Can Tinnitus Have an Effect on Audiogram Hearing Tests?

[Dean2014]

I have extreme tinnitus and have taken several hearing test audiograms. I am concerned my ongoing tinnitus different pitch sounds may have effected an accurate audiogram test result reading.

Anyone have links or information that supports that tinnitus may have an effect on the accuracy of audiogram hearing tests?

 

[attheedgeofscience]

Try this:

https://www.tinnitustalk.com/threads/am-101-tactt1-results-released.1994/page-20#post-38164

 

[Steve]

Can't say I have any links, but the last hearing test I did I was very aware that my tinnitus was mixing with some of the tones and I couldn't hear them until they were quite loud. It's logical that it will have an effect because you hear those tones a lot better if your tinnitus wasn't there.

As ATEOS says in the linked post, a pulsed sound test is much better, a constant tone is difficult to pick out around your tinnitus pitch.

I had a test a lot of years ago where they used white noise. That masked my tinnitus pretty well at the time so I was picking the pitch out of the noise. It felt better and more precise.

 

[Dean2014]

Appreciate the feedback! Was just curious since my audiogram tests are being looked at to see if the loss of hearing is the result of being noise induced from work related incident(s). My concern is the accuracy of the audiogram review since my tinnitus I believe masked out a portion of the tests tones at certain Hz levels. I wasn't aware of the pulsating sound tests as being an option for those suffering from Tinnitus. Thanks again for the feedbacks.

 

[Lisa88]

Yes, I was very concerned about this also. Just had my audiogram and OAE done, which came back as normal, and above average actually. I have multi tone t, sometimes quite loud. The tones they use were warble tones, quite distinct from most t. You can also ask for double test tones etc. But of course, when the test tones get quieter - no matter what timbre, with t blaring, any t might mask those tones. I asked the audiologist about this. There is a margin of error they use for this. As most people's t decibels are quite soft in volume when measured. I was sure I would fail the test. But passed with t and flying colors. Don't forget that these tests are not final. You can always go back and get retested on a better t day, as many do, with better results.

 

[Dean2014]

Thanks Lisa!

 

[Steve]

@Lisa88 That sounds like a pretty good audiologist. I've had several tests and they don't have any answer when I've mentioned the T.

 

[Dr. Nagler]

Can't say I have any links, but the last hearing test I did I was very aware that my tinnitus was mixing with some of the tones and I couldn't hear them until they were quite loud. It's logical that it will have an effect because you hear those tones a lot better if your tinnitus wasn't there.

It's an interesting issue.

We know that external sounds can mask tinnitus.

The question is whether or not tinnitus can mask external sounds. In other words - very hypothetically, if there were a pill that would make your tinnitus disappear, would your hearing thresholds in the pitch range of your tinnitus improve? I may be in the minority here, but I suspect not.

Stephen Nagler

 

[jazz]

I have extreme tinnitus and have taken several hearing test audiograms. I am concerned my ongoing tinnitus different pitch sounds may have effected an accurate audiogram test result reading.

Anyone have links or information that supports that tinnitus may have an effect on the accuracy of audiogram hearing tests?

I agree with Steve. Specifically, I know tinnitus does not affect your hearing per se, but it may affect your perception of sounds that are similar to the tones your audiologist offers in a hearing test. This is particularly true if your tinnitus is loud and/or is similar to the tones in the audiogram. Several months ago, I read an article that explained how tinnitus affects your perception of sound. But I must find the article.

Another hypothesis is offered on the Oregon Health & Science University (OHSU) website. This hypothesis argues that tinnitus will not affect your hearing, but will affect your attention. I think this also makes sense, especially during a hearing test when you're so focused on hearing those tones.

Here's the observation from OHSU:

Is Tinnitus interfering with my hearing?
No. Tinnitus does not interfere with hearing, although it may affect your attention span. On the other hand, tinnitus will seem worse if your hearing loss increases because outside sounds will no longer cover up the tinnitus.
(http://www.ohsu.edu/xd/health/services/ent/services/tinnitus-clinic/tinnitus_facts.cfm)

​

 

[Steve]

It's an interesting issue.

We know that external sounds can mask tinnitus.

The question is whether or not tinnitus can mask external sounds. In other words - very hypothetically, if there were a pill that would make your tinnitus disappear, would your hearing thresholds in the pitch range of your tinnitus improve? I may be in the minority here, but I suspect not.

Stephen Nagler

It's interesting and how I wish we could test it out. Although if we had a comparison of the different hearing tests I'm sure that would come close.

In my last test, one of the tones specifically was very well matched with my loudest tinnitus sound. And because being in the sound proof booth had made mine louder at the time, it was literally when it got too loud, almost painful, that I realised the sound was there. Without my tinnitus mixing with the sound I am sure that would not have happened in the same way.

I imagine it could also depend on where the individual perceives their tinnitus, I perceive mine in my ears so maybe I am more likely to be effected (or feel that I am) in a hearing test.

 

[Dr. Nagler]

It's interesting and how I wish we could test it out. Although if we had a comparison of the different hearing tests I'm sure that would come close.

In my last test, one of the tones specifically was very well matched with my loudest tinnitus sound. And because being in the sound proof booth had made mine louder at the time, it was literally when it got too loud, almost painful, that I realised the sound was there. Without my tinnitus mixing with the sound I am sure that would not have happened in the same way.

I imagine it could also depend on where the individual perceives their tinnitus, I perceive mine in my ears so maybe I am more likely to be effected (or feel that I am) in a hearing test.

Perhaps the reason you have that particular tinnitus tone is precisely because that's the frequency where you have a threshold shift, rather than the other ay around.

I can tell you this - in folks with intermittent tinnitus, their audiograms are similar whether or not their tinnitus is "on" at the time of the testing. (Sorry, I cannot cite a published study to back that up, but most experienced tinnitus clinicians will tell you the same thing.)

Stephen Nagler

 

[Steve]

Perhaps the reason you have that particular tinnitus tone is precisely because that's the frequency where you have a threshold shift, rather than the other ay around.

I can tell you this - in folks with intermittent tinnitus, their audiograms are similar whether or not their tinnitus is "on" at the time of the testing. (Sorry, I cannot cite a published study to back that up, but most experienced tinnitus clinicians will tell you the same thing.)

Stephen Nagler

It is in the same region as a shift, but if the tone was pulsed I wouldn't have the same issues in perceiving it. I've tested myself with a tone at constant volume and when it pulses on and off it's easier to hear it as a distinct tone at a lower volume. Not by a huge way, but enough that it will give a slightly exaggerated reading on an audiogram with a constant tone.

I do also get intermittent tones in the soundproof booths so that doesn't help me identify the test tones at quiet volume either.

 

[KatieMac145]

I'm having a hearing test on Thursday before an ENT appointment. This is the first time my tinnitus and possible hearing problems will be addressed by a professional. I'm definitely going to ask for the pulsing sounds because my T is constant and high-pitched with intermittent stand-out sounds. Hope this is a good starting point!

 

[Dr. Nagler]

It is in the same region as a shift, but if the tone was pulsed I wouldn't have the same issues in perceiving it.

If you think about it, we communicate in pulsed tones - so audiograms by rights should all be done using pulsed tones. In fact, I cannot ever recall having an audiogram that didn't use pulsed tones.

Stephen

 

[jchinnis]

Counterintuitively, pulsed tones aren't easier to hear whether or not you have tinnitus. I remember old research that showed no effect at all on thresholds, although subjects with tinnitus swore pulsed tones were recognized better.

I think tinnitus is tinnitus and hearing loss is hearing loss.

 

[Dr. Nagler]

I think tinnitus is tinnitus and hearing loss is hearing loss.

Tinnitus is tinnitus, which isn't so good.

Hearing loss is hearing loss, which isn't so good.

And you, @jchinnis, are here on Tinnitus Talk, which is absolutely wonderful!

Welcome.

Stephen

 

[Steve]

Of course that should have been the first thing I did, check the research. And you're right @jchinnis

This is an old study, the attached image is from the abstract

http://www.isa-audiology.org/period...80)/Hochberg Waltzman, Audiology, 1972.pdf

And a 2004 study also - 'Hearing thresholds and test-retest reliability were comparable for the 2 signals, and there were no significant differences in the number of false positives or the number of presentations required to reach threshold'

Although people with tinnitus preferred the pulsed tones.

http://www.ncbi.nlm.nih.gov/pubmed/15248804

 

[Danny]

so I've gone to 3 different hearing tests, told them all that I have tinnitus, I had to really focus on listen for the sounds in tests, all 3 test drs. told me the same....I have the hearing of a middle age male....that I have trouble in the upper region of high frequencies..all 3 same diagnosis

 

[Balthazar]

I have mild lower frequency hearing loss and my tinnitus is also around that range. My top end hearing is very good though. I feel it's plausible it could have masked the audiogram tones, but then maybe it's more because I want it to.