Measurement of tinnitus in humans

Little quantitative measurement of tinnitus was possible before the development of the electric audiometer. Since then many ingenious attempts have been made to simulate the phenomenon. Frequency and masking measurements were described first in 1931 by E. M. Josephson and also by R. L. Wegel, and techniques involving loudness balance, free-field matching and taped sound effects have also been used. More accurate measurement of frequency content can be made by means of music synthesizer. A tinnitus measurement protocol should include assessment of: (1) frequency content; (2) loudness; (3) masking characteristics; and (4) objective measurements. Loudness measurements relate to the annoyance caused by the symptom, which depends, too, on the patient's personality and disposition. Masking characteristics also relate to the loudness of tinnitus and give additional guidance about the suitability of making therapy. They are repeatable and easy to perform. Objective measurements, whether performed with a stethoscope or intrameatal microphone, may reveal vascular bruits or cochlear emissions. We must wait to see how representative are the newer objective measurements of the subjective complaint.