New Hearing Test

[Jkph75]

So I went to MEEI and had a hearing test which was more thorough than the other ones I have had. When they tested my hearing though the bone my hearing was at least 10 dB better in the low and mid frequencies, so that all of my frequencies were 10 dB or higher. I think this is what my hearing was before these problems.

They said that there might be something wrong with my middle or outer ear and then did some other test. I spoke with the Dr later who never said anything about it. I guess he didn't seem to think it was significant.

If I could access that hearing, I think I would rid myself of this problem. Any ideas on how to do that or what could be wrong?

 

[GregCA]

So I went to MEEI and had a hearing test which was more thorough than the other ones I have had. When they tested my hearing though the bone my hearing was at least 10 dB better in the low and mid frequencies, so that all of my frequencies were 10 dB or higher. I think this is what my hearing was before these problems.

They said that there might be something wrong with my middle or outer ear and then did some other test. I spoke with the Dr later who never said anything about it. I guess he didn't seem to think it was significant.

If I could access that hearing, I think I would rid myself of this problem. Any ideas on how to do that or what could be wrong?

You're describing conductive hearing loss, with a 10 dB air-bone gap.
It's likely an issue with your middle ear, potentially otosclerosis or some other problem with that ossicular chain (malleus, incus, stapes).
If you have otosclerosis, surgery (stapedotomy) may be an option, although the air-bone gap gain won't be spectacular since you are starting with 10 dB only (my gap was 50 dB @ 250 Hz), but you could have a change in tinnitus.

To debug it further: Rinne test, CT scan, stapedial reflex (usually done with hearing test).

 

[stophiss]

You're describing conductive hearing loss, with a 10 dB air-bone gap.
It's likely an issue with your middle ear, potentially otosclerosis or some other problem with that ossicular chain (malleus, incus, stapes).
If you have otosclerosis, surgery (stapedotomy) may be an option, although the air-bone gap gain won't be spectacular since you are starting with 10 dB only (my gap was 50 dB @ 250 Hz), but you could have a change in tinnitus.

To debug it further: Rinne test, CT scan, stapedial reflex (usually done with hearing test).

Greg,
Any armchair tests/symptoms that a layperson can perform to determine if their tinnitus maybe due to otosclerosis?
thanks

 

[Jkph75]

You're describing conductive hearing loss, with a 10 dB air-bone gap.
It's likely an issue with your middle ear, potentially otosclerosis or some other problem with that ossicular chain (malleus, incus, stapes).
If you have otosclerosis, surgery (stapedotomy) may be an option, although the air-bone gap gain won't be spectacular since you are starting with 10 dB only (my gap was 50 dB @ 250 Hz), but you could have a change in tinnitus.

To debug it further: Rinne test, CT scan, stapedial reflex (usually done with hearing test).

I had a CT. They asked me where I could hear the tuning fork louder and I thought it was by my ear. I'm not sure what the other test is but they put something in my ear and measured pressure. The Dr said I either had vestibular migraines, Meniere's, or autoimmune inner ear disorder. He said that there is no way of telling now because my testing is all normal. He also said he has no idea why steroids are helping my dizziness. I was just thinking maybe there was something less complex going on in my middle ear and maybe by fixing it I could make this better. They didn't mention any of these things, so it must not be any of those. I have described certain symptoms and had drs say,"oh, that's your middle ear." And then just dismiss whatever I had said. I wish I could remember what I got that response to. I keep getting the feeling that somehow the middle ear doesn't count. Which makes no sense.[/QUOTE]

 

[Jkph75]

@GregCA

Also, my main tone is around 1000hz and that is where I had a 15 db gap, so I think you are right and my middle ear must be involved somehow.

 

[GregCA]

Greg,
Any armchair tests/symptoms that a layperson can perform to determine if their tinnitus maybe due to otosclerosis?
thanks

If otosclerosis hasn't affected your inner ear and is purely conductive, what I gathered is that the expected tinnitus is in the lower frequencies rather than a high pitch tone. There is demonstration in one of the studies I read a long time ago that explains the physics behind it: essentially your inner ear fluid being "stuck" by a stacked stapes bone, and some resonance frequency computation. I can't find it anymore (I've read so many!) but it goes through the math to compute what the expected sound/noise is. Some fluid mechanics going on - very interesting. I'll look for it again because I found it fascinating.

But I would say, the first step to determine if your T comes from otosclerosis, is to figure out if you do have otosclerosis in the first place. If yes, then statistically there's a high chance the T is coming from it.

 

[GregCA]

I had a CT.

Have it reviewed by multiple people. I'm not joking. Mine came up "normal" originally, and was confirmed normal by a few doctors from the same hospital. But when I took it outside of network to yet another doctor (yes, I am the determined kind), he found something of interest, and he was right.

It's not easy to see on a CT, so it may show or may not, but you certainly want the best "interpreter" to read it for you.

 

[GregCA]

@GregCA

Also, my main tone is around 1000hz and that is where I had a 15 db gap, so I think you are right and my middle ear must be involved somehow.

Do you have a carhart notch?

 

[stophiss]

If otosclerosis hasn't affected your inner ear and is purely conductive, what I gathered is that the expected tinnitus is in the lower frequencies rather than a high pitch tone. There is demonstration in one of the studies I read a long time ago that explains the physics behind it: essentially your inner ear fluid being "stuck" by a stacked stapes bone, and some resonance frequency computation. I can't find it anymore (I've read so many!) but it goes through the math to compute what the expected sound/noise is. Some fluid mechanics going on - very interesting. I'll look for it again because I found it fascinating.

But I would say, the first step to determine if your T comes from otosclerosis, is to figure out if you do have otosclerosis in the first place. If yes, then statistically there's a high chance the T is coming from it.

Greg,
Based upon the fluid dynamics/resonant frequency you mention...can the common high frequency hiss type of T that I have be the result of otosclerosis?
Or, based upon your study of this, does otosclerosis typically manifest a lower frequency type of T?

Thanks

 

[GregCA]

Greg,
Based upon the fluid dynamics/resonant frequency you mention...can the common high frequency hiss type of T that I have be the result of otosclerosis?
Or, based upon your study of this, does otosclerosis typically manifest a lower frequency type of T?

Thanks

It seems to me that any type of T can be the result of otosclerosis. My understanding from my readings is that the lower frequency T comes from the mechanical/fluid dynamic part of the problem (ossicular chain getting stuck and containing the fluid in the inner ear with some kind of resonance pattern), while the higher frequency T would be more linked to cochlear otosclerosis, when the disease attacks the inner ear (which typically starts around the stapes, and thus, near the high frequency region of the cochlea).

 

[stophiss]

It seems to me that any type of T can be the result of otosclerosis. My understanding from my readings is that the lower frequency T comes from the mechanical/fluid dynamic part of the problem (ossicular chain getting stuck and containing the fluid in the inner ear with some kind of resonance pattern), while the higher frequency T would be more linked to cochlear otosclerosis, when the disease attacks the inner ear (which typically starts around the stapes, and thus, near the high frequency region of the cochlea).

Thank you Greg. Much appreciated.

 

[Jkph75]

@GregCA

I just received my results my bone conduction hearing is as follows:

10 5 -5 10 10 5 10 15

Air conduction

20 20 15 20 10 10 10 15

The biggest gap was 20 db at 1000hz.

My acoustic reflexes were absent in both ears.


There was a note that I might have Otosclerosis but this wasn't discussed with me. He said that I have MAV, Meniere's or Autoimmune inner ear disorder when speaking to him. I also have results from a VEMP if anyone understands them. Is there something about having a baby or losing a lot of weight quickly that could disturb my middle ear? This is all so confusing. I just woke up one day with the tinnitus.

 

[GregCA]

I just received my results my bone conduction hearing is as follows:

10 5 -5 10 10 5 10 15

Air conduction

20 20 15 20 10 10 10 15

The biggest gap was 20 db at 1000hz.

My acoustic reflexes were absent in both ears.


There was a note that I might have Otosclerosis but this wasn't discussed with me. He said that I have MAV, Meniere's or Autoimmune inner ear disorder when speaking to him. I also have results from a VEMP if anyone understands them. Is there something about having a baby or losing a lot of weight quickly that could disturb my middle ear? This is all so confusing. I just woke up one day with the tinnitus.

There's a few clues that point to otosclerosis: tinnitus, low frequency air-bone gap, stapedial reflex missing. I'm not sure why your doctors aren't discussing it with you.
You should know that there is some correlation between pregnancy and otosclerosis. According to http://www.dizziness-and-balance.com/disorders/hearing/otoscler.html : "Pregnancy often has an adverse effect. Otosclerosis is often discovered during or just after pregnancy."

It is hard to understand how a condition suddenly "sets in", but I guess it's true of many conditions: "one day I was healthy, the next one I was not". There has to be a turning point.
I also woke up one day with hearing loss (no T at that point). Then about 6 weeks later, I woke up in the middle of the night with severe tinnitus. At that point I didn't know I had otosclerosis yet. Just a bunch of symptoms that nobody was able to explain.

I suggest you read up on it to understand it better. Nobody will do that homework for you, so you should come prepared when you talk to your doctors.

The earlier you can figure it out the better, as it may be wise to not delay treatment if confirmed.

Good luck.

 

[Jkph75]

There's a few clues that point to otosclerosis: tinnitus, low frequency air-bone gap, stapedial reflex missing. I'm not sure why your doctors aren't discussing it with you.
You should know that there is some correlation between pregnancy and otosclerosis. According to http://www.dizziness-and-balance.com/disorders/hearing/otoscler.html : "Pregnancy often has an adverse effect. Otosclerosis is often discovered during or just after pregnancy."

It is hard to understand how a condition suddenly "sets in", but I guess it's true of many conditions: "one day I was healthy, the next one I was not". There has to be a turning point.
I also woke up one day with hearing loss (no T at that point). Then about 6 weeks later, I woke up in the middle of the night with severe tinnitus. At that point I didn't know I had otosclerosis yet. Just a bunch of symptoms that nobody was able to explain.

I suggest you read up on it to understand it better. Nobody will do that homework for you, so you should come prepared when you talk to your doctors.

The earlier you can figure it out the better, as it may be wise to not delay treatment if confirmed.

Good luck.

Thanks for posting all of this. Is there any treatment besides surgery? I am already deaf in the other ear, so idk if they would want to do surgery. Is this progressively degenerative? I'm scared now that I am going to be completely deaf. Does your hearing fluctuate with this. My air conduction fluctuates but all in the normal range. What were your other symptoms? What expert did you send your CT scan to? Thanks so much for your help.

 

[GregCA]

Thanks for posting all of this. Is there any treatment besides surgery? I am already deaf in the other ear, so idk if they would want to do surgery. Is this progressively degenerative? I'm scared now that I am going to be completely deaf. Does your hearing fluctuate with this. My air conduction fluctuates but all in the normal range. What were your other symptoms? What expert did you send your CT scan to? Thanks so much for your help.

Answers:
1) yes there are treatments besides surgery. The most common one is using Fluoride supplementation. There are alternative treatments with bisphosphonates, bioflavonoids. These treatments are not expected to revert the damage (even though there has been cases of hearing level improvements in studies about cochlear otosclerosis), but they can help arrest the spread of the disease. Surgery can actually revert the conductive hearing loss, but I am not sure you would be a good candidate since, as you mention, it is your only working ear.
2) hearing doesn't typically fluctuate with this (not that I know of - it doesn't for me)
3) I am happy to send you the info by PM

I'm sure you must have mentioned it before but I just don't recall: what is the cause of your deafness in the other ear?

 

[Jkph75]

@GregCA

I'm not sure what the cause of the hearing loss is in my other ear. My mother had a virus when she was pregnant with me. I also went into distress when he was in labor. There is hearing loss on my father's side, but the loss generally occurs in middle age and us not congenital. I think the best guess was the virus. In looking at the audiogram from my deaf side it looks like I have hearing btw 60-70 db through bone conduction. 45db at the lowest frequency, but maybe I am reading it wrong. I wonder if I could access that hearing. I know it's not a lot but any little bit would help. I would appreciate any help so feel free to pm me. Thanks

 

[GregCA]

I wonder if I could access that hearing. I know it's not a lot but any little bit would help.

Definitely! I suggest you look into Bone Anchored Hearing Aids. You may be able to access that little hearing you have left.
Do you have an air-bone gap? (i.e. is your air conduction much worse than your bone conduction in that ear)
If yes, why is that so? (pathology in the middle ear?)
If no, the BAHA may not be recommended since you could amplify without an invasive procedure.

Do you currently wear a hearing aid on that ear?

 

[Jkph75]

Definitely! I suggest you look into Bone Anchored Hearing Aids. You may be able to access that little hearing you have left.
Do you have an air-bone gap? (i.e. is your air conduction much worse than your bone conduction in that ear)
If yes, why is that so? (pathology in the middle ear?)
If no, the BAHA may not be recommended since you could amplify without an invasive procedure.

Do you currently wear a hearing aid on that ear?

Well false alarm. I reread it. I think those were the db levels that they stopped testing at I guess it was just wishful thinking. Boy, I really do wish that I could hear better.

 

[GregCA]

Well false alarm. I reread it. I think those were the db levels that they stopped testing at

Really? It's a bit surprising to me that they would stop at those levels (you even mentioned 45 dB). I've seen audiograms with much higher hearing levels than that.

 

[PaulBe]

The Dr said I either had vestibular migraines, Meniere's, or autoimmune inner ear disorder. He said that there is no way of telling now because my testing is all normal. He also said he has no idea why steroids are helping my dizziness.

Are you sure he isn't a gasfitter? Steroids helping tends to scream inflammation being reduced. That's a good place to start for any Doctor.

 

[Jkph75]

Are you sure he isn't a gasfitter? Steroids helping tends to scream inflammation being reduced. That's a good place to start for any Doctor.

Yeah, idk. They keep telling me that the fact that steroids help isn't indicative of anything because steroids help so many things. Some of them have almost insinuated that I just like taking them or that I just think they are working when they aren't. They really just don't have any idea. I am amazed at how little they actually know about the ear.

 

[PaulBe]

I was too. I had thought that damage to a major sensory organ would be considered a medical priority. It seems to be somewhere below boob lifts in the medical scale of importance.