On the occasion of the medical consultation, the doctor tries to objectify the tinnitus, the inconvenience caused, to know their frequency (acute, severe ...) and their intensity. In addition to the general practitioner, we may need to consult a specialist: an ENT doctor.
An examination of the ear with an otoscope makes it possible to visualize a possible pathology of the external auditory canal (a plug of cerumen, an otitis externa, ...); it also allows to see the state of the eardrum and to diagnose a possible dysfunction of the Eustachian tube due for example to otitis media (or serous otitis or tubal catarrh) seeing an abnormal eardrum, dull or lesion.
A tympanometry can be done to objectify the compliance of the eardrum, that is to say its ability to vibrate under the influence of pressure variations. This examination looks for a tubal dysfunction: if the pressure is high behind the eardrum (because of an inflammation for example), it will tend to burrow in the external auditory canal, if the pressure rises in the duct external auditory, it will be little mobile, which is not normal.
An audiometry is often performed to measure possible deafness associated with tinnitus, to measure the frequency that is reached, to quantify its severity as well as to determine its origin: deafness of transmission where the structures in question are the outer and middle ear, or deafness of perception if the affected structures belong to the inner ear, the auditory nerve or the auditory area.
Other highly specialized tests may be required to correlate tinnitus intensity with the importance of hearing loss.
Auditory evoked potentials are made when the doctor suspects neurological damage, in particular a tumor of the auditory nerve (acoustic neuroma) for example or an attack of the inner ear.
If the results are positive, an MRI will be requested to confirm the diagnosis.
Despite a consultation with a medical specialist, and various examinations, it happens that no cause is found.