Audiologic clinical assessment

Keypoints 1. Tinnitus may be the symptom of many different disorders. An accurate assessment of a patient’s history, symptoms, and signs is important to establish a correct diagnosis. The tinnitus handicap inventory (THI) and the visual analog scale (VAS) are very useful tests to evaluate the handicap caused by tinnitus and the entity of tinnitus, respectively. 2. An objective assessment of ear, head, neck, and temporomandibular articulation should be performed. 3. Pure-tone audiometry (the frequency range from 125 to 16 KHz), tympanometry, acoustic middleear reflex testing, speech recognition threshold testing, and speech discrimination tests help determine the type of hearing loss and the status of the middle ear. 4. Otoacoustic emission (OAEs) testing allows for precise evaluation of the outer hair cell function. 5. Acufenometry is performed to determine pitch and loudness of tinnitus by defining minimum masking levels (MMLs), loudness discomfort levels (LDLs), and the residual inhibition. 6. Auditory brainstem responses (ABR) are used in selected patients for further evaluation and exclusion of disorders such as vestibular schwannoma. Electrocochleography (ECochG) is used in order to evaluate the electric phenomena of the inner ear.