A common treatment for tinnitus is sound masking. Tinnitus is often at its worst in a quiet environment, so sound masking involves playing other noises to stop you from perceiving a ringing in your ears. Testing of the loudness discomfort level helps to identify whether you are a good candidate for sound masking therapy by measuring the volume at which external sound makes you uncomfortable. Minimum masking level testing identifies the lowest volume at which external sound covers your tinnitus. Both are valuable for devising an approach to treatment.

Other Common Tinnitus Treatments

Treatment for tinnitus depends partly on when symptoms occur. If tinnitus disturbs you most at night when you are trying to sleep, your audiologist may recommend a white noise machine for your bedroom. If tinnitus bothers you during the day, you may benefit from masking devices, which generate sound like white noise machines but are wearable devices similar to hearing aids. 

If your tinnitus occurs along with hearing loss, you may be fitted with combined tinnitus hearing aids with the capability to generate sound to mask tinnitus while amplifying external noises to help you hear better.

Treatments such as these may be effective when the underlying cause of the tinnitus is unidentifiable or not treatable. Otherwise, when the underlying cause is resolved, tinnitus may go away on its own.



Tinnitus – Mayo Clinic

Measuring Tinnitus – American Tinnitus Association

Causes of Tinnitus – Happy Ears Hearing Center

Tinnitus and Hearing Aids – British Tinnitus Association