Is a Notch in Hearing at 2 kHz Indicative of Otosclerosis?

[DimLeb]

Hello guys. I'm looking for some help and maybe similar experiences. Like most people here, I'm still trying to find a cause for my bilateral tinnitus. It's very mild and can be masked with anything, but it's multi-tonal and had its periods of increasing so I'm very concerned and anxious about it.

So I've been looking at my audiograms and I'm seeing this 2 kHz notch that seems to appear. I've had plenty of audiograms since March 2021 when my tinnitus began. Some of them showed no hearing loss (0-10 dB at all frequencies), and some showed fluctuations (0-20 dB) like these 2 I'm attaching here (July 2021 - November 2021).

Doctors said every time that it's almost no hearing loss, or at least nothing indicating an ear disease, apart from a hereditary idiopathic cochlea damage.

But I came across some posts about the notch at 2 kHz in otosclerosis and made me really worried as my audiograms kinda have this notch on both ears. I don't really have an obvious problem with hearing loss as I'm a music producer and I check my hearing all the time.

If you are familiar with otosclerosis, is this an indication? Can otosclerosis related tinnitus be bilateral and start long before any noticeable hearing loss? Can both ears be affected at the same time with the same hearing loss pattern?

Thanks in advance for any comment, I truly appreciate anything you can offer!

 

[GregCA]

If you are familiar with otosclerosis, is this an indication? Can otosclerosis related tinnitus be bilateral and start long before any noticeable hearing loss? Can both ears be affected at the same time with the same hearing loss pattern?

It's called a Carhart Notch, and yes, it is one of the clues used to diagnose otosclerosis, but I don't know anyone who's been diagnosed with otosclerosis from just that one symptom.

There's more to do to diagnose otosclerosis. Check if you have an air-bone gap, do the fork tests (Weber/Rinne), inspect the ear drum, check stapedial reflexes, look for family history... if need to go deeper, high resolution CT scan...

Note that you have very little losses: I would be surprised if any doctor says you are "out of spec".

If you've been listening to loud music, you may have suffered synaptopathy, which doesn't show on your audiogram (aka "hidden hearing loss").

 

[DimLeb]

@GregCA, thanks for your insight my friend! I'm familiar with your posts about otosclerosis and was literally reading them just now. I hope you are doing better these days!

I believe I have done all the examinations (except the CT scan) you mentioned and they were good. I also believe the first audiogram has bone conduction (those > symbols above the O and X's), that mostly follow along, so most likely little to no air/bone gap.

As for family history, it was my aunt, my father's sister, who had otosclerosis, but she never complained about ear problems. This history scares me to be honest.

You are possibly right about synaptopathy and hidden hearing loss, as I have beaten my ears with loud sounds being a musician for a decade (gigs, rehearsals, headphones, music making). Thing is, tinnitus appeared long after all these, when I was 95% of time at home using speakers normally. I'm inclined to believe that it's not external damage. Who knows...

I just wish that ENT science was a bit better. You can't even get a solid diagnosis in most cases, let alone treatments...

 

[NYCGuy]

I have a big 2 kHz hearing loss, 35 dB, but my ENT never mentioned otosclerosis may be the cause. Now I should be worried about it?

I do have tinnitus, ear clogged with nose clogged and neck pain but nothing else.

 

[DimLeb]

@NYCGuy, I wish I knew man. It's just that it seems uncommon around this forum to have a notch at 2 kHz, compared to noise induced hearing loss that is commonly at 4 kHz or upper range. Probably they need to see more clues for otosclerosis (e.g. more hearing loss).

Your cause I read was stress? It seems more possible that the hearing loss caused the tinnitus and your other problems, but even that doesn't explain anything because most people have some hearing loss but they don't have tinnitus lol...

Maybe damage (in any way it happens) can cause loss at random frequency spots in some cases, so you can't pinpoint something specific.

If ENTs could actually explain all these, that would be great.