Can Cochlear Tinnitus Become Central Tinnitus?

[Samir]

I am curious about this thing they call "central tinnitus".

The term "central tinnitus" is often misused, as it is obviously the brain that perceives the cochlear tinnitus! However, when used properly, the term "central" refers to tinnitus which has its roots in the brain itself, which represents only a tiny proportion of cases. We'll not talk about the rare cases of auditory hallucinations, which are more related to neurology than hearing.

http://www.cochlea.org/en/impairment/tinnitus

What exactly is central tinnitus and how do you know if you have one or the other?

I know I have seen Auris Medical refer to "peripheral" tinnitus. Is that the same thing as cochlear tinnitus?

Can cochlear tinnitus become central tinnitus?

 

[Reinier]

Central and so called cochlear tinnitus makes me wonder if you can have central tinnitus when both ears have different tinnitus frequencies. I think not.
When phase and frequency in both ears are similar, you experience the sound inside your head. (Same principle applies with external sound. When phase and frequency are the same you will "hear" the sound right between the ears inside your head. Does that make it central tinnitus although the origin is still the cochleas?

 

[Samir]

@Reinier Do you think that central tinnitus is more chronic?

For me, I think it may have started as cochlear tinnitus for me, then moved inside the head. So I guess it's central tinnitus now. Then I have these temporary spikes where it sounds more like it's coming from the left ear. It lasts for a few seconds then goes back to normal.

Does that make any sense?

 

[Candy]

@Samir those spikes are what I believe we call fleeting t, like a long beep for a few seconds in the ears on top of normal t? I used to get them before I had t...now still get them on top of the t now and then.

My main and most intrusive t is an electric hiss but it's centre right of the head, towards my right ear. Plus tonal cochlear noise...

 

[glynis]

@Samir,
I have a high hiss like a gas oven on full in both ears .
When I get the deep drone sound on top its a nightmare and can hear that in both ears and like a mixed sound in my head.
I know it's down to menieres and hearing loss.
The high hiss never goes and have habituated to it but not sure if the deep drone is from menieres and more central.

Love glynis

 

[Elinor]

What exactly is central tinnitus and how do you know if you have one or the other?

Was wondering the same, ended up voting "I don't know".

 

[Samir]

@Samir those spikes are what I believe we call fleeting t, like a long beep for a few seconds in the ears on top of normal t?

Yes, but for me it's usually in the left ear. I have had it in the right ear a few times. When it's in the left ear it's usually around 6 kHz, when it's in the right ear it's usually around 5 kHz. I never have them in both ears at the same time.

If this is "fleeting" T, then what is a "spike"? Is fleeting T the same as "temporary" T? I just don't know how to put words on these experiences, but I think most of us have had them.

@Elinor I also voted I don't know. But I think I may have "central".

Do you also get this "fleeting" or temporary T where one of your ears rings loudly for a few seconds and then stops?

I had that happen yesterday in my left ear and it startled me. I moved my head to the right, as to avoid it. Not sure if this thing is in the ear or in the brain when it does that. Maybe it just feels like it's in the ear?...

 

[Alue]

The term "central tinnitus" is often misused, as it is obviously the brain that perceives the cochlear tinnitus! However, when used properly, the term "central" refers to tinnitus which has its roots in the brain itself, which represents only a tiny proportion of cases. We'll not talk about the rare cases of auditory hallucinations, which are more related to neurology than hearing.

That's a pretty crappy explanation.

My most bothersome tinnitus is perceived in my head and not in my ears. It was noise induced and I don't think it started out that way (entirely in my head).

 

[Reinier]

Do you think that central tinnitus is more chronic?

I really don't know.
In my case I know it will never go away (without the help of brilliant researchers ). It is noise induced. Damaged inner ears and nerves as we all know will not regenerate.

I could understand that central tinnitus is less prevalent than cochlear tinnitus.
Just read posts. Most people with tinnitus have had (a) noise incident(s).
Quote: "when used properly, the term "central" refers to tinnitus which has its roots in the brain itself, which represents only a tiny proportion of cases."
On the other hand I read that it is suggested that noise trauma could damage not only the cochlea, but also the brain.

It is highly unlikely that damage in both my inner ears is similar (frequency wise). Not so for hearing threshold.
The frequency spectrum of the noise that damaged both ears was the same for both ears. So I assume that is why tinnitus frequency in left and right ear is equal. Both tinnitus frequencies are the same, but not the phase. Therefore I do not experience my tinnitus in my brain.
After all, phase (time difference between left and right) allows us to determine where a sound is coming from.
Because there is no "phase lock" between left and right tinnitus frequency, I sometimes experience my tinnitus "swooshing" through my head from left to right or the other way around. Also I wonder if the brief (one or two seconded) of complete silence I very occasionally experience is when the phase of the tinnitus frequency between left and right ear is 180 degrease. 180 Degrease phase shift cancel out.

I can understand cochlear tinnitus (basic understanding). Central tinnitus I can not. The brain after all is sooo complex.

 

[Samir]

@Alue So your tinnitus started out as cochlear/peripheral but has later shifted to central tinnitus?

Yeah, it's a crappy explanation. It says "as it is obviously the brain that perceives the cochlear tinnitus". Well doh! Both kinds are perceived in the brain, assuming there is more than one kind.

I'm not sure what to make of this. They say "when used properly, the term "central" refers to tinnitus which has its roots in the brain itself". By this they mean that it's triggered by the brain and perceived in the brain? What would cause this kind of tinnitus? Aspirin? Mental stress? The trigger point being the auditory cortex?

My tinnitus is likely caused by inner ear damage due to repeated intense noise through headphones. It feels more like the ringing is in the head. It felt a bit like it was in the ears in the beginning.

 

[Bidyut saha]

I voted "I don't know". My T was beginning in my ears and after a month it's always in my head. Only very few of times its ringing in my ears very slowly. So what I think my T is central?

 

[Samir]

Most people with tinnitus have had (a) noise incident(s).

Is your tinnitus central?

On the other hand I read that it is suggested that noise trauma could damage not only the cochlea, but also the brain.

Good point! I have been thinking about this myself. But everyone talks about damage in the cochlea. Do you have any links to papers that discuss higher brain function damage due to noise trauma? Doesn't have to be related to tinnitus, just the evidence that higher brain functions can be damaged by noise would be of great interest, regardless of tinnitus.

It is highly unlikely that damage in both my inner ears is similar (frequency wise). Not so for hearing threshold.

You mean like having most damage at 8 kHz in the left ear, while having most damage at 6 kHz in right ear? Despite being exposed to the same noise in both ears (exploding engine)? What do you mean by "not so for hearing threshold"? You mean it's not seen on the audiogram?

Even if you are exposed to the same noise, I don't think it affects both your ears the same way. Hearing loss is cumulative and you may not lose frequencies evenly in both ears. So if you have previously damaged 8 kHz region in the left ear, the engine explosion may add to that damage in the same region and cause permanent loss. More so than in the right ear.

The frequency spectrum of the noise that damaged both ears was the same for both ears. So I assume that is why tinnitus frequency in left and right ear is equal. Both tinnitus frequencies are the same, but not the phase. Therefore I do not experience my tinnitus in my brain.

So this is central tinnitus then? If you feel like the ringing is in the brain?

After all, phase (time difference between left and right) allows us to determine where a sound is coming from.
Because there is no "phase lock" between left and right tinnitus frequency, I sometimes experience my tinnitus "swooshing" through my head from left to right or the other way around. Also I wonder if the brief (one or two seconded) of complete silence I very occasionally experience is when the phase of the tinnitus frequency between left and right ear is 180 degrease. 180 Degrease phase shift cancel out.

Interesting! Very interesting!

You may be onto something here. Maybe not as a cure, i.e. phase out tinnitus tone, but in understanding the condition. I think this may be related to binaural fusion.

I don't experience that my tinnitus shifts from one ear to the other like that. At least not now. But in the early beginning, it really felt like my left ear was somehow lagging behind or lacking input compared to the right ear. The audiogram did show a slight decline in high frequency in the left ear, compared to right ear. This might have been the moment when my brain decided to compensate by increasing the gain for the left ear.

That might explain why the ringing started in my left ear. Then went to the right ear, then back again to the left ear, then middle of the head, then it stayed there and the intensity went down a little. So it was as if my brain was doing two things: increasing gain, and balancing.

I can understand cochlear tinnitus (basic understanding). Central tinnitus I can not. The brain after all is sooo complex.

I agree, it is complex. Hopefully there are scientists out there who understand this much better than we do, who can help uncover some of the secrets of the brain and hearing. Binaural fusion is a very interesting concept. It may help explain some of the things that tinnitus patients experience. Such as this phase shifting you experience.

At least we know much, much, much more than ancient Egyptians did 4500 years ago! We know so much more about everything! Not just tinnitus and hearing. About every part of our body, and the universe! I just hope it doesn't take us another 4500 years to fully understand and cure all forms of tinnitus.

 

[Samir]

I voted "I don't know". My T was beginning in my ears and after a month it's always in my head. Only very few of times its ringing in my ears very slowly. So what I think my T is central?

Do you think your T was caused by noise? Did it start in one ear or both ears?

My T was most likely caused by intense noise through headphones. It was some technical problem that caused a long continuous "PEEEEP" in the headphones. Since then I have started to have problems with my ears, and after many months I started to develop T. It was first in my left ear, then right ear, then in the head. After some months it went down in intensity a little. Now it's always in my head. Sometimes I get fleeting loud T in the left ear for a few seconds.

I am not sure... but my T may be central. At the moment it feels like inside my head, not in the ears.

 

[Bidyut saha]

Do you think your T was caused by noise? Did it start in one ear or both ears?

My T was most likely caused by intense noise through headphones. It was some technical problem that caused a long continuous "PEEEEP" in the headphones. Since then I have started to have problems with my ears, and after many months I started to develop T. It was first in my left ear, then right ear, then in the head. After some months it went down in intensity a little. Now it's always in my head. Sometimes I get fleeting loud T in the left ear for a few seconds.

I am not sure... but my T may be central. At the moment it feels like inside my head, not in the ears.

Yes , 6 months ago one day i was talking with someone over hours and I was not careful that one part of my earphone was unfurled. After finish talking I noticed my left ear is ringing very loudly like a electric sound as like u. And after 3/4 days in both ear then head. After one month of beginning my ears are stop ringing but in my head always sound like wind which move all over my head.
Note: since one week the weather hv change in our city. We r enjoying the sun shine. I don't know why my T also change his sound. Now its not a sound like wind or hissing. It's like a electric eeeee tone and not very loud. I can go out and do work and concentrate.
Sorry 4 my very bad English. Thank you

 

[Samir]

@Bidyut saha Thanks for sharing your experience! I can see that this is similar to what happened to me. Since this happened, I have stopped using headphones and earphones. I don't want to risk any more of my hearing. I'm sorry about your T. I hope you will get better. Take care of your ears!

 

[Bidyut saha]

@Bidyut saha Thanks for sharing your experience! I can see that this is similar to what happened to me. Since this happened, I have stopped using headphones and earphones. I don't want to risk any more of my hearing. I'm sorry about your T. I hope you will get better. Take care of your ears!

I am also stop useing all the ear/headphones and I take my ear plugs always when I go out. God bless you.

 

[Alue]

@Alue So your tinnitus started out as cochlear/peripheral but has later shifted to central tinnitus?

Yeah, it's a crappy explanation. It says "as it is obviously the brain that perceives the cochlear tinnitus". Well doh! Both kinds are perceived in the brain, assuming there is more than one kind.

I'm not sure what to make of this. They say "when used properly, the term "central" refers to tinnitus which has its roots in the brain itself". By this they mean that it's triggered by the brain and perceived in the brain? What would cause this kind of tinnitus? Aspirin? Mental stress? The trigger point being the auditory cortex?

My tinnitus is likely caused by inner ear damage due to repeated intense noise through headphones. It feels more like the ringing is in the head. It felt a bit like it was in the ears in the beginning.

Are they trying to indicate cochlear and central have different etiologies? I don't know about the differentiation between cochlear and central as the explanation seems rather nebulous to me, but I perceive my tinnitus more in my head now. I can almost feel it in my head behind my ear. Especially on my bad side. It started out in my head and ears and after a month or two it was mostly in my head. I remember putting a lot of thought into it because I was doing the AM101 trials at the time and I figured if it was effective it would probably only work on cochlear tinnitus. There was also a big deal made about acute tinnitus and chronic tinnitus with the thought that tinnitus becomes chronic somewhere around 3 to 6 months, but I honestly think it becomes chronic in a much shorter time-frame.

 

[Reinier]

Is your tinnitus central?

No. Although both ears the same frequency, I hear the tinnitus not in the middle between my ears.
Frequency of tinnitus in both ears has been (objectively) determined by audiologist and was/is 9.5 kHz).

just the evidence that higher brain functions can be damaged by noise would be of great interest

I am not sure if it was evidence. I think it was suggested. I glanced at it. Therefore I do not think I will find it again. Unfortunately. I will however store this in my database (brain ) and send you a link if I see it again.

You mean like having most damage at 8 kHz in the left ear, while having most damage at 6 kHz in right ear? Despite being exposed to the same noise in both ears (exploding engine)? What do you mean by "not so for hearing threshold"? You mean it's not seen on the audiogram?

Both ears the same frequency. Because the source (loud explosion) I was exposed to had the same frequency spectrum (no reflection from walls etc.). One ear was exposed to more sound than the other. One ear pointing more to the sound source than the other ear. Also perhaps one ear more susceptible to damage than the other ear.

i.e. phase out tinnitus tone

The problem is that a lot of tinnitus is not one frequency but a frequency band. For example my tinnitus often sounds like purple noise. How do you phase lock to purple noise? You can only phase lock to one frequency.
Perhaps there is nothing in it. But at the moment I can not see a difference between the effects my tinnitus gives me and the effects I experienced when I was doing a lot with audio and did not have inner ear damage.

 

[Samir]

Are they trying to indicate cochlear and central have different etiologies?

That's what it seems like to me.

If this is what they are saying, then tinnitus that starts out in the ears (cochlear) and then transitions to ringing in the head cannot possibly be central? It's rooted in the ears, i.e. cochlear tinnitus, even though it is now perceived to be more inside the head.

That's why I made that question. If it can become central. Anyway! It is not clear to me what exactly they mean by this.

I remember putting a lot of thought into it because I was doing the AM101 trials at the time and I figured if it was effective it would probably only work on cochlear tinnitus.

Yes, the AM-101 was said to be for acute peripheral tinnitus.

Did the AM-101 have any positive effect on your ringing in the ears or behind the ears?

There was also a big deal made about acute tinnitus and chronic tinnitus with the thought that tinnitus becomes chronic somewhere around 3 to 6 months, but I honestly think it becomes chronic in a much shorter time-frame.

Yes, I wonder how they come up with those numbers. I also think it becomes chronic much quicker. Probably like 5 days max. I know my "ringing" sensation only began around December last year. But I had already been experiencing some kind of static sound for at least 6 months, if not more. That first sound did not bother me as much as ringing. I thought nothing of it.

But does static also qualify as tinnitus? Well... if tinnitus is perception of sound without external source, then I would say yes. So if that's the case, then my tinnitus started 6 months before it changed sound character and before I recognized it as tinnitus.

So for me, it came on gradually, sneaked up on me so to speak. I wouldn't know for sure how long after acoustic trauma I started to experience sounds without external source. But my guess would be that it started only a few weeks after.

 

[Samir]

Frequency of tinnitus in both ears has been (objectively) determined by audiologist and was/is 9.5 kHz).

How do they do that?

I will however store this in my database (brain ) and send you a link if I see it again.

The problem is that a lot of tinnitus is not one frequency but a frequency band.

I can only assume this is because of different noise source, and varying level of previous damage. We don't wear down our ears evenly. Just like you don't wear down all the tires evenly on a car.

For example my tinnitus often sounds like purple noise. How do you phase lock to purple noise? You can only phase lock to one frequency.

Yes, that would be very complicated.

But it's interesting to me that my tinnitus is mostly 6 kHz tone. The noise I was exposed to was also around 6 kHz. It sounded like a pure tone, but I have a recording of it, and when I looked at it I saw it was multi-tonal, centered around 6 kHz. I don't think it's just a coincidence that my tinnitus is now also 6 kHz.

 

[Reinier]

How do they do that?

Sorry. Subjectively. Objectively is not (yet) possible.
When I went for a check-up we did another test to determine my tinnitus frequency. My audiologist was surprised I was again spot on the same frequency .

 

[Samir]

When I went for a check-up we did another test to determine my tinnitus frequency.

So they play different tones for you? Until you stay stop? All the way up to 9.5 kHz?

That's interesting because they usually stop at 8 kHz.

My audiologist was surprised I was again spot on the same frequency .

You mean the audiogram looked the same as last time?

 

[Reinier]

So they play different tones for you? Until you stay stop? All the way up to 9.5 kHz?

That's interesting because they usually stop at 8 kHz.

Yes. Also it was possible to go up to 12 kHz.

You mean the audiogram looked the same as last time?

No not audiogram (although that most likely would not have changed). We did the same exercise. Increase frequency until I found the matching frequency.
For plotting an audiogram they stop at 8 kHz. I believe equipment calibrated for higher frequencies is also much more expensive. The consensus is/was that if you hear up to 8 kHz (and not sloping down at 8 kHz too much) you do not have inner ear damage. I think this is changing slowly with al the research going on.
But to determine tinnitus frequency they will go higher. You don't need calibrated (sound level) equipment for that.

 

[sleepy]

I have acoustic damage via headphones. I also get this loud ringing noise in my ears, either my left or right. It sounds like the ringing noise when you get hit with a flashbang in a videogame. I have to forcefully pop my ears sometimes to make it go away. It makes me uncomfortable at times because the noise is sometimes double or triple the volume. It usually last a few seconds or so.

My T used to be either of my ears. After I used my headphones again the next day my T felt like it was coming in the middle of my head. I've noticed that I have hyperacusis now. My T always feels worse at night. I'm nearly two months in with T and I still can't understand it. I have three tones now compared to my previous one tone.

 

[Samir]

Also it was possible to go up to 12 kHz.

Cool! Do you know what brand they used?

No not audiogram (although that most likely would not have changed).

Mine did change a little after 2 months. It looked like my hearing improved at 6 kHz. But it was around this time that I started to hear the ringing all the time. So probably my brain increased the gain actually. Assuming that theory is a real thing.

I believe equipment calibrated for higher frequencies is also much more expensive.

Audiometers are not very cheap. But I don't think the ones that go high in frequency are that much more higher in price. But there may be some added cost in calibrating them which is something they have to do regularly, I assume.

The consensus is/was that if you hear up to 8 kHz (and not sloping down at 8 kHz too much) you do not have inner ear damage. I think this is changing slowly with al the research going on.

How do you know it's changing? Have you been secretly going to audiologist conferences?

The medical researchers are definitely poking the audiologists in their eyes! Or is it the ears... But I wonder how much more it will take for the audiologist community to change their heart and start adapting to the latest amounting research evidence that the standard hearing test is not sufficient. Maybe we need to throw some sand in their eye... I mean ears!

I don't mean to make fun of audiologists. But they need to start listening! If they can't hear well, let them have hearing aids installed...

Seriously though! They are usually the first ones that the patient meets. So they need to be able to set correct diagnoses, and preferably with improved and objective tests. I know there are no ways to visually inspect cellular integrity of the cochlea. But what they can do already is start testing for very high frequency hearing loss. That should be a simple thing for them to do. It's something they already work with, they know how to use audiometers, they just need to extend the frequency range of the test. I am sure that would have a great clinical value. Maybe they don't need to do it on all patients, but on those where they see fit. Perhaps people with normal looking 8k audiograms but who have tinnitus.

But to determine tinnitus frequency they will go higher. You don't need calibrated (sound level) equipment for that.

But what if your frequency is at 14 kHz? Will they go as high? I think there was one member who had 15 kHz ringing.

But basically, this T frequency matching is something everyone should be able to do with a tone generator? If so, then everyone should be able to do it at home.

 

[Samir]

I have acoustic damage via headphones.

Same here!

I also get this loud ringing noise in my ears, either my left or right. It sounds like the ringing noise when you get hit with a flashbang in a videogame. I have to forcefully pop my ears sometimes to make it go away. It makes me uncomfortable at times because the noise is sometimes double or triple the volume. It usually last a few seconds or so.

I think this is what people call fleeting T.

It sounds like the ringing noise when you get hit with a flashbang in a videogame.

You used to get that ringing while playing a videogame? Or was this a sound effect in the game?

I have to forcefully pop my ears sometimes to make it go away.

You can make it stop ringing by popping your ears?

the noise is sometimes double or triple the volume. It usually last a few seconds or so.

Yeah, for me it usually lasts up to 10 seconds, no more. It's always in one ear, usually the left ear which seems to be the bad ear.

My T used to be either of my ears. After I used my headphones again the next day my T felt like it was coming in the middle of my head.

I continued to use headphones for some time after the first incident. I had not realized then that I had damaged my ears. I only realized this when I started having constant ringing. I stopped using headphones and earphones completely. I suggest you do the same.

Mine also feels like it's in the head now, but it started in the left ear. The bad ear.

I've noticed that I have hyperacusis now.

Your hyperacusis might get better. I hope it does. Mine was mild, and I had it before I got tinnitus. It is almost completely gone now, about 4 months after I realized I had tinnitus.

My T always feels worse at night.

That might be because it is generally more quite at night. So you may notice it more.

I'm nearly two months in with T and I still can't understand it. I have three tones now compared to my previous one tone.

You are still early into this. You will get better, but you need to give it more time. Still, I wish there was a cure. But there is not. Not at this point in time. There are however different ways of managing it so it doesn't bother you as much.

 

[sleepy]

Same here!


I think this is what people call fleeting T.


You used to get that ringing while playing a videogame? Or was this a sound effect in the game?


You can make it stop ringing by popping your ears?


Yeah, for me it usually lasts up to 10 seconds, no more. It's always in one ear, usually the left ear which seems to be the bad ear.


I continued to use headphones for some time after the first incident. I had not realized then that I had damaged my ears. I only realized this when I started having constant ringing. I stopped using headphones and earphones completely. I suggest you do the same.

Mine also feels like it's in the head now, but it started in the left ear. The bad ear.


Your hyperacusis might get better. I hope it does. Mine was mild, and I had it before I got tinnitus. It is almost completely gone now, about 4 months after I realized I had tinnitus.


That might be because it is generally more quite at night. So you may notice it more.


You are still early into this. You will get better, but you need to give it more time. Still, I wish there was a cure. But there is not. Not at this point in time. There are however different ways of managing it so it doesn't bother you as much.

Sorry, I'm using my cellphone so it's difficult to quote what you highlighted.

My fleeting T sounds like a flash bang effect in a video game. Thanks for highlighting that, I'm still quite new to this so I'm unfamiliar with some of the terminology.

My T was almost disappearing during my first onset. Nearly two weeks in I used my headphones again which made my T worse. Previously my left ear had no T sound. My right ear had maybe .05-1/10 ring sound only. Now I have central high pitched crickets. When my cricket sound lowers I can hear a faint fire alarm on my left and a ringing on my right.

When I get my fleeting T I think I can stop it. I forcefully pop my ears by pinching my nose and blowing in. I'm not sure if it helps, but it feels like it offers me relief. My fleeting T lasts 5 seconds or so on either ear. I never had it happen on both ears yet.

I feel like my H is what's causing my T to spike. All the accumulated loud noises seem to take it's toll throughout the day and make my T louder at night. I'd also like to note that I sometimes wake up with quiet T. Sometimes 2-3/10 in the morning and at night it's usually a 5+/10.

I do hope for a cure one day and hopefully it's cheap.

 

[Telis]

For me, the high pitched tinnitus noises are all over my brain, even behind my eyes, the lower pitches seem to be in the ear, or even sound like they are coming from an outside source.

 

[Reinier]

Cool! Do you know what brand they used?

No I don't. But I think the set used by most ENT/audiologists will go higher than 8 kHz. Except the output level is not calibrated for frequencies higher than 8 kHz. For determining tinnitus frequencies you can use something that is not calibrated. The frequency will also be an approximation.

It looked like my hearing improved at 6 kHz. But it was around this time that I started to hear the ringing all the time.

Interesting. Have you read the document on stochastic resonance? http://journal.frontiersin.org/article/10.3389/fnins.2016.00597/full

Audiometers are not very cheap.

It is also headphones. It is an expensive headphone that has a flat frequency response for higher frequencies. But I think most of all the consensus is there is no need for frequencies higher than 8 kHz to check hearing.

How do you know it's changing? Have you been secretly going to audiologist conferences?

You asked the question and answered it better than I could .

But basically, this T frequency matching is something everyone should be able to do with a tone generator? If so, then everyone should be able to do it at home.

I agree. Just be careful with high frequencies. Sometimes you can still do damage when you think you need to increase the level way up to hear the high frequency. Know what you are doing!