Tinnitus Without Hearing Loss. How Is This Possible?

Lisa88

Member
Author
Feb 6, 2014
627
Tinnitus Since
11/2013
Had all the tests done which all came back normal. Onset of t from local lidocaine anesthetic 4.5 months ago. Maybe it crossed the blood brain barrier. Can't seem to work it out.
But if the theory is that t is making up for a frequency lost by hearing. What would the reason be for t without hearing loss? Probably nobody knows, right?!
 
Had all the tests done which all came back normal. Onset of t from local lidocaine anesthetic 4.5 months ago. Maybe it crossed the blood brain barrier. Can't seem to work it out.
But if the theory is that t is making up for a frequency lost by hearing. What would the reason be for t without hearing loss? Probably nobody knows, right?!

The key word - when it comes to audiograms - is "normal". An audiogram is concerned with the ability to hear speech. As long as you are within the 0-25db range for 0-8 kHz, your hearing is considered normal. But that does not mean that your inner ear is not damaged in some way. There is no way to really link an audiogram with tinnitus. An audiogram was not invented for that purpose. The person who comes closest to really linking the two is Dr. Wilden. He has several websites; the one below, is the German version:

http://www.dasgesundeohr.de/tinnitusaudiometrie.htm

He essentially explains that already with a db-loss of 10 or more, your inner ear function is "challenged". To understand why that is, you have to remember that the energy carried by a sound wave doubles for every 3db. Put another way: a 10db loss means that a sound wave has to be 3 times "stronger" in order for a person to hear that sound with the same intensity as someone who has 0db hearing loss. So a 10db hearing loss may look "innocent" on an audiogram, but in reality it is not. [This is something I have had to explain to many ENTs during the past year - and they all look equally surprised each time; perhaps because I am educating them, or they simply don't get it?]

I have met dr. Wilden four times. I would describe him as "very passionate" about the topic of hearing loss and laser therapy. Once he "gets going", he cannot stop talking about the subject. Perhaps the most important lesson I have taken away with me from those conversations is that in +90% of all tinnitus cases, the cause is damage to the inner ear. Even if the audiogram looks "normal"...

I am not surprised that your other tests came back normal. They nearly always do in tinnitus cases.
 
Also talking high frequency audiogram and OAE etc.
What is interesting is that my t is mid frequency, yet my mid frequencies are above average, and even slightly better than shown before I had t.
As we age, we all lose our higher frequencies, yet not everyone has t.
My humble theory is that not all t cases are due to hearing loss.
Another theory also is that the lidocaine (intranasal) crossed the blood brain barrier and changed the brain chemistry in some way around the auditory cortex or elsewhere.
I know even scientists don't know at this point. But as we delve further into the science, more literature is revealing correlations to different parts of the brain.
 
There could be many possible reasons.. some of them are:

1. Hearing Loss, most likely issues in the cochlea.
2. Hearing nerve issues.
3. Issues in the auditory cortex in the brain.
 
Have since had all the hearing tests done including OAE and high frequency audiogram, passed with flying colors. MRI of the nerve looks normal. Yes, I think it was a chemistry change in the auditory cortex, induced by the lidocaine.
 
testing 8 frequencies means testing 0.04% of your hearing capacity.

so you have hearing loss like we all do, it simply can't be demonstrated by testing 0.04% of your hearing capabilities.

OAE up to 20khz tests around 0.1% of your hearing capacity.
 
What they all said above. My hearing test only went up to 8000khz, and recently I noticed a hissing noise at 12000khz. It's sad because this is how they test kids hearing in schools as well, on top of the fact that they only test hearing there once every 5 years at most. Maybe it's changed since I've been in school. On the other hand, Tinnitus can mean hundreds of different things. You should get your doctor to see if there's anything else wrong with you. Best bet is to do your homework before you go because chances are your doctor will know less then you about this issue.
 
What they all said above. My hearing test only went up to 8000khz, and recently I noticed a hissing noise at 12000khz. It's sad because this is how they test kids hearing in schools as well, on top of the fact that they only test hearing there once every 5 years at most. Maybe it's changed since I've been in school. On the other hand, Tinnitus can mean hundreds of different things. You should get your doctor to see if there's anything else wrong with you. Best bet is to do your homework before you go because chances are your doctor will know less then you about this issue.
Where I live hearing isn't even tested at school, we only have one dental check at the age of 7 (2nd grade) and one test for bad sight and that's it..
 
Yes, as we age, we all lose hearing in the higher frequencies. My t however is a low frequency t. Reviewing the results of both MRI and hearing tests, I really think the changes for me have occurred at the brain, central auditory cortex level.
 
The key word - when it comes to audiograms - is "normal". An audiogram is concerned with the ability to hear speech. As long as you are within the 0-25db range for 0-8 kHz, your hearing is considered normal. But that does not mean that your inner ear is not damaged in some way. There is no way to really link an audiogram with tinnitus. An audiogram was not invented for that purpose. The person who comes closest to really linking the two is Dr. Wilden. He has several websites; the one below, is the German version:

http://www.dasgesundeohr.de/tinnitusaudiometrie.htm

He essentially explains that already with a db-loss of 10 or more, your inner ear function is "challenged". To understand why that is, you have to remember that the energy carried by a sound wave doubles for every 3db. Put another way: a 10db loss means that a sound wave has to be 3 times "stronger" in order for a person to hear that sound with the same intensity as someone who has 0db hearing loss. So a 10db hearing loss may look "innocent" on an audiogram, but in reality it is not. [This is something I have had to explain to many ENTs during the past year - and they all look equally surprised each time; perhaps because I am educating them, or they simply don't get it?]

I have met dr. Wilden four times. I would describe him as "very passionate" about the topic of hearing loss and laser therapy. Once he "gets going", he cannot stop talking about the subject. Perhaps the most important lesson I have taken away with me from those conversations is that in +90% of all tinnitus cases, the cause is damage to the inner ear. Even if the audiogram looks "normal"...

I am not surprised that your other tests came back normal. They nearly always do in tinnitus cases.

From what you've said, you seem quite knowledgeable on this topic. Could you answer a hearing loss question for me?
 
Had all the tests done which all came back normal. Onset of t from local lidocaine anesthetic 4.5 months ago. Maybe it crossed the blood brain barrier. Can't seem to work it out.
But if the theory is that t is making up for a frequency lost by hearing. What would the reason be for t without hearing loss? Probably nobody knows, right?!
There are many reasons besides hearing loss for developing T. In my case T started after I stopped taking Klonazepam. T is one of the withdrawal symptoms. T can also be induced by stress, and sometimes there is no clear cause at all
 
hearing tests have very low accuracy.

Tinnitus without fail in hearing system does not exists except objective tinnitus.

Your hearing has some damage, this is the reason for tinnitus.
 
Had all the tests done which all came back normal. Onset of t from local lidocaine anesthetic 4.5 months ago. Maybe it crossed the blood brain barrier. Can't seem to work it out.
But if the theory is that t is making up for a frequency lost by hearing. What would the reason be for t without hearing loss? Probably nobody knows, right?!
a 0-8000hz audiogram is not the most reliable way of checking for hearing loss.

Humans can hear up to a range of pure tones up to 24,000 hz or more in early phases of life.
Any damage in super ultra high frequencies could induce tinnitus.

Not to mention damage to the synaptic connections of the inner ear cause hearing loss that "distorts hearing" rather then
disables the ability to hear pure tonal noises.


In this study it showed patients with tinnitus had lack of input from the auditory nerve.


It may be possible some people with tinnitus do not have hearing loss but it is more rare such as Neck/jaw misalignment and a tumor in the auditory brain. But it is 100% fact tinnitus and hearing loss are related.
 
a 0-8000hz audiogram is not the most reliable way of checking for hearing loss.

Humans can hear up to a range of pure tones up to 24,000 hz or more in early phases of life.
Any damage in super ultra high frequencies could induce tinnitus.

Not to mention damage to the synaptic connections of the inner ear cause hearing loss that "distorts hearing" rather then
disables the ability to hear pure tonal noises.


In this study it showed patients with tinnitus had lack of input from the auditory nerve.


It may be possible some people with tinnitus do not have hearing loss but it is more rare such as Neck/jaw misalignment and a tumor in the auditory brain. But it is 100% fact tinnitus and hearing loss are related.


Since that normal audiogram ( and 4 years after onset), I had a another hearing test which showed an audiometric notch at 6KHz of mild loss. A year before when tested, it had all still been at normal level. Although this notch can often be diagnosed as a sign of noise induced loss, I have always been very careful with ear plugs etc since onset. One of my main t noises has been at 6KHz, so it is my understanding that now this loss is related. It is my belief, that t set up a vulnerability in my auditary track and induced some of that loss at the same Hz level. I had also gone through various anxious situations that year, plus blunt trauma to the affected ear. Of course, we all had a vulnerability in our auditory track to get t in the first place, where others when exposed to the same triggers do not develop t. The audiologist too seems to think that t and that loss are related.
 
Since that normal audiogram ( and 4 years after onset), I had a another hearing test which showed an audiometric notch at 6KHz of mild loss. A year before when tested, it had all still been at normal level. Although this notch can often be diagnosed as a sign of noise induced loss, I have always been very careful with ear plugs etc since onset. One of my main t noises has been at 6KHz, so it is my understanding that now this loss is related. It is my belief, that t set up a vulnerability in my auditary track and induced some of that loss at the same Hz level. I had also gone through various anxious situations that year, plus blunt trauma to the affected ear. Of course, we all had a vulnerability in our auditory track to get t in the first place, where others when exposed to the same triggers do not develop t. The audiologist too seems to think that t and that loss are related.
it is an established fact hearing loss and tinnitus are related.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208401/
 
a 0-8000hz audiogram is not the most reliable way of checking for hearing loss.

Humans can hear up to a range of pure tones up to 24,000 hz or more in early phases of life.
Any damage in super ultra high frequencies could induce tinnitus.

Not to mention damage to the synaptic connections of the inner ear cause hearing loss that "distorts hearing" rather then
disables the ability to hear pure tonal noises.


In this study it showed patients with tinnitus had lack of input from the auditory nerve.


It may be possible some people with tinnitus do not have hearing loss but it is more rare such as Neck/jaw misalignment and a tumor in the auditory brain. But it is 100% fact tinnitus and hearing loss are related.


This is a great video. Will check the rest of info over. Thank you for posting.
Perhaps most of us lose the very high frequencies over time. But some of us do not readily hear t, and some of us do. Not sure how this can be explained. I do remember years ago spending time in sound proof booths and not hearing t. Wish I had hindsight and could go back to that time and really study it again. It is quite soothing to know that perhaps everyone does have t a little bit. And perhaps everyone from young adult onwards experiences hearing loss in the very high frequencies. This in itself would explain the link. I do know though that some people have low frequency t, and normal audiograms at 0-8000Hz. So this might not explain the hearing loss connected to that specific gain. Not sure that one size fits all. It is a complicated study.
 
I don't know the answer to most things either, thats why I want actual researchers like Charles Liberman, Roland Schatte, Susan Shore to answer these questions.

I know researchers are extremely busy but I'm sure they must have some time to answer questions on a tinnitus forum.
 

Log in or register to get the full forum benefits!

Register

Register on Tinnitus Talk for free!

Register Now