TTTS After Exposure to Loud Sound

[kingsfan]

I couldn't really find an answer to this with the search feature here, so thought I would ask. If it's already been answered in the past, a URL to the previous post would be appreciated.

Sometimes after I have been exposed to a loud sudden sound, such as something falling on the floor, I experience a temporary increase in TTTS that settles down after a day or few.

Could this be an indication of slight hearing damage from the incident or a symptom of very mild hyperacusis? Or maybe just a natural defense mechanism of the ear?

It only ever happens in the right ear, the ear with less severe tinnitus. I have never experienced TTTS in my left, and worse, ear.

 

[Rudedog205]

I believe it's the acoustic reflex which is the natural defense mechanism of the ear to protect itself from loud sounds. I couldn't tell you whether that means you are doing damage although I am sure it would depend on the person. I also experience this but in both ears and I would say my tinnitus is probably between mild and moderate. This reflex is also known as the stapedial reflex.

As for why you don't feel it in your ear with more severe tinnitus I believe the abstract to a study I found below may hold the answer.

Abstract
Chronic tinnitus is a prevalent hearing disorder, and yet no successful treatments or objective diagnostic tests are currently available. The aim of this study was to investigate the relationship between the presence of tinnitus and the strength of the middle-ear-muscle reflex (MEMR) in humans with normal and near-normal hearing. Clicks were used as test stimuli to obtain a wideband measure of the effect of reflex activation on ear-canal sound pressure. The reflex was elicited using a contralateral broadband noise. The results show that the reflex strength is significantly reduced in individuals with noise-induced continuous tinnitus and normal or near-normal audiometric thresholds compared with no-tinnitus controls. Due to a shallower growth of the reflex strength in the tinnitus group, the difference between the two groups increased with increasing elicitor level. No significant difference in the effect of tinnitus on the strength of the middle-ear muscle reflex was found between males and females. The weaker reflex could not be accounted for by differences in audiometric hearing thresholds between the tinnitus and control groups. Similarity between our findings in humans and the findings of a reduced middle-ear muscle reflex in noise-exposed animals suggests that noise-induced tinnitus in individuals with clinically normal hearing may be a consequence of cochlear synaptopathy, a loss of synaptic connections between inner hair cells (IHCs) in the cochlea and auditory-nerve (AN) fibers that has been termed hidden hearing loss.

Wojtczak, Magdalena et al. "Weak Middle-Ear-Muscle Reflex in Humans with Noise-Induced Tinnitus and Normal Hearing May Reflect Cochlear Synaptopathy." eNeuro vol. 4,6 ENEURO.0363-17.2017. 27 Nov. 2017, doi:10.1523/ENEURO.0363-17.2017

I could be totally off in my thinking here so someone smarter than me like @Matchbox should probably correct me if I am wrong but I would assume this could possibly mean the stapedial reflex in your ear with worse tinnitus might be significantly weaker than the one with the milder tinnitus which is why you aren't feeling it as much.

 

[Wrfortiscue]

Mine has done this and some have mentioned it's due to anxiety?

 

[Stacken77]

Hi @kingsfan.

I have quite some experience with TTTS, so I thought I would share.

Could this be an indication of slight hearing damage from the incident or a symptom of very mild hyperacusis?

Now, I may be wrong of course, but I believe worsening of TTTS symptoms doesn't necessarily have to indicate more damage being done. My TTTS is only limited to my right ear, it got worse from a month of sound deprivation, but then a lot worse after a 2 hour conversation. I won't believe that the conversation made structural damage to my cochlea, but it definitely was too much for my sound sensitivity. After that incident, my TTTS has been really bad, but now it's improving as I'm slowly exposing myself to sound again. Before, my own voice would always trigger spasms, but as I used my voice more often at work, it has diminished completely, even with custom molded earplugs which has a high occlusion effect.

So I believe TTTS is an issue of the brain and a sign of some degree of sensitivity to sound. It also seems to be frequency specific, because the spasms to my voice has almost resolved completely while the shaking of a key chain still makes it go nuts. I've also experienced it spasm to sounds that don't exist, I once had a zapping sound in the brain when trying to sleep and I felt my right ear spasm lol. More reasons for me to assume it's purely a brain issue.

I'd of course try to stay away from the sounds that cause worsened TTTS in the future though, just to be safe. It ain't really fun to have it spams to everything.

All the best,
Stacken

 

[Nadia231]

This is very interesting, I have the same symptoms. My left ear has always had the worst tinnitus but no TTTS. And in my right ear, where my tinnitus is slightly lower, I experience spasms with basically every tiny sound (cutlery, mouse click, turning on/off the lights, typing on my keyboard, scratching my face, this one is weird)...

I can't really answer your question as my TTTS is just constant, non stop. It just reacts to every sound. I think it is hearing damage and protection, because my slight hearing loss is also in that ear.

 

[kingsfan]

Hi @kingsfan.

I have quite some experience with TTTS, so I thought I would share.

Now, I may be wrong of course, but I believe worsening of TTTS symptoms doesn't necessarily have to indicate more damage being done. My TTTS is only limited to my right ear, it got worse from a month of sound deprivation, but then a lot worse after a 2 hour conversation. I won't believe that the conversation made structural damage to my cochlea, but it definitely was too much for my sound sensitivity. After that incident, my TTTS has been really bad, but now it's improving as I'm slowly exposing myself to sound again. Before, my own voice would always trigger spasms, but as I used my voice more often at work, it has diminished completely, even with custom molded earplugs which has a high occlusion effect.

So I believe TTTS is an issue of the brain and a sign of some degree of sensitivity to sound. It also seems to be frequency specific, because the spasms to my voice has almost resolved completely while the shaking of a key chain still makes it go nuts. I've also experienced it spasm to sounds that don't exist, I once had a zapping sound in the brain when trying to sleep and I felt my right ear spasm lol. More reasons for me to assume it's purely a brain issue.

I'd of course try to stay away from the sounds that cause worsened TTTS in the future though, just to be safe. It ain't really fun to have it spams to everything.

All the best,
Stacken

I think I have been down the same road as you with TTTS.

It was really bad immediately from the onset of my tinnitus (only in my right ear), but began improving over the next 2 to 3 weeks. Then my tinnitus worsened exponentially from an Audio Reflex test. This is when I began wearing earplugs heavily. It gradually worsened until I started gradually increasing the volume of my studio monitors and home theater speakers over the course of several months. This cleared it up almost completely, but now I get it temporarily when exposed to any sudden loud sounds. It usually either clears up completely after a night of rest, though sometimes it takes a few days.

 

[kingsfan]

I believe it's the acoustic reflex which is the natural defense mechanism of the ear to protect itself from loud sounds. I couldn't tell you whether that means you are doing damage although I am sure it would depend on the person. I also experience this but in both ears and I would say my tinnitus is probably between mild and moderate. This reflex is also known as the stapedial reflex.

As for why you don't feel it in your ear with more severe tinnitus I believe the abstract to a study I found below may hold the answer.

Abstract
Chronic tinnitus is a prevalent hearing disorder, and yet no successful treatments or objective diagnostic tests are currently available. The aim of this study was to investigate the relationship between the presence of tinnitus and the strength of the middle-ear-muscle reflex (MEMR) in humans with normal and near-normal hearing. Clicks were used as test stimuli to obtain a wideband measure of the effect of reflex activation on ear-canal sound pressure. The reflex was elicited using a contralateral broadband noise. The results show that the reflex strength is significantly reduced in individuals with noise-induced continuous tinnitus and normal or near-normal audiometric thresholds compared with no-tinnitus controls. Due to a shallower growth of the reflex strength in the tinnitus group, the difference between the two groups increased with increasing elicitor level. No significant difference in the effect of tinnitus on the strength of the middle-ear muscle reflex was found between males and females. The weaker reflex could not be accounted for by differences in audiometric hearing thresholds between the tinnitus and control groups. Similarity between our findings in humans and the findings of a reduced middle-ear muscle reflex in noise-exposed animals suggests that noise-induced tinnitus in individuals with clinically normal hearing may be a consequence of cochlear synaptopathy, a loss of synaptic connections between inner hair cells (IHCs) in the cochlea and auditory-nerve (AN) fibers that has been termed hidden hearing loss.

Wojtczak, Magdalena et al. "Weak Middle-Ear-Muscle Reflex in Humans with Noise-Induced Tinnitus and Normal Hearing May Reflect Cochlear Synaptopathy." eNeuro vol. 4,6 ENEURO.0363-17.2017. 27 Nov. 2017, doi:10.1523/ENEURO.0363-17.2017

I could be totally off in my thinking here so someone smarter than me like @Matchbox should probably correct me if I am wrong but I would assume this could possibly mean the stapedial reflex in your ear with worse tinnitus might be significantly weaker than the one with the milder tinnitus which is why you aren't feeling it as much.

This is very interesting and makes a lot of sense. I'm still not sure why my other ear experiences it at all when I've never had it before my tinnitus.

 

[Rudedog205]

This is very interesting and makes a lot of sense. I'm still not sure why my other ear experiences it at all when I've never had it before my tinnitus.

Like I said, I could totally be wrong on that, but it's a thought I had. It could have something to do with the muscles being injured too or atrophying (as in @Stacken77's or your case). I couldn't say for sure though, this is all mostly a mystery to me.

 

[kingsfan]

Like I said, I could totally be wrong on that, but it's a thought I had. It could have something to do with the muscles being injured too or atrophying (as in @Stacken77's or your case). I couldn't say for sure though, this is all mostly a mystery to me.

The info you provided makes the most sense, but yeah, still a mystery

 

[Stanlex]

IDK. When I am in complete silence and suddenly some loud noise happens (like when a plastic bottle pops) then my tensor tympani fire to the point it is very unpleasing, almost hurting. But when I am at some extremely loud place, like a concert, I do not have any problems with tensor tympani at all. So I would say, that it may be normal when sometimes your tensor tympani fires and it hurts, because it only protects your ears from sudden noise damage.

 

[kingsfan]

IDK. When I am in complete silence and suddenly some loud noise happens (like when a plastic bottle pops) then my tensor tympani fire to the point it is very unpleasing, almost hurting. But when I am at some extremely loud place, like a concert, I do not have any problems with tensor tympani at all. So I would say, that it may be normal when sometimes your tensor tympani fires and it hurts, because it only protects your ears from sudden noise damage.

Thinking back to all the times this has happened, I think you are spot on.

 

[LukeYoung]

Mine has done this and some have mentioned it's due to anxiety?

I think it could be. I've had it twice, and both of those times is during anxious periods. I currently am experiencing it.

 

[NofaceHorse]

My TTTS came after a sleepless night when I was bothered by many things at once. I stopped using headphones but it has persisted (albeit improved) since as I still had anxiety. That being said I believe hearing loss has a role in it but anxiety also affects it in some way. Sucks that there is no settled science about it.

 

[LukeYoung]

I believe coming off benzos, no matter how long I took them, gives me TTTS as well.

That's the only other time I've had it.

Benzos excite me, I get the paradoxical effect from them, which is the opposite of what they should do.

 

[kingsfan]

Sitting here tonight, no TTTS happening whatsoever. It just comes for days/weeks at a time and then just goes away with no rhyme or reason.