Why Do Some Tinnitus Sounds Hurt?

Does the pain ever go away? I've had pain for as long as I can remember.

 

I agree, it looks like a total mindfuck this does. I have both high pitched tinnitus and low pitched rumbling, and if I had to bet I'd be very sure that the rumbling is closer to the middle ear than the high pitched tinnitus, and that the former would be caused by the latter, but that's all I can say. A few weeks ago I was triumphantly saying how tinnitus discovered with stapes surgery was proof it was in the middle ear but when I looked into the papers talking about it it seems way more complicated and uncertain. Silverstein says in the seminar he doesn't know if the middle ear influences the inner or the other way around and even he talks about central gain on the unoperated ear for some odd reason. It's also really annoying to have a high pitched continuous tinnitus from stapedial spasm documented in the literature but it being so loud it was definitely objective and heard externally whereas in our cases it's not so.

I think Silverstein also wrote about stapedial preservation in stapes surgery, and the impression I got from him is that the stapedial is probably involved in discerning signal from noise, then it would be the muscular outcome of spatial hearing which is in the brain apparently, so no wonder all the researchers are obsessed with the brain. I'm hoping that frequency is something that's been talked too much about as it would reduce the importance of the difficult or impossible to cure cochlea and auditory nerve, instead what would be affecting us would be the shape of the sounds and not the way our hair cells capture them. But I'm rambling here, like Trashboat on chat hyperacusis trying to capture an imaginary dragon...

 

Also, @PaulBe, is there somewhere where you've written up your symptoms? Mine are high and low pitched T and reflex sound sensitivity as you probably already know.

 

I don't think I have. I've chimed in a lot with everyone else, but I don't think I've really given much of my own story here, which I guess is a bit rude. Its late in the Southern hemisphere just now, but maybe tomorrow I'll drop you a PM, or if Telis doesn't mind I'll come in on this thread.

 

No I don't mind at all mate.

 

Mine started two/half years ago. It wasn't there then it was. No warning, no gigs played for previous week. Just sitting quietly when suddenly became aware of this swirling screech. Actually sounded like multiple tones all rising to a crescendo at random times then dropping out as the next one built. Then after a few days I thought the car music player had broken...then I realized it was me. That whole thing with crinkling paper bags, water going down the plughole, clatter of dishes...all distorted, over-prominent, intensely uncomfortable and frightening. Sudden loud sounds percussive across my maxilla as though the noise was being transmitted along a sensory somatic nerve pathway. Occasional dizziness, all the sound phobias that follow, the emotional breakdown, the ignorant, uncaring Doctors, the Audiologist who was really a Neuromonics rep...the whole thing. These days? Mostly high frequency T that sometimes swirls and is sometimes constant, like a stylus being dragged across a pane of glass. I've had some TTS type symptoms, but I've never found them to be significant. I certainly don't get much of the thumping that others refer to but I do sometimes get like a fine ringing chime which is subtle, but vaguely percussive. These days my tolerances have improved and I can listen to music much more freely than I could, but I seem to move in this constant cycle of two or so days of sound intolerance, then it just goes away (though never the T) for one to three days, then it comes back. That's the part I have the most difficulty with because it suggests a possible reversible cause, but it also locks in the fear of "is it getting better, is it getting worse". Well really, its probably stayed the same. All my basic audiology says small HF loss in the Left (everything is in the one ear), not considered significant, so like a lot of us, I'm left with "so what the hell is this then?". Too much store gets placed in audiology results when the real problem doesn't lie with quantity of hearing, but quality. This is all why I've fallen into the muscle activity camp to a large extent. It would explain apparent reversibility of my symptoms, it isn't well researched, but there is enough anecdotal reportage of improvement when the muscles are dealt with to suggest it be taken seriously...but at the same time, nothing is ever isolated in the human body so I've come to think that the problem lies with the interplay of muscles and nerves together. More chicken vs egg really. Do the muscles react to the sound signal the damaged nervous tissue produces, causing them to miscue their responses, or are the muscles activating inappropriately (altered thresholds), causing the nerves to correctly interpret sound that is coming into them already distorted at muscle level? is it a mix of both? Given that my symptoms have improved a bit lately with high-dose (laxative level, dammit!) of magnesium, am I treating muscle or nerve dysfunction, or, like the sound therapy crowd, am I just amusing/kidding myself as the slow, slow process of natural nerve repair takes place?

(phew)

 

Remarkable how probable it is that that cycle would probably pass as ''setbacks and habituation'' in the sound therapy lingo.

Whether this is mechanical or not is taking on dizzy new heights as far as I'm concerned these days as I added the hyperacusis sufferers group and especially the canal dehiscence groups in facebook where we now have to deal with a round window reinforcement protocol that is deemed illogical by well-respected ENTs while for now having anecdotal successful stories. This is like a medieval tale of knowledge, you waste time learning and the hole just gets bigger and bigger!

 

And by ENTs I meant neurotologists of course, like Carey at John Hopkins or Hain at Chicago Dizziness and Balance center. ENTs lol...

 

Yes I've thought that too. I tried (very nicely) to explain it over at sound therapy central, but (like usual) it couldn't be hyperacusis because it wasn't identical to something Jastrebof may have uttered twenty years ago.