Can Someone Verify If I Have Subjective, Neurological, Somatic or Objective Tinnitus?

I have posted other threads describing my tinnitus. Not being an expert I am unsure. Despite having seen a dozen different ENT's.

I am 52, in pretty good shape physically, not overweight, athletic, no Diabetes, other than smoking, occasional caffeine (I drink de-caf), and a glass of wine now and then I am in pretty good shape for my age.

I have had a normal life, been around loud sounds, but nothing overwhelming, Had mild tinnitus after running a machine once in awhile that went away within hours.

Approx. July of last year, I acquired mild tinnitus. I was pretty busy at the time and was able to keep my mind off of it. Due to personal matters my stress levels increased significantly by October where the tinnitus was to the point of a nervous breakdown.

I went to numerous ENTs, all with mixed results (50% said I had borderline hearing loss 50% said I had mild hearing loss in the low decibels). All pretty much told me the same, there is no cure, wear hearing aids and it will go away or you will learn to live with it.

I was never given a formal diagnosis other than my tenittis is a result of hearing loss. I took an MRI, they probed and scoped and did all X-rays and all were fine.

I had some mild ear infections from swimming in my 20's, and 30's but again nothing severe.

My symptoms are constant 24/7 high pitch ringing (ringing is a poor verb, it's more like a ultra high frequency) in both ears. Since July, there have been only two times it has stopped for maybe 5 minutes. No reason, it just stopped suddenly, and I am not even sure it really stopped, maybe I just was in shock.

I do notice stress creates massive spikes. I suffer from insomnia so use 5 mg of Diazepam to sleep, I know a lot of people have a hard time sleeping with tinnitus, I don't, the Diazepam really helps. Lately I have been getting a lot more sleep than normal and see no improvement.

My question is:

Are the below classifications correct? Or are there more? And what type of tinnitus do I have?

The Four Different Types of Tinnitus:

1. Subjective tinnitus: The most common form of tinnitus. Subjective symptoms can only be heard by the affected individual are usually caused by exposure to excessive noise. This type of tinnitus can appear and disappear suddenly, and may last 3–12 months at a time. In some severe cases, it may never stop.
2. Neurological tinnitus: Usually caused by a disorder, such as Meniere’s disease, that primarily affects the brain’s auditory functions.
3. Somatic tinnitus: Related to the sensory system. This form is caused, worsened, or otherwise related to the sensory system.
4. Objective tinnitus: A rare form of tinnitus that may be caused by involuntary muscle contractions or vascular deformities. When the cause is treated, the tinnitus usually stops entirely. This is the only form of tinnitus that can be heard by an outside observer, and the only type that has the potential for a permanent fix.

 

Hi @mcgsmith2000.

I am surprised that you have been tested by more than one ENT doctor and they haven't been able to diagnose the cause of your tinnitus. Whilst they don't treat tinnitus they should at least be able to tell you with some certainty, whether there is an underlying medical condition within your auditory system that is causing it, as this is their area of expertise.

Tinnitus is often linked to one of the four main causes that you have listed, the most common being subjective resulting from exposure to loud noise. Regularly listening to audio through any type of headphones including earbuds and headsets, at too high a volume are the most common followed by exposure to other types of loud noise. If you are a regular user of the devices mentioned then it's likely you have noise induced tinnitus.

If your tinnitus isn't noise induced then it's likely caused by an underlying medical condition within your auditory system, which includes hearing loss, ETD, Meniere’s disease that you have mentioned; a host of other ailments within your auditory system could be responsible. This really needs to be investigated by a more skilled ENT doctor or Audiovestibular Physican. Once you get a diagnoses then the doctor can advise you on treatment.

If your tinnitus is noise induced then it's not something ENT doctors usually treat. In this case you should be referred to Audiology and see an audiologist that practices tinnitus and hyperacusis management. Various treatments are available that can include: counselling, sound therapy, hearing aids and medication. If your tinnitus is caused by hearing loss then hearing aid(s) can help, the audiologist should be able to advise. Stress which you have mentioned can also be linked to tinnitus, counselling combined with medication can usually help. Once stress is brought under control the tinnitus usually subsides.

All the best,
Michael

 

A few thoughts.

There are only two types of tinnitus: objective and subjective.

The other things are possible causes.

Meniere's is definitely not a neurological disease.