Audiogram and Other Hearing Test Results

Our audiograms look very similar (2nd one).

Can I ask how old you are? Have you had any changes over the last 9 months?

 

Thanks for the reply!

I was really wondering if anyone had come across this kind of audiogram before. I have a low tone, around 900 Hz in my left ear that came on suddenly around 4 months ago. No fluid in ear but I have had a lot of mucus from my nose that I can’t seem to clear. This led me to get my hearing test and this was the result.

I’m 33, can’t think of any instances where I could have damaged my ears and the audiologist couldn’t give me a definitive reason for the result and resulting tinnitus, other than he didn’t think it was NIHL but that ETD could be the culprit.

Next stop an ENT?

 

Is the tinnitus you had previously in both ears higher pitched?

In this case I would recommend you to see an ENT. Usually ENTs know almost nothing about tinnitus and it's no use seeing them, but I think this kind of audiogram is unusual and can have causes that an ENT might know something about. Don't expect too much though, but I think it's worth a shot.

I'm in audiology school but we haven't really started looking at audiograms as they relate to specific pathologies yet. In a few months we will, I'll try to remember to show your audiogram as an example and ask my teachers what they make of it.

Any specific event that stands out 4-5 months ago? Virus infection, COVID-19 even? Any vertigo or balance issues?

 

Yes, the tinnitus I normally have is very high pitched - I’ve had it since a child and has never bothered me.

The new tone in my left ear is unusual in that it is much lower, almost a resonating sound much like a tuning fork rather then the continual hiss I’m used to.

I don’t have any memory of feeling particularly ill at all, just woke up one day feeling stuffy, no cough or other cold symptoms at all. I believe I may have caught covid-19 around February so a long time before the issue. I can’t recall any recent balance issues or vertigo either. I have had in the past but couldn’t say when - A long time ago, maybe over a year at least.

That would be great if you can remember this post, and, as it stands at the moment, from your understanding you don’t believe it’s NIHL or age related and is something middle ear related?

 

Based on the info I can find, it seems more likely to be ETD, otosclerosis, Meniere's, ETD, viral cause rather than noise induced hearing loss. NIHL almost always affects the higher frequencies first. Don't be worried by all these possibilities, they are just examples.

 

I'm 39 years old.

I'm now 11 months post-acoustic trauma. As for improvement, it's hard to tell, e.g. I don't remember exactly how loud my tinnitus was at all points in the past. It's also hard to tell if things have objectively improved vs. habituating. That all said, I think the % of days where my tinnitus is "very annoying" is definitely lower than it used to be. Today is one of those annoying days however.

 

Here are two audiograms taken a few months apart almost two years ago. I am 37 years old. When I wonder why my tinnitus is severe, I guess this is the explanation. Hearing loss was the main factor and antidepressants triggered it.

 

My right ear is so jacked.

My first audiogram is three weeks post my acoustic trauma:



This one is six weeks later:



I had another one four weeks later and all high frequencies are 25 dB or higher.

I had yet another one last week and I have 60 decibel losses in all low frequencies and 60 to 70 decibel losses in the high frequencies. FML. 1000 Hz is @ 20 dB loss. Audiogram looks like a circus tent.

 

This is pretty severe hearing loss in the normal speech/music frequency range. What antidepressants do you feel caused this? Most SSRIs are not considered to be ototoxic. They may increase tinnitus due to serotonergic stimulation, but they do not cause sensorineural hearing loss like NSAIDs, certain antibiotics and chemotherapy drugs.

 

Where have you learned this? The list of ototoxic substances by the ATA puts most of the SSRIs on there as potentially ototoxic, and most other sources I've read either cite this or say the same. Many here on the forum agree they are a potential source of danger, and some even cite them as causes.

I do believe it's very unlikely every single substance on there is dangerous, but SSRIs have not seemed like a "just in case" inclusion.

 

Hi Doug, I've had a lot of hearing loss over the years from clubs, firearms when I was younger from a lack of education on the topic. But something in 2017/18 seemed to take out about 20 dB. I used Advil daily for several months and also spent time in noisy South East Asia which probably caused this hearing loss. The hearing loss is the main issue and I guess the Effexor XR triggered the inevitable perfect electrical storm In my head. I hope you're doing well.

Love and respect,
Stu

 

Did your left ear stay above 20 dB? On your first audiogram the left ear looks pretty good.

twa

 

Yes. My left ear is at 10 dB basically across the board. Up to 5 dB at 8 kHz.

I had a bunch of earwax removed after the first audiogram in that ear which seemed to make everything good again. It improved more after the 2nd audiogram as well but I have no issues on the left, just the right side.

I'm down to a 70 dB loss now though at 6 kHz and 8 kHz. Lower frequencies are a little worse too if I recall correctly.

I took high doses of SSRIs for years and never noticed any issues but who knows.

 

That's great! Your left ear seems to be in good shape, you have really good hearing even at the high frequency. That is where I have a dip, still normal but a dip. Hopefully, there will be a regenerative therapy that can help in the near future.

 

If I could get rid of this roaring I think I could function. It's been so bad lately. It's been waking me up so much. I've slept maybe two hours in the last three days.

 

I can imagine that would be rough. Praying things calm down for you and you can get some much needed rest.

twa

 

Hi,

I had a hearing test and the results came back.

Is it normal that I have in my left ear a dip because of the beeping I hear in my left ear? The tones/beeps of the hearing test sound exactly the same as my tinnitus, so I did not know at some point if it was the test or my ears. What do my results tell?

 

I am 66 and have been diagnosed with "age-related" high frequency hearing loss. The medical term is presbycusis. Attached is my audiogram.

I would kill for some of your audiograms, which show pretty minor hearing loss. My high frequencies are pretty much gone. Weird thing is that I never even noticed that I had a hearing problem until my tinnitus started last Labor Day weekend. I have never had any problems hearing conversations in loud restaurants, or hearing the TV on low settings... no problems at all. And then boom. The ENT speculated a virus, but said viruses usually affect one ear a lot more than the other. My hearing loss is very symmetric.

 

Have you looked into hearing aids? They may help you.
Good luck!

 

Could I please have help with my audiogram?

I got this done a year ago by an audiologist. I only just got into my ENT who read through it. He was quite fast in the way he talked and I was overwhelmed and anxious so I missed key bits!

He said some things about the audiogram showing that the right ear has nerve cell deafness where it dips but the left ear doesn’t. He said the the nerve cell deafness in the left ear may just be to the same level of the right ear. And that the added loss on the audiogram may be, I think he said conductive? He looked in my ears and said something about the Eustachian tube in the left ear too. He told me to use Nasonex to support/fix the Eustachian tube in the left ear.

 

You have an "air bone gap" of 20 dB in your left ear at 4000 Hz. Without the conductive portion, your SNHL would be the same in both ears at that frequency. The blue bracket indicates where you could hear when they bypassed the middle ear with bone conduction and represents your "cochlear" hearing.

I'm guessing he noted the ear drum was distended or retracted which would be a sign of the Eustachian tube not being able to equalize pressure so he is assuming that's the cause.

 

Thanks FGG! This makes sense to what he was talking about.

What causes an air bone gap and is there anything other than Nasonex I can try to help it?

 

An "air bone gap" isn't a structural thing. It's a term/description of an audiogram finding where frequencies played over air (regular headphones) are heard softer than when frequencies placed adjacent to your temporal bone (you may remember they switched from over the ear headphones to something you placed next to your head directly during your audiogram).

When you audiogram shows an "air bone gap", it means that when you bypass the middle ear by letting sound vibrate through your skull instead of travel over the air into your ears, you hear better. So some of your hearing loss at that frequency isn't from the cochlea and that's the "gap". Treating that depends on the cause and your ENT has to assess and treat you for that.

 

I’m not sure what to do because my ENT just left it at that. He said there could be some kind of surgery they could do but it’s probably not worth it. But to me the gap between my left and right ear is the tinnitus. I don’t get tinnitus in my right ear. I recall the possibility of Eustachian Tube Dysfunction or ear bones.

Isn’t it weird that the conductive hearing loss trends with the sensorineural hearing loss?

 

It's not that it trends with the SNHL. It's that you also have SNHL and the effects are additive.

As far as Eustachian tube dysfunction treatment, the best person to answer that is the person who did the in person exam on you and your ears.

 

Nope, that's fairly common.

 

Thanks for the replies. This is very helpful. I am feeling more equipped to make the right questions when I go back in to the Doctor or another ENT.

I think I see now that the conductive loss could potentially be at 20 dB across the whole graph yet the SNHL is at the higher frequency.

What do I need to ask for to ascertain what is causing the conductive component? At this stage the ENT only really had a look in my ears - it was a very rushed appointment. I'm reading horror stories about degenerative causes of conductive hearing loss and now I'm just stressed.

An ENT is very hard to get into in my area and very expensive so the wait is exhausting. I wish I knew the right questions to ask at the time.

 

You mean, like otosclerosis?

You could ask your doctor to propose a plan to root cause your conductive losses. If you are worried about your middle ear bones, ask your doc about a CT scan.

 

I was told that mild (5 to 10 dB) air bone gaps are common, normal for everyone. You only have 20 dB of a gap at 4 kHz. Weirdly, when I was looking this up just now to independently verify it, I found this which not only agrees but says sometimes a 20 dB gap at 4 kHz can be normal too:

The Vanishing Air-Bone Gap - Audiology's Dirty Little Secret

Show this to your audiologist.

Also, most of your issue appears to be SNHL to me so I wouldn't stress as much about your conductive loss unless it starts changing. But get a further work up if your ENT recommends it.

 

Yes that is the one. I Googled, read the horror stories, and then convinced myself I had it. This is quite a normal process for me.

Thanks, I will do this.

I came across the 4 kHz air bone gap thing also while doing my Google spiral. In some articles it says 3-4 kHz which is interesting. The only reason I'm not sure about this is that tinnitus is only in my left ear and that is the ear that has the added conductive loss.

Thank you!