New Member — Lots of Questions About Hearing Test Results for Tinnitus Sufferers

Greetings fellow T sufferers:

Just joined the forum today. I see older threats that reference the issue on my mind this morning – but I thought it best to post a new one to solicit your thoughts. There’s a bit of backstory here, so bear with me.

I don’t recall T being noticeable until roughly 12 years ago. Possible causes are the usual suspects – loud music, meds, personality. I check all the boxes. I also have hearing test results (2013) that have confirmed at least mild hearing loss in both ears – a little worse in the right one. I sought the hearing tests right about the time I got interested in mixing audio. We live in such a wonderful age; in this shiny metal box at my fingertips, I’ve audio processing power that was unimaginable 20 or 30 years ago! In a word, technology has rekindled a lifelong interest in music production, and it’s become something of an after-hours passion for me. But with that rekindled interest came a sudden and quite unwelcome awareness that my ears aren’t what they used to be.

Since noticing T, I’ve had flare ups off and on. They’ll stick a while before fading away, but the most recent one, hitting me about a month ago, seems worse than usual (I detect just a smudge of what I’d describe as pressure in the ear) – and so I went to see an ENT yesterday morning. I should also add that the onset of this most recent fare-up is concomitant (more or less) to a head cold and lingering congestion, which can certainly exacerbate the T.

I had two primary goals with the ENT visit – 1) to have the doc look into the ear for an obvious sign of infection, or for structural problems in the ear of which I may be unaware, and 2) to ask lots of questions about the role of diet, stress, medications, stimulants and alcohol, exercise, sleep, and new sound therapy treatments that seem to have some success leveraging the brain’s neuroplasticity to basically rewire its hearing mechanisms (this is a pathetically patchy version of it, even in layman’s terms, but bear with me). I wasn’t there to have another test done, especially with roaring tinnitus in both ears (little louder in the right) and possibly congested tubes.

So the Doc wanted the hearing test done anyway, and I agreed to do it, reluctantly, and the results were deplorable. He told me I had very significant loss in both ears right down to the 2k, and that I was a good candidate for hearing aids, as I likely have trouble hearing others in normal conversation. These results are much worse than those from the test 2 years ago, and for an amateur audio enthusiast, this is deal-breaker news.

I spent yesterday afternoon nursing coffee in a local shop, staring out the window and brooding over the bad luck – but the experience has left me with a few questions and concerns about the test itself. I want to add here that since yesterday’s visit – I’ve spoken to friends and family (they’re growing tired of my questions already!) for honest evaluations of what I myself thought to be the case; my hearing is by no means perfect – I can perceive it as imperfect – but I don’t think I have (nor have ever) trouble with (what I’ll call) routine hearing – conversations, television, environmental noise, etc. I can’t find anyone to tell me otherwise.

I let the doctor and the audiologist administering the test know that I felt congestion in the inner ear. They did the usual checks, but let me know they wouldn’t detect congestion in the Eustachian tubes – which is my best guess where the problems are – and I’m about 70% there’s something going on in there. I don’t know why they would administer a test like that unless all systems were go; all it did was give them test results that put me in a tailspin of worry, at least for the afternoon.

There were a few other key differences between this and the last test in 2013; in 2013, the administrator told me to hit the button “whenever you think you hear it,” emphasis on “think” – which I did. This last one did not offer this instruction – and there were a handful of occasions where I thought I’d heard the pulse, but just wasn’t 100%, and so left it alone. I understand this is the best we can do; we can’t hook up wires to the brain and download data with which to diagnose hearing issues; we can’t monitor a person’s sensitivity to sensory input, only his or her reactions to it. But it still seems to me an incurably sloppy way to test the hearing mechanism.

The second key difference is that in 2013, I distinctly recall hearing warble tones, which I suspect are easier to discern through the noise of T. Didn’t get them this time around.

There’s a third difference, it occurs to me now. For previous tests, I was given non noise-cancelling (why not noise cancelling??!!), over-the-ear phones. This time, I had buds inserted into the ear canal – which for me, with the mild congestion, felt like sticking fingers, which gives you a noise floor from the body doing its thing (heartbeat, breathing, shifting in the chair, and so forth) through which I’m supposed to discern decibel cuts across the frequency spectrum. I’m using “noise floor” to refer to a baseline noise that’s always there – kind of like the rumble of a record needle or the hiss you’d hear from listening to music from listening to tape (for those of us old enough to remember vinyl LPs and cassette tapes) – perhaps the wind and rumbling of the tires on the road that sit beneath the conversations you have in a car.

I’m scheduled for an MRI next week, which I welcome, as I want them to have as good a look at the ear. Fingers crossed they don’t find anything too sinister – but honestly, if they find nothing, it leaves me with the lingering question – what the heck is going on? But back to the test: while wrapping up the scheduling for that, the ENT doctor told me the most curious thing. I asked him if acute tinnitus might skew test results to a degree, to which he replied that it would not. He mentioned that tinnitus might obscure tone recognition at its own notch frequency, but beyond that, it shouldn’t affect frequencies above or below it. I’d read similar things online previously.

But must that be the case for everyone? The more I think about it, the less it makes sense to me. Now,
I’m open to the possibility that I may be rationalizing bad news to a degree; I don’t like the test results, so I question the method, right? But here’s what has be doubting it:

Firstly - the Doctor recommended hearing aids – meaning, I assume, that persons with test results similar to mine need have them. He specifically mentioned the likelihood I’m having difficulty hearing others in routine conversations – and yet, to my absolute best knowledge, I have no issue following conversations. None in my circle of friends or immediate family think this is the case. My wife is insisting it isn’t. I’m never in a situation where I have to cup my hands around my ears and ask people to repeat themselves – I that means anything. I don’t listen to music or the television loudly, ever, and don’t have to.

Secondly, for me, the T is absolutely a noise floor – and if I had to position it in the stereo field, I’d pan it hard right and hard left with about a 6db boost in the right, and to the front – “front” meaning it’s closer to me in acoustic space than are other environmental sounds. Everything I hear is heard with an incessant hum of T in front of it. So how on Earth can it not interfere with my sensitivity to very subtle cuts and boosts across the frequency spectrum? Environmental sounds are around us all the time, and I’m sure that each of us has experienced not being able to discern one sound source over another due to relative volume, and where the competing sounds are nowhere near each other on the spectrum. A whistling tea kittling kettle in the kitchen may interfere with your telephone conversation if you’re close enough to it. If a motorcycle roars past the house while my wife is telling me to do the dishes, I might not have heard her instruction, even though the frequency fundamental of the motorcycle engine is nowhere near that of her speaking voice. By analogy, if what the ENT says about T is true, then I ought have no problem hearing her through or over or under the roaring of the motorcycle; I’d have problems only where environmental sounds share the same frequency fundamental as her voice – and this is just never the case.

There’s a measure in audio engineering whereby an engineer will “duck” certain instruments behind certain others in order to obtain a better overall mix balance. For example, the engineer might program a guitar part to drop or “duck” three or more decibels whenever a vocalist kicks in, which allows the vocalist (arguably the more important of the two musical elements) to cut through the mix. Without ducking, at it’s best, a recording sounds less impactful; at its worst, a recording can sound downright muddy – especially in larger arrangements. With my T, there is never any ducking. The T - which (I should have mentioned this already) is more or less a pitched sine wave – and it doesn’t “duck” out of the way of other competing sine waves –which are the core of a hearing test. For me, there is always the experience of noise interference. And if this is the case, how can this experience not skew test results to a degree?

And then there’s the role of attention – I’ll call it that. Part of an audio engineer’s curriculum (what I’d hoped to do eventually – now the jury’s out on it) is to train the mind (I prefer mind to brain in this context) to listen sound very attentively (rather than passively), listening for cuts and boosts in the frequency spectrum, compressions, distortions, reverb and delay times, and so forth - all the things that make music sound delightful or horrible, depending on your point of view. I’ve no doubt the other arts are comparable in this respect; it’s a process of subtlety and refinement. I’ve 20/20 vision, but I know I don’t see color as would a professional artist, even if he or she were vision impaired. My eyes are fine, but I haven’t cultivated that sensitivity to color, hue, light, form, all the visual ingredients that a painter will know and work with intimately, even if he or she is sporting coke-bottle glasses. The sensitivity to me seems to me in the mind, in the refined sensibilities of the artist, rather than his or her eyes.

Where am I going with this?

I’m writing this note while sitting at my kitchen table, I’m hearing lots of different, competing sounds – TV, wife singing to baby, kid fussing at a video game - but I’m not listening to any of it. It’s washing over me because I can’t keep it from doing so – not without walls, acoustic baffles, ear plugs. Now, if I have to know what it is my wife or child is saying, I’ve got somehow to focus the listening on just that element while “tuning out” the TV, radio, whatever else. I put that in quotes because as you know, in acoustics, you can’t really tune out sound waves if they’re there to be heard. You can’t direct or scope down your hearing quite the same way you can with vision– focusing your eyes on one particular aspect of a painting, in such way that you don’t see (or see as well) other aspects of it that are competing for your attention. If you’re in a room full of people and someone asks you a question you can hear perfectly well, you’ll have greater difficulty hearing that same question at the same volume if there’s another person beside him or her speaking to you at the same time, even more difficulty with more speaking persons. It has nothing to do with your losing hearing sensitivity to the questioner; it has everything to do with the fact that the listening part of the mind doesn’t like distraction. Interestingly for me, this inability of the mind to scope down sounds, tones, timbres in relative isolation is probably what makes music sound so delicious – but that’s another discussion.

Now, back to the hearing test. That T noise floor is a constant distraction. You don’t hear passively in a listening booth – you listen carefully– you have to – and I have to believe it’s easier for persons who don’t have competing sounds in their head, most especially sounds that resemble or are even identical to the sine waves the examiners throw at you, which describes T for many people. Yesterday, I had the distinct experience of not being able to pull my listening attention away from the T and directing it towards tones that unfortunately were no different from the T in timbre. If felt that if I could only turn down the T volume, I’d have a better go at it. Of course I can’t.

Was the hearing test an actual test of hearing in a global context, or was it as test of how well I can discern sine waves beneath the noise floor of yet another sine wave?

All this yammering (thank you for sticking it out this far!) has me wondering – does it make sense to administer standard hearing tests to T sufferers without qualifying the results? What would be the better test? Would it make sense to have someone with perfect hearing sit a test with a sine wave matched to your T in both frequency and volume, administer to him or her the standard test against that T noise floor, and then compare his or her results to yours?

I’ve seen comments from persons who report excruciating T with normal or near normal hearing test results. It’s different for everyone – I realize that. I’m hoping persons reading this can share similar stories, thoughts or concerns they themselves may have had interpreting less than stellar results. I’m also curious to know if anyone has had relevant discussions with ENT doctors and audiologists who corroborate these views, or who may have sound reason to doubt them. I'm all ears.

And I apologize if I’ve seemed a little too hard on the ENT - nice guy - no one wants to be told they need ear amps. T is so strange – there’s not much they can do, and it's occurred to me he’s probably just giving me textbook answers. It may be best to try to find a more experienced researcher, even if it’s a distance to negotiate.

Thanks for reading, and thanks in advance for your comments.

 

Nice to meet you. I too have a Mri for next week. While this will be my first time with a ENT doctor I still am not expecting a huge change in my T. With the tests I really don't know if it would be good idea or not as I'm new to this as well. Another member suggested taking different supplements to help with T and I'll be doing that soon too. As far as tuning it out goes the only thing that has helped is I have a air washer next to my bed that helps mask the noise. I hope you can get this figured out too

 

When you go for the MRI, have good quality earplugs! Those machines are ridiculously loud.

My right ear has severe hearing loss and I do use a 4 channel, hearing aid/masker. I does help quite a bit.