A few months ago I realized many H patients might not be like me at all, when I talked to Maura at Hyperacusis Sufferers and she said she had no thumping at all. Unlike me, where all the thumps come in tandem with any type of pain, after which they both promptly disappear hand in hand. The thumps are a sort of pain though, mostly because of how all-around us sound is in life. Other ways my sxs are not like so many other H patients is I don't have setbacks, or at least the only worsenings I had were in the two or three acoustic traumas years ago. While I think
@Briann is right to suspect that this might not apply to other people's H, I'm certain Baumgartner is speaking wrongly for my etiology. It isn't entirely pulsatile or ''pulsing'' at all, though it's widely believed to be such. It's only pulsatile if you think it thoroughly through, in the sense that the pulses (trashes about, to and fro) come with sound and are often not louder than the external sounds. I also do vibrate in my ears when I talk but talking is like the sound generators sold by therapists, it generally creates a background noise or vibration throughout the body that increases the minimum sound levels, a process that merely makes the theoretical movements of TTTS lest pronounced. And while I don't see typical H patients complain like I do about the sound of coffee cups being placed on tables, the closest testimonies to my sxs I've read were those that went through tenotomies, botox, or even some who also have glaring autophony issues, most probably from patulous dysfunction of the tubes, who complain more about being touched in the ear constantly than of electrical pain. Baumgaertner then goes on to talk about TMJ, which is the typical cliche and little to do with my circumstances of acoustic trauma. The issue with him is that Jastreboff didn't differentiate between misophonia sufferers that apparently feel nothing in their ear, and this sort of Aristides/Harold Kim triangle of the bermudas where myoclonus can't be externally dxed despite all the myths stating the contrary and yet also have complaints about sound that don't follow patterns of pure loudness measurements. Other things that haven't helped in my differential dx; the official H questionnaire doesn't differentiate between TTTS and H as it obsesses about psychological issues; my local spanish expert in sound therapy and author of one of the biggest papers on TTTS together with Westcott in the 2000s died in a motorbike crash, but before that dxed me with a mix of H and misophonia precisely because of the above lack of documentation. And if we take Baumgaertner at face value, those errors will just be repeated in the future.
One of the things Kim I think said to anxiousjon was that it could be the veli palatini vibrating, in which case a tenotomy is a failure. Either way, while it does cause me doubts all this talk about how a stapedius or tensor contract with speech and yawning, I wouldn't be surprised if the tests used to measure these contractions are really just measuring the opening and closing of the patulous wall.
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