I am an otolaryngologist. Tinnitus is a very common problem and rarely serious. We worry about one sided more than two and pulsatile tinnitus is more concerning. The book answer is for scanning pulsatile tinnitus but my 25 years of experience (and the same for my partner) is that we find something a lot less than stated rates for the diagnosis. A hearing test with air lines, bone lines , and word discriminations is the bare minimum. If it’s symmetric and word discrims ok, generally don’t work up anymore. Pulsatile is a different can of worms. Still usually don’t find a cause. Put pressure on the jugular vein and see if it goes away for the person with it, if so, likely a venous hum. Once in awhile you find aneurysm, dehiscence at skull base, or gloms tumor. Not every year in a general,ent practice.
I have had high freq hearing loss since grade school. Luckily not very progressive. My hearing has probably saved me 10,000s in chasing the next best thing. I’m happy with my Ascend’s and luxman and still, a sucker for the monster receivers I wanted and couldn’t afford as a kid. No medications help in studies and academy does not recommend medications. I have some people on low dose elavil and they feel it helps. It may be so if I gave them chicklets too.
I have had high freq hearing loss since grade school. Luckily not very progressive. My hearing has probably saved me 10,000s in chasing the next best thing. I’m happy with my Ascend’s and luxman and still, a sucker for the monster receivers I wanted and couldn’t afford as a kid. No medications help in studies and academy does not recommend medications. I have some people on low dose elavil and they feel it helps. It may be so if I gave them chicklets too.