What Happens at Your First Tinnitus Consultation

1. Case history (10 to 15 minutes)

We ask about the sound itself: ringing, buzzing, hissing, pulsing, or something else. We ask when it started, whether it is in one ear or both, whether it is constant or comes and goes, and what makes it louder or quieter. We ask about noise exposure history, family history, medications, head or neck injury, jaw problems, ear infections, and how the tinnitus is affecting your sleep, work, mood, and relationships. The goal is to understand your tinnitus, not just measure it.

2. Validated tinnitus questionnaires (5 to 10 minutes)

You complete two short standardized questionnaires: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). These are the same instruments used in every major tinnitus clinical trial. They turn a subjective experience into a score we can track and compare against your future visits, so you can see whether treatment is helping.

3. Ear exam and middle-ear testing (10 minutes)

Otoscopy to check the ear canal and eardrum, plus tympanometry to check middle-ear pressure and eustachian tube function. This rules out simple mechanical causes like wax impaction or fluid behind the eardrum.

4. Diagnostic hearing test (20 to 25 minutes)

A full pure-tone audiogram covering standard frequencies plus the extended high frequencies (above 8 kHz) where tinnitus-linked hearing loss is often hiding. We test each ear with headphones and with a bone conductor. We measure your comfortable and uncomfortable loudness levels so we know how sensitive to sound your ears are. When indicated, we add speech-in-noise testing to measure how well you understand conversation in a noisy room.

5. Tinnitus pitch and loudness matching (10 to 15 minutes)

This is the part most patients have never had done. We play tones and noise samples into your ears and match the pitch, quality, and loudness of your tinnitus. We measure the minimum masking level (how loud an outside sound needs to be to cover your tinnitus) and residual inhibition (whether the tinnitus quiets down for a few seconds after masking stops). These numbers directly guide which treatment is likely to help you.

6. Treatment plan review (15 to 20 minutes)

We sit down with you and walk through what the testing showed and which treatments fit your profile. Depending on your results, this may include:

• Lenire bimodal neuromodulation — an FDA-cleared 12-week home treatment for chronic subjective tinnitus. Best for patients whose tinnitus is stable, moderate to severe, and not solely caused by another treatable medical condition.
• Prescription hearing aids with a tinnitus program — when hearing loss is contributing to the tinnitus, hearing aids often reduce the perceived loudness dramatically. Many patients report their tinnitus becomes background noise they no longer notice.
• Tinnitus retraining therapy (TRT) — a structured counseling-plus-sound protocol that trains the brain to stop reacting to the tinnitus signal.
• Sound therapy — customized masking sounds, notched-music therapy, or bedside sound machines for patients whose tinnitus is worst at night.
• Referral pathway — for tinnitus that has vascular, medical, or psychological drivers we do not treat in-house, we refer to trusted local ENT, cardiology, or mental-health partners.

You leave with a written plan and a written price. You do not have to decide the same day.