Improper Diagnosing of Tinnitus, High-Frequency and Hidden Hearing Loss

Hello! If you are frustrated by your health care providers telling you "everything looks fine" after looking at your audiogram or making you listen to a tuning fork, then sending you home without a more in-depth explanation, you might want to give their diagnosis a second thought. Perhaps they left out some tests that are showing to be useful in the proper diagnosis of tinnitus.

According to research both older and newer, testing frequencies beyond 10kHz is necessary for obtaining useful information for tinnitus patients who report higher frequency pitches. Drawing conclusions based on audiograms that only show typical speech frequencies up to 8kHz is inadequate and leads to higher rates of "idiopathic" diagnoses, and is leaving out the opportunity to collect important data for research on tinnitus and hearing loss.

You may want to print out a copy or email this to your audiologist, ENT, or even general practitioner to update their knowledge (which may require updating):


"Best-Practices" Flowchart of Tinnitus Diagnosis and Management:
https://www.tinnitusresearch.net/index.php/for-clinicians/diagnostic-flowchart


Extended High Frequency testing:
https://journals.lww.com/thehearing...=2017&issue=03000&article=00008&type=Fulltext

The above article contains relevant research justifying the need for ENT and Audiology clinics to utilize audiometry that ranges between 8kHz all the way up to 20kHz, and contains strategies and suggestions for dealing with concerns of repeatability and testing duration.

Audiometer headphones for good repeatability:
https://en-de.sennheiser.com/audiom...-testing-closed-dynamic-ear-protector-hda-300

Tinnitus and Range of Frequency Loss:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438350/

Although the conclusion of this particular research project said that the exact (or close approximation) frequency of tinnitus wasn't significantly correlated with the edge of the high-frequency loss, it was reported that patients had tinnitus frequencies that were higher than the edge of the hearing loss on the audiograms. This shows that we can at least get some useful information through extended high-frequency audiometry. Newer research is expanding upon these findings mentioned below.

Hidden Hearing Loss:
http://canadianaudiologist.ca/issue/volume-5-issue-2-2018/hidden-versus-not-so-hidden-hearing-loss/

The above article suggests that "speech-in-noise" tests are more useful than typical pure-tone audiometry (only going up to 8kHz) for diagnosing problems of hearing in noisier, social environments. "Threshold assessment at high frequencies (from 10k - 20 kHz) should be considered for inclusion in test batteries when patients report difficulties understanding speech-in-noise despite audiometrically normal thresholds up to 8 kHz. Although there are no clear causal relationships between high frequency hearing and speech-in-noise test performance, high-frequency hearing loss in relatively more noise-exposed participants has been reported by multiple teams (citations 33,36,37) and may be one of the first changes among long-time users of personal audio systems.(75)... Empirical data are needed to assess this specific suggestion, and determine the strength of any potential relationships between high-frequency hearing and speech-in-noise performance. Regardless, documentation of deficits to the high frequency regions of the cochlea will provide a tool for counseling patients on the importance of protecting their ears from loud sound to reduce the risk of further damage."

 

Nicely researched and written. Thank you for your contribution.

Here is a little video I put together on this subject.

Playlist: Tinnitus Questions Answered

 

Show them the research by Liberman and Kujawa on hidden hearing loss that's a fun way to tell your local ENT is wrong.

 

I honestly don't give a crap anymore. I'm not a doctor. I have no way of helping to find a cure in any way other than being a lab rat in an experiment. I just want the government to step in and fund research on curing diseases, especially tinnitus. Instead they spend waaaaaaay to much money on weapons and welfare for people that don't want to work. TBH I hate this world. If they would fund research on curing diseases instead of blowing it all on missiles and bombs then we could probably cure 99% of disease. BUT NOOOOOOOOOOOOO. Bombs and war kill the terrorists.

 

I have tinnitus partly from a chiropractor jamming this two pronged nerve thermometer into my spine and hurting me so bad I got hooked on ototoxic BC powders and then that and sorta loud music screwed my ears. My life is almost ruined now.

I am almost positive that he was trying to purposefully hurt me so I would feel like I needed to come back for his 30 visit treatment program he was trying to sell me on. What's worse is that he sat right next to me in Church, and was well loved and respected by the congregation and the pastor so if I said anything about it then I would instantly be labeled a liar and possibly sued for slander. I just quit the Church instead. I'm so sick and tired of this. I just want my life back.

 

Wow John, that sounds terrible. As a chiropractor and a Christian, and, well, just as a person, I am truly sorry for your suffering. That seems like it was a miserable experience that continues.

 

Tbh the love of my wife and son and my faith in Christ and absolute knowledge that everything will be reconciled in eternity is what gives me strength to endure. My T isnt that bad all the time, it is sometimes though and makes work more difficult. At least I get good sleep and I get days when it's almost gone. Today was not one of those days. It is just a small taste of the curse of death that is on all of us and a result of sin. A real eye opener for sure. May Jesus hasten His return, Maranatha!

 

Oops, the video I showed above is not relevant, it was just the beginning of the playlist of videos. Here is the one I meant to show:

Can “HIDDEN” Hearing Loss Cause...

 

dude, if you think you can help me, I'll fly out to your practice and let you put your hands on me. I'm willing to try anything. My tinnitus sounds like castrati diamonds slicing through glass. Like an electromagnetic dog whistle. Sometimes it's basically gone, other times, it's not.

 

Most people are able to help themselves fairly effectively for less than it costs to even pay for the flight.

What I would recommend is to get your Tinnitus Recovery Score, for free, here: https://tinnitussynergy.com/ . The score interpretation will be emailed to you and will let us know if you can be helped. Then it is a matter of choosing your approach.
(I have a video explaining the Tinnitus Recovery Score, but I can only give the link by request, since it does promote my program.)

 

High Frequency Audiometry and its importance for the hearing loss early diagnosis.