How Many People Here Have Noise-Induced Tinnitus but Good Audiograms?

I myself have moderate to severe tinnitus that came on after an acoustic shock but on a standard audiogram my max drop is 15 dB for a single frequency, and 10 dB or less for everything else. I'm aware of extended audiograms and hearing loss that may occur above 8 kHz, however excluding that, I'm curious if I am at all unique in having bad tinnitus and a "strong" standard audiogram.

My primary concern is that I'd like to benefit from the seeming advent of regenerative medicine we are experiencing, but I wonder if restoring hearing will be beneficial for me given I don't have what would normally be considered heavy loss.

As a bonus, assuming we gain the ability to restore hair cells and synapses, should we target 0 dB audiograms as an ideal? How do we know where to draw the line?

 

No measurable hearing loss from 200 Hz-8000 Hz. The audiologist didn't even understand the concept of extended audiograms when I asked. In fact my hearing is "above average." Regenerative medicine could definitely help tons because higher frequency hearing is the first to go, so you definitely shouldn't neglect extended audiograms up to 16 kHz. I guess we should target improved quality of life rather than relying on the flawed metric that is audiograms.

 

My audiologist told me my hearing is as strong as a child's. Yet, I have tones blaring in my ears that are in the same frequency range that was tested.

 

Mine's pretty good/suspected noise induced. It's consistent at 5 dB until I hit 2 kHz where my right ear drops to 10 dB, then at 3 kHz both L/R drop to 15 dB.

From then on, hearing remains at 5 dB from 4 kHz to 8 kHz, where on 8 kHz my left ear drops to 10 dB while my right stays at 5 dB.

 

That’s the problem with hearing tests. I can guarantee you that all of us that suffer from hyperacusis or tinnitus have cumulative damage. FX-322 has a good chance at resolving these issues.

 

Humans (and other animals) are not normally equally sensitive to all frequencies that's one reason a normal range is used. Most people are maximally sensitive around 4000 Hz.

Human Hearing: Amplitude Sensitivity

Anyway, if you are mostly hovering around 10 dB - 15 dB, you may not have much, if any, hair cell loss in those frequencies. Most people with noise induced hearing loss that have audiogram changes have them much worse in the extended frequencies so it is not unique to have noise induced hearing damage and a normal standard audiogram. It is worth getting an extended audiogram unless you are too noise sensitive for it.

Also, per Liberman, many times synaptopathy is much more prevalent with noise induced hearing damage than hair cell loss. Synaptopathy will not show up on an audiogram and will cause hearing damage as "hidden hearing loss." In that case, a synaptopathy drug would benefit you more.

I also have a suspicion that most people with noise induced hair cell damage on an extended audiogram probably have at least some degree of synaptopathy further towards the apex (i.e. in the standard range) as Liberman has experimentally found synapses to be more sensitive to at least certain types of noise damage than hair cells.

 

Mine drops of a bit at 7500 Hz-8000 Hz on days when I have loud tinnitus, and it does not on quiet days... Just another example of how the standard audiogram is limited, outdated and not to be trusted.

I've not experimented with testing extended frequencies much myself, it gives me spikes.

 

Consider yourself lucky. I would give the world to have a "normal" audiogram and only be concerned with tinnitus.

 

Possibly the majority of tinnitus sufferers don't have any hearing loss that can be detected by a regular hearing test.

 

My audiogram detected no significant loss whatsoever. Between 250 Hz and 8000 Hz, it's all between -5 dB and +5 dB.

Yet I have several screaming, reactive and competing tones and other ear issues. Suspecting a combination of noise, whiplash and stress/anxiety for mine. Haven't had any improvement either.

 

Keep in mind that this audiogram is displayed on the website of one of the leading hospitals in Belgium as a perfectly normal audiogram:



Mine looks way better than that ("You have the hearing of a newborn baby") except for the 4000 Hz frequency where I have a "nudge" of -20 dB, but still considered as perfectly normal hearing.

I do however have tinnitus in both ears due to cumulative noise exposure + an extremely loud accident with in ear headphones to kickstart this nightmare. 4 weeks after this accident I woke up with a loud low pitched roar in my right ear > currently high pitched electric buzz in both ears, it's been a while since I heard the loud lowpitched roar.

I still wonder if I need to be looking at FX-322 or Otonomy for my specific case.

 

I only got audiograms up to 8000 Hz and while they vary slightly I never had a dip below 20 dB and most frequencies were 10-15 dB.

 

Standard audiogram - max 10dB hearing loss, mostly at 0-5dB
Hovewer, I have 25-50dB drop in range 10-16 KHz (I'm only 23 so probably that's not age-related high frequency hearing loss)

 

I think the problem is ENTs are labelling "normal hearing" what should be labelled "ok hearing for the noisy urban environment in which we live".

So they draw the line of normal on hearing loss up to -20 dB / -25 dB.

 

On audiograms, out of personal experience:

- With very good hearing it is possible to hear a pure tone at the right pitch and also the vibration the sound carries, a "roundness" to the sound.

- Hearing a pure tone at 5 dB at 8 kHz does NOT mean hearing the right pitch of 8 kHz. It is possible to hear the tone but at a different pitch (usually lower), which is a sign of things not going well...

- Sometimes, in my case specially after noise exposure, our hearing can amplify and distort sounds. To me this means the hearing system is doing an effort to try to hear above its real threshold. So maybe the audiogram shows that I heard 8 kHz at -10 dB but my hearing is really overcompensating and there is more hearing loss than shown at the audiogram.

- Speech is harder to perceive and decode than pure tones on a audiogram, so it is important to get a verbal audiogram, testing the ability to perceive speech. This can also be done with masking noise in several ways (static, noise that change, noise of a different pitch, noise that closely resembles frequencies involved in understanding speech etc etc)

 

My hearing loss is negligible and yet I still have noise-induced tinnitus. I'm certain it's hidden hearing loss.

 

I have negligible hearing loss but horrible tinnitus.

I have one dip 20 dB @ 3 kHz and I also do have 3 kHz tinnitus which was the most prominent frequency at first, sadly I now have 10 tones due to noise exposures over the years but my audiogram remains the same. Even my extended audiogram is really good, on my right ear I got a -5 dB at 16 kHz, my left ear is slightly worse between 0 and 15 dB for the extended audiogram. I also have high frequency tinnitus on the left ear.

It's my understanding though that there is no meaningful average for the extended audiogram so the results are quite meaningless? You would have to compare against yourself.

 

I have been wondering the same thing. Sounds at these frequencies also seem loud very fast as if there's some loudness recruitment at work.

 

If sound volume somehow seems to accelerate, or for instance you switch on TV and you start turning up volume point by point, and at a certain moment from one point to the next the sound is perceived way louder, or clearer, there is a issue there, and it is likely recruitment.

 

I live in France and had 4 different audiograms with different ENTs.

These were high-frequency audiograms, going up to 16 kHz.

The 4 audiograms showed more or less the same results.

I've been to an audiologist to try out hearing aids.

There I did the most precise, longest and accurate audiogram I've ever done.

Instead of checking let's say 15 different frequencies, they maybe checked for 50.
They investigated really precisely Hz by Hz where I've got the biggest gaps in my hearing and where the main tinnitus tones are located.

I don't know how it goes in other countries, but here in France, I can tell the most informative and accurate audiogram we can have are with an audiologist.

Cheers.