Treatment of difficult cases of deafness and tinnitus, especially in patients with long-term deafness and tinnitus, must first identify the site of origin of the deafness and tinnitus, and then search for the cause of the condition. In general, the examination and evaluation of the cause of deafness and tinnitus is complex and time-consuming. The audiological examination usually includes several electrical audiometry tests to determine the baseline curve (because pure tone hearing is affected by many factors such as the patient’s emotion, cognitive level, instrument performance and the operation of the testing technician, the hearing curve has a characteristic of fluctuating, and if the pre-treatment hearing level is not accurately evaluated, it will cause a lot of confusion and misjudgment in the evaluation of the efficacy after treatment. Therefore, the baseline curve), auditory brainstem potential (ABR), multi-frequency steady-state evoked response (ASSR), otoacoustic emissions, and acoustic conduction pit test (tympanogram and stapedius muscle reflex) must be determined prior to treatment. Etiologic evaluation also needs to be performed optionally depending on the patient and may include enhanced scans of the inner ear canal and pontocerebellar horn region, blood biochemistry, immunology, and endocrine testing to maximize confirmation of the etiology and the presence of a pathologic basis in vivo. Until the cause is clearly identified, there is no talk of responsible treatment at all. In some patients or in specific cases, it may be necessary to treat while examining or treat while examining: initial identification of the lesion site by testing, further testing to explore the cause by observing the initial treatment response, followed by adjustment of the previous treatment based on the possible causes detected, and finally the elaboration of an individualized treatment plan.