Tinnitus Producing External Sound

Discussion in 'Dr. Stephen Nagler (MD)' started by mrd28s, Dec 22, 2014.

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    1. mrd28s

      mrd28s Member

      Michigan, USA
      Tinnitus Since:
      01/2000, severe at 2006, externally audible at 2011
      Cause of Tinnitus:
      noise damage, machinery
      Rather frequently my tinnitus can be heard external. My son has heard my T from two foot away while watching TV, at a volume that I could hear without my hearing aids, (LOUD) and my audiologist at about 50% normal conversation in a quiet room. In addition, out-of-tune harmonic reverberations between an external sound and my T frequency can sometimes be painful, with one occasion caused from different frequencies from different ears.
      Also I periodically hear phantom sounds/incoherent conversation?/music, almost like tuning into a radio station.
      Any experiences with patients with any of these issues? Advise?
      Further information in "Tinnitus loud enough to be heard by others!"
      • Hug Hug x 1
    2. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Atlanta, Georgia USA
      Tinnitus Since:
      @mrd28s -

      The condition you describe has in the past been termed "objective tinnitus." Most authorities are currently of the opinion that all tinnitus is subjective and that what had previously been referred to as objective tinnitus is more properly termed a "somatosound." The distinction is important because somatosounds originate as directly measurable sound waves, whereas tinnitus originates not as a sound wave but rather as an electrochemical signal from within the auditory system.

      I have treated a number of patients with somatosounds, the most memorable being a lady whose husband could hear her tinnitus readily in bed as they lay next to each other at night. In her case the somatosound originated from an acquired stenosis within a vein high up in her neck. We were able to cure her by dilating the vein with a small catheter inserted through her femoral vein in the angiography suite.

      The key to curing somatosounds lies first and foremost in properly identifying the source of the sound. If the source cannot be found or if it can be found but not safely corrected, then and only then would I consider TRT, which is obviously not a cure but in such a setting can be highly effective in facilitating habituation of the somatosound.

      Dr. Stephen Nagler

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