Hidden Hearing Loss and Tinnitus

Here's an explanation, or rather, a hypothesis, that explains why some people sometimes have a "perfect audiogram" and think they don't have any hearing loss, yet they have Tinnitus.

Roland Schaette talks about tinnitus research...

 

Apparently yes, once input has been restored T and H reduces as a result.

They theorise this as it's the case for people with wax impactions, osteoporosis I think it's called and various other hearing ailments.
Once the underlying cause has been treated people's T usually goes down as a result or even disappears completely.

 

I would imagine so, when I first developed H in 2014 I had insane Tonic Tensor Tympani spasms from every little sound that happened.
Once my ears healed and my H and T reduced so did my spasms along with it to the point that I no longer had them unless I was exposed to a very loud sharp noise.

When my H severely worsened in March it was the same story all over again, my dogs nails on a wooden floor would cause my ears to thump from the sound but as it improved a little over the next few months the spasms or thumps began disappearing again.

It's without question in my opinion that once the damage has been repaired these spasms dissappear too, it's happened with me twice now.

 

An interesting article, easy to understand:
http://www.canadianaudiologist.ca/issue/volume-4-issue-6-2017/bridging-the-gap-feature/

 

I think central gain hypothesis makes the most sense to explain everything because I can hear (what I assume) is my nervous system every so often or doing certain activities.

 

I agree.

I underwent a visual evoked potential this summer. With electrodes placed on my head, I sat inside a windowless room and halfway through the test commented on how odd the thunder sounded outside. The doctor administering the test laughed and told me that the sound of thunder was actually my muscles moving. So I moved my arm, and sure enough the electrodes picked up the sound which was identical to the low rumble of thunder. I was kind of fascinated so the doctor let me test out movements. He said that everything happening inside our bodies makes noise, that if we could hear inside ourselves we would probably be shocked. I asked what nerves would sound like, he said very high pitch.

A few months later I saw a highly ranked ear specialist and was asking random tinnitus questions (why does my ear sometimes seem to click, why does the noise sound different if I move my jaw, etc.). He told me that we have different types of ear hair cells, some that help us hear external noises and some that prevent us from hearing internal noises. Our brain helps with this filtering as well. A possible theory is that whether or not we hear tinnitus depends on which type of hair cells are damaged.

It could very much be that we’re hearing internal nerve noise.

 

I've spammed this video about hidden hearing loss a million freak times, lol.

Central gain explains why people with all sorts of different hearing loss have tinnitus and the abnormal loudness discomfort.

It explains personally why I hear my nervous system buzzing at times.

Still there are missing pieces of the puzzle on what tinnitus does once it leaves the auditory brain and how long of a therapeutic window would exist for hearing restoration?

 

The 4th of July is coming up and lots of people are going to be shooting fireworks here in the US.
Get hearing damage, tinnitus, pass the ol 0-8000hz, sign up for this forum claiming no hearing loss.

 

Missed Hearing Loss in Tinnitus Patients with Normal Audiograms

Highlights

Notched hearing loss was detected in 49% of the tinnitus patients with normal audiograms at their tinnitus frequencies.

The notched hearing loss of some patients may be induced by dysfunction of OHCs who showed notches on their DPOAE tests.

Tinnitus patients showed notched hearing loss with normal DPOAEs may be due to the lesions in IHCs or postsynaptic structures.

The fine step frequency audiometry improved detection of missed hearing loss over conventional audiometry in tinnitus patients

ABSTRACT
The prevalence of tinnitus is positively correlated with hearing loss, although, tinnitus can also present alongside clinically normal pure-tone thresholds. As standard pure tone audiograms (PTA) only sample at octave or inter-octaves, they potentially can miss lesions between the tested frequencies. Here we investigate if tinnitus patients with normal audiograms have hearing loss missed by standard PTA testing, referred as “missed hearing loss” in the paper. Hearing thresholds in 106 tinnitus patients who have a normal PTA were tested using fine frequency resolution (1/24 octave step) audiometry, referred as precision PTA (P-PTA), at ±1/3 octave band centered at their tinnitus frequencies. Tinnitus pitch, loudness and residual inhibition were evaluated based on the result of P-PTA. DPOAEs were also tested to evaluate the function of outer hair cells (OHC). Using the P-PTA test, we found that 49% (52 out of 106) of tinnitus patients with normal audiograms showed sharply notched hearing loss and most of the notches were at their tinnitus frequencies. Using a fine frequency step (1/24 octave) to assess tinnitus pitch, the successful matching rate increased to 84%, significantly higher than the rate measured in traditional method (51%, Fisher’s test, P < 0.0001, n = 106). The number of patients whose tinnitus loudness was less than 5 dB SL increased from 26% to 55% after the loudness reassessment based on the tinnitus pitch match (n = 106, Chi-Square test, P<0.01). The percentage of patients who showed positive residual inhibition of tinnitus also increased from 31% to 54% (Chi-Square test, P<0.05). DPOAEs revealed significantly reduced OAE amplitude in the tinnitus patients, suggesting that OHC dysfunction may contribute to their notched hearing loss. However, in 13 out of 31 patients with notched hearing loss, their DPOAE did not show any reduction which suggests that their notched hearing loss may be induced by the dysfunction of the inner hair cells or afferent synapses (synaptopathy). Our study confirmed hidden cochlear impairments in tinnitus patients with seemingly normal audiograms. We conclude that P-PTA can help identify a mild hearing impairment that may otherwise be missed by conventional PTA and that P-PTA can also improve tinnitus evaluation accuracy.

Source: https://www.sciencedirect.com/science/article/pii/S0378595519300760