Tinnitus examination by an ENT to diagnose treatable conditions like middle ear infection, acoustic neuroma, concussion, otosclerosis, etc. Evaluation of tinnitus will include a hearing test (audiogram), measurement of acoustic parameters of the tinnitus like pitch and loudness, and psychological assessment of comorbid conditions like depression, anxiety, and stress that are associated with severity of the tinnitus. The accepted definition of chronic tinnitus, as compared to normal ear noise experience, is five minutes of ear noise occurring at least twice a week. However, people with chronic tinnitus often experience the noise more frequently than this and can experience it continuously or
Tinnitus retraining therapy with tinnitus have a comorbid psychological injury or illness (e.g., post-traumatic stress disorder, depression, anxiety, obsessive compulsive disorder, stress, dysfunction of the temporomandibular joint, etc.) that can exacerbate the tinnitus. It has been proposed that tinnitus is caused by mechanisms that generate abnormal neural activity, specifically one mechanism called discordant damage (dysfunction) of outer and inner hair cells of the cochlea. The psychological basis for TRT stems from the fact that the brain exhibits a high level of plasticity. In turn, this allows it to adjust to any sensory signals as long as they do not lead to negative effects.