How to Know if You Have Permanent Tinnitus

Thought i would share how to find out if you have permanent tinnitus or not. The first test is the typical pure tone audiogram up to 8000 htz that almost every ENT will perform. If that has substantial hearing loss greater than 20 DB at one of the frequencies then that is likely to be a red flag.

So what about those of us with normal audiograms? Well the trick to this answer is that you can have a perfectly normal audiogram (with Normal hearing) however the cochlear damage that is resulting in your Tinnitus will appear very clearly on DPOAE tests. For those wondering what DPOAE means it stands for Distortion Product Otoacoustic Emissions. The test will will show near exact proximity to where your Tinnitus is coming from. DPOAE measures your hair cells which many scientists agree are part of the reason many if not most get T (from damaged hair cells).

If you have Tinnitus in 1 ear, and despite having a perfect near normal audiogram this is in particular of interest as the Rights vs. Left DPOAE results will show dips where the T is.

Hope this will be of help for those wondering why I have Tinnitus with PTA. My advice is it's very clear on DPOAE.

 

So do you have permanent Tinnitus.? I'm going to an Audiologist in a few weeks. I'll ask her for DPOAE and otoacoustic tests you had mentioned before.

 

It took a while for me to figure out normal audiogram with Tinnitus however it's very clear to me where the problem is. My problem is right at the 1500-2000 HTZ which are absent on the DPOAE test. Thus during my fall the damage was done to my hair cells at the 1500-2000 frequency which are perfectly present on the left ear. This correlates perfectly with research from the Tinnitus institute in Oregon which has seen thousands of Tinnitus patients including those with head injury.

"There is often a slight loss in unusual places on the audiograms, say, a 15-20 dB asymmetrical dip at 1000 or 1500 Hz. These mid-range ‘dips’ are suspected to be related to the trauma of the impact on the cochlea, the nerves that connect to the brainstem area, and the sensitive auditory neural tissue in the brainstem itself. These unusual affects appear in more than 2/3rds of the cases evaluated here over a 7 year period. Essentially healthy younger people do not demonstrate this mild mid-frequency ‘dips’, compared to the head-injured patient."

Your level of T with a normal audiogram can be clearly indicated on DPOAE. You will for sure, with 100% certainty have an usual dip on it's graph.

Best of luck!

 

I had a MRI of brain and ear done. wouldnt cochlear damage show up there? I didnt see anythhing regarding that in my mri results below.

IACs: (ear mri)
Posterior Fossa:
Brainstem and cerebellum appear unremarkable. No cerebello-pontine
angle cistern mass.
A vascular loop of the right anterior inferior cerebellar artery
slightly enters the right porous acusticus.
A vascular loop of the left superior cerebellar artery abuts the
medial cisternal segment of the left trigeminal nerve near the root
entry zone.
Temporal Bones:
Seventh and eighth nerve complexes appear unremarkable, without
evidence of mass. Otic capsule structures appear normal in signal.
Mastoid signal within normal limits. No other temporal bone signal
abnormality is identified.

 

No. MRI does not test for hair cell damage that is trauma induced.

 

This research proves permanent tinnitus is caused by hair cell damage which might not be evident on standard Audiograms.

 

What research?

Also I visited an ENT and had a hearing test, speech clarity, conductivity test, and two other tests whereby they measure your "auditory nerve" activity. Did I have a DPOAE test done?

My audiogram was normal, auditory nerve activity was high around 7 where most people are 5 or below...

Normal audiogram but I still have distortion and ringing. Life really sucks you know.

 

Is OAE test different from DPOAE ? My OAE upto 8k was normal i.e. haircells present. But i remember the audiologist mentioning in the report "outer hair cells present " sorry for the confusion, does that mean things are fine ? Also the standard audiometry showed that i have T frequency of 8k and i have a dip of around 10db in that range. But the audiologist said thats probably not because of my concussion and it must be there before the injury.

 

I must give it a try. My regular test shows -15-20db Lost at 4k.
What worries me is that since the last flight and cold ( I was wearing er20 during the flight) i noticed my left ear got worse and i hear less high tones. This is crazy as when t started i was protecting myself and i still remember my hearing was same in both ears. Now i notice ringing is comming mostly from left ear when I hear less. I can simply test it by moving the fingers against each other next to the ear. Right is soft and delicate , left is similar but less detailed and less sensitive. I guess with the omission test I can be 100 sure I lost hearing? I also noticed that at some point my hearing would hear high freq tones when played the first time and then it would shut them off. Can hearing adjust like that and change depending on the day? Could this mean that there is still a chance for the hair cells to stand up?

 

Hi Asian-

Can you please post a graph of your DPOAE test results?

Tinnitus patients will usually see a notch dip on DPOAE graphs.

 

What about the people with hearing loss but no tinnitus? There has to be more to it than hearing loss?

 

Hi Newfie-

I don't think that you had a test measuring hair cells which is DPOAE test.

 

Hi Katkin-

That is a good question. In my opinion the gradual aging process gradually loses hair cells rather than shock or immediate hair cell lost of a traumatic event.

Traumatic events usually cause a significant loss of hair cells rather than gradual aging process. Traumatic events can be triggered by things that damage the cochlea (loud noise, head injury, toxic meds, etc).

Also many, if not all Tinnitus patients will see a notch in their DPOAE graphs.

 

Hi Bwspot-

the DPOAE test might not measure hearing loss directly however it will tell you at what frequencies your hair cells are absent. Absent hair cells, particular by notch dips on hearing graphs tend to signal Tinnitus.

Best of luck with your further tests.

 

Hey Martin...

I have a stupid question. Is the DPOAE test the same as Otoacoustic Emissions test? or are they different?

 

Hi Ricky- There are transient and distortion product otoacoustic tests. I recommend Distortion product. Pretty much everyone on this board will see some abnormalities with that test.

 

@martin12
My DPOAE test does now show any hair cell loss.

 

My Audiogram looks good too. ENT thinks my T is due to concussion I had after the assault.

 

Did he give you hope that your T may in time go away?

 

My ENT doc doesn't know if this is permanent or temporary. He leaned more towards there is no cure for T and to just accept it for now that it very well could be permanent. my ENT himself has similar T like since childhood.

However my T has gone down in volume since getting a lumbar puncture so I have hope that eventually T will go away. but I have the feeling the concussion and high CSF volume damanged some auditory nerve which doesn't show up on the MRI.

And the funniest part to all this is the 2 guys who attacked me are out there probably assaulting more innocent people as they have not been charged due to lack of eye witnesses.

 

My father in law has hearing dmage from being a fire arms instructor. No T. its got to be more than hearing loss

 

Hopefully it continues to go down in volume and eventually goes altogether! How about a dose of T for those two idiots who caused this, may make them think twice id say

 

It's certainly a very odd condition/symptom which most people have no idea exists. It's also very odd that the human body with all of it's capability is unable to repair this part of it's body. Why humans cannot regenerate hair cells like birds is unfortunate.

 

Is it hair cells or is it some type of nerve change? Would be nice if the body could take care of both of them

 

I could not agree more. I don't know if it's nerve damage or hair cells however are the hair cells not attached to nerve cells?

Did you have a DPOAE test? If so please post.

 

I do have a dip around 5 in my left ear dpoae test. However my audiologist says it's nothing to worry about and my hair cells are in normal range.

 

my 2 ENTs and audiologists said its nerve damage. I have asked Dr. Nagler's opinion about nerve damage in doctor's corner. Please look into that

 

Nerve damage as in hair cell damage? If you had cranial/vestibular nerve damage your balance would also be off. RIght?

 

I just had this test done. I lost almost all my ultra high frequecy hearing pretty much over night from ototoxic drugs. Here are the test results. I had almost perfect hearing prior to T. I could very easily hear up to 17-18khz, I have been very smart and careful with my hearing in the past, also kept in tip top health. I had no idea I could loose a major chunck of my hearing so quickly from taking medication. My right ear is definatly the loudest T which seems to be exactly in line with this test. I hear so many tones I can't even keep track of them in both ears and head, I guess this is all those frequencies I quickly lost which shows up in the results here. I think that my brain went totally haywire trying to pick up all these frequencies which were almost instantly destroyed.

 

there are no hard and fast rules.

there are plenty of people out there with significant notches and no tinnitus....