Tympanophonia can be a consequence of a variety of diseases and pathological conditions diagnostics of which encounters difficulties. The comprehensive clinical examination of the patient is necessary to determine the cause of tympanophonia including elucidation of the following characteristics: initial (acute or gradual) sensation of sound in the ear(s), duration of persisting clinical manifestations, the presence of an acoustic or craniocerebral injury, characteristics of the noise, viz. continuous or intermittent, clicking sounds, paroxysmal or pulsed noise (synchronous with the heart beating), fluctuating, audible to the patient alone or to the surrounding people as well, unilateral and bilateral noises (either symmetric or asymmetric), perception of noise in the head rather than ears., high- and low-pitched noise together with the accompanying neurological symptoms. The analysis of these characteristics makes it possible to differentiate between objective and subjective sensation of noise in the ear(s), determine the amount of additional studies needed for the evaluatio of the conditions of a given patient, identify the possible cause of tympanophonia, establish the nosological diagnosis, and distinguish a group of the patients in need of emergency otological management.