Do All Tinnitus Necessarily Have Hearing Loss?

[Asian]

Hello Doc. I have had tinnitus since about 14 months. All the hearing tests are fine in the normal human hearing ranges except a very slight dip that the audiologist says may not maynot be related to the concussion. Even the OAE test came back negative indicating the hair cells are probably fine. I still haven't got tested in the higher frequencies as the audiologist didn't feel the need to do so. My tinnitus occurred as a result of my head smashing on concrete. I want to know your thoughts on:

Do you think almost every tinnitus has the hearing loss component in it ? In have read at several places that tinnitus can be because of stiff jaws and necks, muscular spams, atlas and axis instability which maybe because of closed head injuries , vitamin deficiency, infection etc. Do you think for tinnitus to happen there always has to be some hearing loss in 100% cases regardless of what started their tinnitus? Do you think the spasms and stiffness, instability of upper cervical area etc just contribute to the noise already present because of the hearing loss? Or they can alone be the cause of tinnitus ? I have always wondered about this thing. I would appreciate if you throw some light on it.
Thanks for your time

 

[Dr. Nagler]

Do you think almost every tinnitus has the hearing loss component in it ?

I believe that all tinnitus is in one way or another related to hair cell loss. But since we all lose at least 0.5% of our hair cells for every year of our adult life, there is no real way to prove it. In terms of trying to actually cure tinnitus, I suspect that the exact cause(s) of tinnitus will have to be identified. But fortunately, in terms of obtaining substantial meaningful lasting relief from tinnitus (i.e., an appreciable lasting decrease in tinnitus severity), that is not the case.

Dr. Stephen Nagler