New York Post Article on Hyperacusis

[Juan]

To be honest I don't think anyone has a good explanation for all my symptoms. I've asked a few experts (as in leading scientists in the field) and they have different opinions. If you're interested in the details, read on.

What I do know is that when my surgeon opened my ear on suspicion of otosclerosis, he did confirm the diagnosis visually (it is actually visible to the naked eye - you just have to push the ear drum to the side to see it), and there were 4 doctors present during surgery so I think I can trust the report.

However, I really don't fit the mold: otosclerosis is normally a slow progressing disease. It takes years if not decades to degrade your hearing to the point that you start thinking about hearing aids or surgery. In my case, a few weeks is all it took to create a 50 dB air bone gap. My initial SNHL was sudden, overnight. In addition to this, nobody in my family has this (it is supposed to be hereditary), and also I'm a male (it is supposed to hit females twice as much).
The other part of the puzzle is that I originally showed symptoms of sensorineural losses, which then progressed to mixed losses (sensorineural + conductive). Mixed loss are typically indicative of problems with both the middle ear and the inner ear. I also suffered from bad hyperacusis at that point.
I did the surgery and H went away almost completely. My air bone gap closed and I'm now left with sensorineural losses in the high frequencies.
If my problem was only in the middle ear, I should not have sensorineural losses.

When I try to make sense of all the info from the various doctors and neurotologists, I think that what may have happened to me is that a pathological focus (i.e. a bone remodeling site) started damaging the area where the middle ear and the inner ear connect, which is around the stapes bone (it's the most common area where damage starts in otosclerosis). This, unfortunately, created damage on both sides of the "border", creating the mixed loss. The middle ear side was fixed with surgery: no more conductive losses and H. The inner ear side did not get fixed and may actually have been hurt a bit more during surgery: it is not uncommon to have high frequencies take a toll after a stapedotomy. The area where the prosthesis gets inserted is where the footplate of the stapes is which is at the base of the cochlea. That is where the high frequency hearing apparatus resides.

My guess is that the disease hasn't progressed into the inner ear far enough to be clearly visible in a CT scan, but it is doing enough damage at the periphery of the cochlea to impact the high frequencies.

So to go back to your question, I think there was (and still is) a component of my issue that is related to the inner ear, even though the most common cases of otosclerosis are pure middle-ear issues.

What do you mean by "a 50 db air bone gap"?

 

[GregCA]

What do you mean by "a 50 db air bone gap"?

It means the difference between the air conduction and bone conduction was 50 dB. That typically means that your middle ear (and sometimes the ear drum) is responsible for that loss. The consequence being that it is sometimes fixable.

 

[Juan]

It means the difference between the air conduction and bone conduction was 50 dB. That typically means that your middle ear (and sometimes the ear drum) is responsible for that loss. The consequence being that it is sometimes fixable.

Ahh ok, thanks, I understand it now. Another question.. I have started to do some exercises for my jaw. One of them consist on putting the tip of the tongue on the upper part of the palate and then opening the jaw. Well, when I get ear pressure my eardrum pops loud when I do this exercise. I am not sure if it could be a middle ear issue.. how did you notice your h was due to a middle ear problem? Was it popping or crackling sounds that led you to think it was a middle ear issue?

 

[GregCA]

Ahh ok, thanks, I understand it now. Another question.. I have started to do some exercises for my jaw. One of them consist on putting the tip of the tongue on the upper part of the palate and then opening the jaw. Well, when I get ear pressure my eardrum pops loud when I do this exercise. I am not sure if it could be a middle ear issue.. how did you notice your h was due to a middle ear problem? Was it popping or crackling sounds that led you to think it was a middle ear issue?

No, it's because my surgery got rid of most of my H, and that surgery addressed the middle ear.
The exercise you are doing sounds like what we do for TMJ. It's quite possible that it affects the middle ear: everything is connected there and you are moving a lot of "piping" around when you do that exercise.

 

[Juan]

No, it's because my surgery got rid of most of my H, and that surgery addressed the middle ear.
The exercise you are doing sounds like what we do for TMJ. It's quite possible that it affects the middle ear: everything is connected there and you are moving a lot of "piping" around when you do that exercise.

Thanks for you quick answer! I am considering going through a couple of tests, CAT scan and maybe even MRI, because things are going worse lately, noticing a lot of pressure that does not go away in months, hearing worsening (the dip at 8.000 must be around 60 dbs by now), and loud sounds feeling more hurtful than ever. I checked my jaw recently and the doctor said it was ok, not the cause of this. My H is most probably due to exposure to loud noise, but things are going worse very fast, and this time things feel different from what I have been experiencing for so many years.