The contribution of otoneurological evaluation to tinnitus diagnosis

Tinnitus has been reported for nearly 80% of patients referred to the otolaryngology services. Usually, its evaluation is based on tonal and vocal audiometry, tympanometry, brainstem-evoked potentials, electrocochleography, and otoacoustic emissions. However, as the cochleovestibular system works as a unit, the use of vestibular tests has been proposed to evaluate tinnitus. Many patients with tinnitus have altered vestibular test results even in the absence of vestibular symptoms. This finding accounts for the indication of complete vestibular and audiological evaluation of tinnitus. The aim of this study is to analyze the contribution of otoneurological evaluation in the diagnosis of tinnitus. Patients were selected and divided into two groups. Group 1 was composed of patients complaining about tinnitus only, whereas group 2 was composed of patients with tinnitus associated with dizziness, hearing loss, and fullness. All submitted to otoneurological evaluation based on directed clinical history, physical examination, tonal and vocal audiometry, tympanometry, and vestibular examination. A total of 195 patients were analyzed. The otoneurological evaluation was conclusive in the diagnosis in 48 cases (75%) in group 1 and in 94 cases (72%) in group 2. The present study showed that otoneurological evaluation contributes to the etiological diagnosis of tinnitus.