Tests/Procedures to Avoid

Please avoid these tests as they can make Tinnitus or Hyperacusis worse.

1) Tympanometry
2) Acoustic Reflex
3) Electrocoleography
4) Caloric Test
5) Syringing Ear Wax Removal
6) Microsuction
7) cVEMP/VEMP

 

I posted a thread on how the ECOG test made my tinnitus much worse and gave me H.

For the benefit of all the members of the forum. Note the following

- Generally, try to avoid ear tests or sound tests that are loud. Doctors (except some renowned ones) don't understand how debilitating tinnitus is, I am sure most of you know this by now. You will probably ask the doctor is it safe/would it have no impact my tinnitus? they will say yes. Don't trust the doctor when they say its safe. Of course, they will say its safe, they are prescribing the test in the first place. They don't take tinnitus seriously. While it's generally safe, it might not be safe for us who already have ear damage. So you need to make a judgement call on the importance of test

- Doctor are inclined to prescribe as many tests as possible for commercial purposes. While I am not ruling out the importance of some tests, many tests are there for the sake of a diagnosis. Many diagnoses don't have a treatment solution except waiting for nature to do the recovery. The point is that its wise to ask "if my results were abnormal, what would the next steps be." Sometimes taking the treatment and checking if it is effective is a safer option than doing the test then taking the treatment.

 

How loud is the electrocochleaography?

 

It was very loud in my ears. The thing is that the electrodes are placed just next to to the cochlea.

 

@Jiri had also done a test "acoustic reflex" which caused him to have a nasty spike.

 

Here is a timeline so you get a better gist of what happened to me.
I write everything down.

Sep 23 - Tinnitus on left ear ear first day, no hyperacusis
October 1 - Started to protect my ears from tinnitus, no hyperacusis
October 10 - Audiologist trip, normal hearing but cochlea cells on the left ear don't work well
October 26 - trip to the ENT, hyperacusis presents itself on October 21
Nov 1 - first spike after being at a restaurant for 10 minutes, spike lasted for 5 days
Nov 10 - Hyperacusis goes away from left ear, tinnitus is mild
Nov 15 - CT scan, comes out normal
Nov 22 - I fall on my head while running from leaf blowers, dizziness begins, no hyperacusis
Dec 10 - MRI, no spike, no hyperacusis
Dec - Now have been having balance problems that was later linked to High Blood Pressure
Dec 24 - Trip to the mall without earplugs, spike that lasted five-six days, afterwards back to baseline, no hyperacusis

This is where things get interesting.

January 15 - Caloric Test-water placed into both ears, one at a time, to make nystagmus, testing for vestibular issues, third test was cancelled because I had water in my right ear
January 16 - clicking/popping sound in right ear, hyperacusis in right ear
January 17 - Tinnitus spike from a fire alarm at the library, tinnitus soars
January 17 - January 26 - Bad tinnitus spike, can hear it over everything, eventually it goes back to baseline
January 27 - Hyperacusis on the left ear
February 1 - Tinnitus on the right ear, scratching sound, can be louder than the left ear, very mild
February 2 - Severe hyperacusis on both ears, popping sounds on both ears, but mainly in the right ear

 

I do not agree.
I am very skeptical when looking for spike causes. Many tinnitus sufferers are intensively looking for causes of deterioration or improvement. It is very easy to come up with a superstition in which random coincidences are considered a causality.
I am monitoring my tinnitus since 6 months. I haven't found a cause for better and worse days.

 

I have the test done where they do a progressively loud noise in your ear and it is kind of have to tolerate it.
I did so and did not get any type of spike but my tinnitus at the time was mild.
For example, during this time. I was able to in an arcade without a spike.

Same thing when I had an MRI. Everyone is different though.

 

The tympanometry is harmless done by itself. I think many people here confuse it with the acoustic reflex test because some machines do both unless the audiologist intentionally disables the acoustic reflex portion of the test.

 

It's true. It's only gonna add more damage to your already damaged ears.

 

Hm, it's going to be changing the pressure in your ears but you will hear some sounds too.

 

I had water irrigated into my ear and it caused pressure. I am sure the vibrations damaged my cochlea cells in both ears.

 

I think it depends on the circumstances. It exerts pressure on the ear drum (negative & positive) up to a certain point. I can see how some ears could react negatively to that. I've declined that test every single time since my surgery because I have a titanium prosthesis in lieu of a stapes bone and the linkage between the prosthesis and the cochlea is a simple piston, which is very different from the contact surface that a real stapes bone has with the cochlea. I'm unsure that the resistance of my ossicular chain is identical to that of a "regular ear", and I don't want to find out unless absolutely necessary.

Every single time, when I asked the audiologist "is this test absolutely necessary? why are we doing it?", the answer was "we do it as a matter of routine testing with all hearing tests", without any understanding of what the patient is coming in for. It turns out it was never needed.

I don't know of any "safe tests". There's always some amount of risk: infinitesimal risks can become significant to a population whose hearing apparatus is not perfectly healthy and can be considered "out of the norm". I'd proceed with caution.

 

In your case, I can understand declining, but I'm willing to bet most people see harsher pressure changes in everyday life. Do car doors slamming bother you?

 

I don't think so. The way they pressurize the ear is very different from the pressure changes from sound/noise. It's more like a pressurization you'd feel when you change altitude (or dive). In a typical test, the pressure applied is in the order of tens if not hundreds of daPa (deca-Pascals) - that's 100-1,000 Pascals (source). For everyday sounds, the pressures are much lower, in the order of 1 Pascal for 94 dB SPL (source). That's 2 to 3 orders of magnitude difference, if my math is right.

Not since my hyperacusis has subsided. I don't particularly like them (like any other harsh sound), but I don't notice any bad effects from it.

 

My onset of tinnitus and hyperacusis came as a result of the first two tests on this list. Prior to this I had a daily fleeting tinnitus for like 7-10 days. If I had known then that this could create tinnitus and hyperacusis, I would never have gone in for a 'routine' test. I winced in pain at the end of both tests. The only thing I can think of is that I've been under stress and dealing w/chronic pain. Maybe my auditory nerves were hyperactive, thus the fleeting tinnitus.

Later that night, the hissing began and I had sensitivity to sound. 2 months later I was getting better handling it, but just recently had a setback after either a dental cleaning or going to church (both w/ear plugs). Hyperacusis is back and tinnitus seems slightly louder. The worst is distortion of certain sounds and sensitivity to some electrical signals/EMFs.

 

When I was mentioning a car door slamming I was talking about the pressure change in the cab, not the sound pressure.

So, for an airplane sitting at sea level that's about 14.696 PSIA and if it's pressurized at 8,000' that's 10.91 PSIA for a difference of 3.786 PSIA. ±50daPA is about ±0.0725 PSIA.

 

I've never really understood the point of these test... Unless you're having hearing aids made or prepping for trt/cbt, I believe that there's no reason to undergo them. I also feel like it's malpractice on the part of ENTs to subject patients to them without warning them of potential complications.

 

Ah ok I misunderstood you, sorry. That pressure doesn't bother me at all actually. Do you feel it?

 

Hi,

Has anyone any idea if the otoacoustic emission test is safe to undergo for someone with both tinnitus and hyperacusis? I'm prepping for trt/cbt and might have to do this tomorrow.

I saw this comment and I'm quite nervous now:

and also here: Tinnitus and otoacoustic emissions: is there a link? https://www.ncbi.nlm.nih.gov/pubmed/2340968

I also hope it's not the same mechanism of action as e.g. tympanometry or the infamous acoustic reflex test..

 

I would also include sound tolerance tests too. They further compounded my Acoustic shock disorder.

 

According to this article VEMP test can cause hearing loss (as is the case with me where my hearing dropped by 20 dB).
https://www.ncbi.nlm.nih.gov/pubmed/25853612

 

I had a big panic with the otoacoustic emissions test today this particular machine tests up to 10 kHz and the 10 kHz sounded loud, I immediately pulled the earphone out of my ear and declined to do the rest of the test.

The audiologist assured me it was not dangerous and that the sound was 20 dB SPL and may have sounded loud because it was a high frequency.

I just hope I don't get a spike from this I'm going through such a hard time already.

She actually tried it on herself before she tested it on me but she said it didn't bother her.

 

These Tests/Procedures that I have listed are not safe people with NIHL, who have tinnitus or hyperacusis, their ears are more risk for damage. I was at the audiologist yesterday and I have hearing loss in noisy areas (something which has gotten worse). Still have a drop on 3 kHz and 6 kHz. Even the Audiologist said that our (us who have tinnitus and hyperacusis) ears are sensitive and there is a risk of damage from the tests.

 

Hi,

I'm about to have some hearing tests just to check how my hearing is. I want to know if any of these tests should be avoided.

1 - UHF audiometry + SPS + SRT - I know it's safe.

2 - Acoustic Reflex - nothing to say here, I'm not gonna let those b* abuse my ears with this f* test.

3 - DPOAE.

4 - Loudness Discomfort Level - I prefer to avoid this one as well

5 - Tinnitus evaluation

6 - Tympanometry - I know there is a debate about its safety but any comment on this one is also highly appreciated.

Another question is that do you think these are enough to find if there is hidden hearing loss?

 

Tympanometry is loud. I'd avoid that.

 

I guess Acoustic Reflex is loud - Tympanometry itself is supposed to be around 40 dB. Am I right?

 

Dunno.

 

Any idea on DPOAE and its loudness? I'm so convinced to have this one but only if it's not loud.

 

It stars with 40 db, but it goes up to 90 - 110 db. Extremely inappropiarte noise levels, especially for people suffering from T or H. (And even for normal people, it is too loud). Usually many doctors perform some kinda "Tympanometry in disguise" on you. They call it "Impendance Test", but what they really do is a combination of Tympanometry Test and Acoustic Reflex Test. But in the first place Tympanometry tests are completely unnecessary. They're not really revealing and if the audiometry doens't show somethign special, there's absolutely no need of performing a Tympanometry test