This article is from the Tinnitus FAQ, by email@example.com (Mark Bixby) with numerous contributions by others.
The following flowchart from the Cecil Textbook of Medicine, 1992 (19th
ed.), W.B. Saunders, shows the logic for diagnosing the common causes of
tinnitus (note that this chart omits some causes such as TMJ disorders):
ear exam--->(audible sounds)-+-->sync w/respiration--->patent eustachian tube | | | +-->sync w/pulse--->aneurysm, vascular tumor, v | vascular malformation, (no audible sounds) | venous hum | | | +-->continuous--->venous hum, acoustic emissions v neurological exam-->(normal)-->audiogram | | | +-->normal--->idiopathic tinnitus | | | +-->conductive hearing loss v | | (brain stem signs) | v | | impacted cerumen, chronic | | otitis, otosclerosis v | multiple sclerosis, +-->sensorineural hearing loss tumor, ischemic | infarction v BAER test | v +---------+--------------+ | | v v abnormal (neural) normal cochlear | | v v acoustic neuroma noise damage other tumors ototoxic drugs vascular compression labyrinthitis Meniere's Disease perilymph fistula presbycusis