Tests, imaging & measurement

A difference between air conduction thresholds (through headphones) and bone conduction thresholds (through a vibrator on the skull). It means sound is being blocked before it reaches a working inner ear, which points at a mechanical and often treatable cause.

The competing audiogram rules that decide how big a difference in hearing between the ears should lead to an MRI scan for a vestibular schwannoma.

The chart produced by a hearing test, plotting the quietest sound you can hear at each frequency. It measures hearing, not tinnitus — no audiogram shows your tinnitus.

A dip in hearing at one frequency band with better hearing either side of it, classically around 4000 Hz after noise exposure. There is no standardised definition of one — expert reviewers agreed on whether a notch was present in only about 71% of cases in one study.

A test recording the electrical response as sound travels up the auditory nerve and brainstem, rather than the quietest tone you can detect. It can stay abnormal after hearing thresholds have recovered, which is why it is used to detect demyelination an audiogram misses.

The main US, UK and German tinnitus guidelines do not recommend a routine blood panel. Which targeted tests make sense, from thyroid and iron to syphilis.

Sound delivered by vibrating the skull directly, using a small oscillator behind or in front of the ear, so it reaches the inner ear without passing through the ear canal or middle ear. Comparing it against air conduction is what reveals an air–bone gap.

No single specialist treats tinnitus. When to see a GP, an audiologist, an ENT specialist or a psychologist, and which symptoms need same-day care.

The unit on an audiogram's vertical axis. It is not absolute loudness: 0 dB HL is the quietest level a young healthy reference ear detects at that frequency, so your threshold is the distance from that reference. Negative values are possible and simply mean better than average.

Not knowing what a tinnitus evaluation actually involves is a common reason people put it off. A practical walkthrough of what typically happens.

European radiologists have published when imaging is indicated for tinnitus and when it is not. The answer turns on two questions, and for most people the recommendation is no scan — which is not the same as being dismissed.

Tinnitus has no blood test, so trials measure it with questionnaires. What the two standard ones ask, what a score means, and how big a change has to be before it means anything.

Faint sounds the healthy inner ear produces on its own, recorded with a probe in the ear canal. They come from the outer hair cells, so their presence or absence says something about those cells specifically rather than about the whole hearing pathway — which is why the test appears on reports alongside an audiogram rather than instead of one.

Serial hearing tests before, during and after treatment with drugs that can damage the inner ear, and the scales used to grade any change they find.

Swelling where the optic nerve enters the eye, seen by a clinician looking into it. It is the finding that establishes raised intracranial pressure, and it cannot be assessed without the right instrument.

Comparing your tinnitus against generated tones to describe its frequency. It depends on your own judgement on the day and is not an objective measurement.

The mean of your thresholds at 500, 1000 and 2000 Hz — the single number most hearing reports lead with. It averages away the shape of the curve, so a normal average can sit alongside a clearly abnormal audiogram.

The standard hearing test: tones at different pitches and volumes, with you indicating when you hear them. It covers a defined frequency range, so damage above that range can be missed.

The symbols, the numbers, and the part nobody explains — in 51,989 patients, the shape of the curve predicted whether tinnitus was the reason they came in.

A test of how well you understand speech, often against background noise. People can have near-normal tone thresholds and still struggle to follow conversation in a noisy room.

A 2025 study found pupil and facial-movement patterns predicted tinnitus severity. Why an objective test would change everything about treating it.

A self-report questionnaire that rates how much tinnitus intrudes on sleep, concentration, mood and daily life, built to detect change with treatment.

A self-report questionnaire that scores how much tinnitus disrupts daily life, from practical limits to emotional distress, rather than how loud it sounds.

What each tinnitus questionnaire measures, how it is scored, its severity bands and the change that counts: THI, TFI, TQ, Mini-TQ, TRQ, VAS and ESIT-SQ.

A measurement of how the eardrum moves under changing pressure. It assesses the middle ear rather than hearing itself.