Why Isn’t TRT the Holy Grail?

[lapidus]

How are they different?

They are different in their goals. TRT can't treat/heal tinnitus and doesn't claim it can. It's a tool to reach habituation to tinnitus. But TRT does claim it can actually treat/heal/cure hyperacusis. There are also different treatment protocols depending on which category (1-4) you're in according to Jastreboff.

 

[stophiss]

Exactly Stophiss, sort your shit out. Look at all the carnage you have caused

How I roll Ed. I am the straw that stirs the drink. I sense you are the same and what I like about you.
Rock on brother.

 

[stophiss]

Treatments are far more profitable than cures.

To me Paul and I will say I find you write with great insight, I really believe this doesn't matter in the least and same mantra for cancer and other diseases. Could more money be directed toward tinnitus to find a so called cure? Sure and yes money is misplaced when cosmetic issues like male pattern baldness are put in front of tinnitus for example with real suffering. But think about the poor short bald dude too.
Seriously, even with misplaced priority of which disorder to fund based upon correlation in suffering, to me keeping a half baked therapy alive in lieu of finding a cure has nothing to do with how funding is appropriated or how zealously a cure is pursued.
My opinion.

 

[Canador]

When I got H in 2014 I improved greatly over the first year,when I actually think about it I quickly realise sound therapy had nothing to do with it.

Bill,

To what do you attribute such great improvement?

If we strictly subscribe to Liberman's theory, how could you have improved so greatly that first time?

 

[Michael Leigh]

They are different in their goals. TRT can't treat/heal tinnitus and doesn't claim it can. It's a tool to reach habituation to tinnitus. But TRT does claim it can actually treat/heal/cure hyperacusis. There are also different treatment protocols depending on which category (1-4) you're in according to Jastreboff.

Well said Lapidus. Many people that haven't had TRT treatment and would probably like to try it, are influenced by the wrong advice given by some people that no nothing about it or how effective it can be for some that have tinnitus and hyperacusis. Results will vary between individuals. It reduced my tinnitus to a very low level the first time around and completely cured my hyperacusis till this day.

 

[PaulBe]

The secondary problem which many of us have, myself included, is access to a high quality TRT service. I think its an area that would benefit from some para-medical glasnost. Australia has a few too many Audiology groups, run by ENTs in the background and spruiking Neuromonics systems in lieu of providing a full, professional TRT service. I see Neuromonics as a huge hindrance to developing a full holistic TRT service because its so easy to just sell a (generously-priced) package instead of putting in the treatment legwork and building the therapeutic relationships and doing the advanced study. As such it also holds back the advancement of audiology as an active, professional healthcare discipline. Dr Nagler once wrote an excellent treatise on what Neuromonics was all about which is still on here somewhere.

 

[PaulBe]

Treatments are far more profitable than cures.

yeah I did say that. Actually, if you look at it, apart from antibiotics, most of what we would call "cures" tend to be surgical, not medical.

 

[PaulBe]

It reduced my tinnitus to a very low level the first time around and completely cured my hyperacusis till this day.

Michael, can you say with certainty that your hyperacusis was directly impacted by the use of TRT and that it wouldn't have settled on its own? If yes, was the sound of a particular character and was it calibrated (frequencies/volume etc) to work within the specifics of your hyperacusis?

I have an overpriced hearing aid/masker which has just one white noise tone that I don't use much because it sounds just like my tinnitus. Masking tinnitus with more tinnitus is a bit zero-sum.

 

[Michael Leigh]

Michael, can you say with certainty that your hyperacusis was directly impacted by the use of TRT and that it wouldn't have settled on its own? If yes, was the sound of a particular character and was it calibrated (frequencies/volume etc) to work within the specifics of your hyperacusis?
I have an overpriced hearing aid/masker which has just one white noise tone that I don't use much because it sounds just like my tinnitus. Masking tinnitus with more tinnitus is a bit zero-sum.

@PaulBe

Hi PaulBe

I believe that my hyperacusis wouldn't have been completely cured, as it is now nearly 20 years on, if I didn't have TRT and wear white noise generators. I will explain how severe my tinnitus and hyperacusis was to give you an idea of what I went through.

My tinnitus and hyperacusis was caused by listening to music at too high a volume through headphones. I had been listening to music for many years through them but didn't realize on occasions the volume was too loud. I remember at night when all was quiet, I could hear ringing and thought nothing of it. By the morning it would be gone because sounds in the day was masking the tinnitus so I wasn't aware of it. If only I knew then what I know now. On one occasion I removed my headphones after listening to music and suddenly became aware of the loud ringing. The noise trauma was so bad my whole head become completely numb and this feeling stayed with me for nearly 6 months. It felt like my head was under water. I could hear but everything sounded muffled and distorted. It was quite a frightening experience because I thought I can completely blown my hearing and I would never recover.

My sensitivity to sound was very acute. Conversation with someone would hurt my ears and I had to ask people to lower their voice. I couldn't tolerate the sound of kitchen plates and cutlery being washed up and the pain was almost unbearable. Road traffic noise was another daily ordeal, and I had to use earplugs when going out to cope.
After six months I was seen at ENT and referred to a hearing therapist and started TRT. I wore white noise generators for up to 10 hours a day and used sound enrichment at night using a sound machine by the bedside.

After 2 years my tinnitus reduced to a level that I rarely heard it and the hyperacusis was completely cured. As you known in 2008 after noise exposure, I believe caused by listening to my HI-FI one evening. The tinnitus returned with a vengeance but the hyperacusis did not. Last summer I went to an arcade, which was packed with people playing on slot machines, and music was playing. The sound level meter registered 100 decibels. I had my earplugs with me but didn't use them as this was a test – if the sound becomes uncomfortable then I would have. My ears didn't hurt or ring and I stayed there for thirty minutes. The next day my tinnitus was quiet and I experienced no symptoms of hyperacusis. Some people that habituate to tinnitus also have hyperacusis which hasn't been cured. This often makes a person sensitive to sound, which many people call: "Reactive tinnitus". If hyperacusis isn't cured it will always remain a problem. It can cause tinnitus to spike and make people always sensitive to sound.

Reading some of the posts in this forum, I believe many people are describing hyperacusis type symptoms. It comes in different levels of severity just as tinnitus does but needs to be treated. Sometimes it can be cured naturally without treatment but in severe cases as mine was, white noise generators need to be worn. It is not a quick fix. This treatment takes time.

It is best to keep the white noise below the level of your tinnitus, it mustn't be at the same level as your tinnitus or masking it. Over time your brain will habituate to the white noise and push the tinnitus further into the background, making it less intrusive. The white noise will treat your hyperacusis, by desensitising the auditory receptors or gateways in your brain, which have opened up. Over time they will gradually close back down to normal.

Some people find it difficult to wear white noise generators or hearing aid straight off for 8 hrs. In your case you have a dual-purpose unit. I normally advise people to slowly introduce the device to their auditory system and brain. First wearing it for 2 hrs and then taking it off or 2 hrs. Over a few weeks increase the wearing time slowly until a total of 8 hrs or more is achieved. It is advisable to not to wear the device when sleeping and to use a sound machine by the bedside for sound enrichment. Ideally, you should be wearing two white noise generators to keep your auditory system in balance. Since you have hearing loss in just one ear. Your hearing therapist could supply you with another device but disable the hearing aid section via computer leaving only the white noise in operation.

Many people that have reservations about TRT not being affective, but have never tried the treatment. I have had it twice in 20 years and know that it has helped me on both occasions. There are two parts to TRT. Counselling and sound therapy. Sound therapy is using white noise generators, to treat the tinnitus and the hyperacusis. Counselling as I've described in my post:

Tinnitus, A Personal View:

Tinnitus counselling is a vital part of TRT. Tinnitus can become a problem when the patient starts to believe nothing can be done about the condition. If one isn't careful anxiety and depression can start to take hold. Through regular counselling sessions with a Hearing Therapist the patient learns not to look at their tinnitus as non life threatening and not to be constantly afraid of it and to be monitoring every little change in its perception.

At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

Michael

 

[PaulBe]

q2. What form did the counselling take. What approach did they use and how did they establish what you needed from counselling?

 

[bill 112]

Bill,

To what do you attribute such great improvement?

If we strictly subscribe to Liberman's theory, how could you have improved so greatly that first time?

Time and natural recovery,that's what I believe healed me and not sound therapy,just time and patience and a lot of hope.

The synapses may have become stressed and a lot of them recover but some or a lot do not and detach.Given enough time the surviving synapses recover to a degree but the damaged ones are gone for good.This explains the various different levels of recovery from individual to individual,no two people are ever the same.

Libermanns theory has something that Jastrebroffs doesn't have and that's evidence,cold hard evidence whilst Jastrebroff has.....none really,just an educated guess that's accepted simply because there's nothing else to say otherwise,that was until Liberman showed up.

Liberman showed that nearly everytime someone experiences a TTS synapses are lost.Hearing thresholds recover and the hearing loss is said to be temporary but it's anything but that.It explains why people experience Temporary T after a concert,the synapses are stressed but recover and maybe a few are lost but not enough for you to notice.Keep going to these concerts and eventually you'll probably experience chronic T or H or temporary H and that's when you finally notice something is wrong,a symptom has risen to your attention and that's when you finally take notice.You go and get hearing tests done and they're all normal simply because your haircells survived but your synapses didn't,of course they can't test the nerve fibres so they tell you"your hearing is perfect"and it's a brain thing that might go away on its own.If you lose haircells alongside synapse loss they tell you it's from hearing loss because they can physically find evidence of a hearing loss.

So many people come here and state"my T came from a concert but I have no hearing loss according to my audiologist so I don't know what the cause truly is"
And then they go off looking at their jaws,tension a whole host of things when it's most likely that you did indeed damage your hearing at that concert only your audiologist can't actually find it.Just because they can't find it doesn't mean it isn't there,the sooner the better they role out this hidden hearing loss test the better in my opinion.

I completely agree with Libermans theory 100%,it makes perfect sense when you sit back and think about it,it's logical and he has good evidence to back it all up.

 

[Michael Leigh]

q2. What form did the counselling take. What approach did they use and how did they establish what you needed from counselling?

Hi PaulBe
Most people that get a referral to a Hearing Therapist or Audiologist for tinnitus management and particularly CBT or TRT therapy, will find the person that they are seeing was either born with tinnitus or acquired it at some time in their life. My hearing therapist was born with it.

As I said in my post: At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

I felt that my hearing therapist had a deep understanding of tinnitus and what I was going through and it helped a lot. My therapy sessions lasted 1 hr sometimes more. I can't really elaborate any more. Anyone that has been referred to a Hearing therapist or Audiologist for counselling (not necessarily CBT or TRT) will usually find the discussions are about life and how the tinnitus affects them.

Counselling is very important in tinnitus and it's something that many people do not realize, and are often far too quick to dismiss it as nothing. It is the negative thinking that is often associated with tinnitus that can affect many people being unable to habituate to their tinnitus and lead a normal life. It is for this reason, many of my posts in "started threads" I advise people to PRINT and refer to them often.

Just reading my positivity posts on the computer is not enough because the message is soon forgotten. For it to sink in and to be effective they have to be read often. The same applies to other members that have written positive posts and stories. People should print them and refer them often for the message to sink in.

Becoming positive with tinnitus doesn't happen overnight or in a few weeks, that's why CBT and TRT treatments, which are counselling takes many months of therapy. It involves the retraining of the mind and the way a person thinks about tinnitus, life and eventually accepting tinnitus as unimportant.

It is for this reason Professor Jasterboff states in his book TRT: If a person just wears white noise generators and doesn't have tinnitus therapy, habituation is likely not to be very good. I agree with him to a certain point. Many people habituate to tinnitus and the hyperacusis cures in time. However, when these conditions are severe professional help is needed. Unfortunately, TRT is an expensive treatment and beyond some peoples budget. I believe it is one of the reasons many people are quick to dismiss it and say that it doesn't work. It is a therapy not a cure.

Hope this helps
All the best
Michael

 

[PaulBe]

Sounds like a variant of grief counselling. You were lucky to have it through your NHS. Would you still get it that way these days? You don't get it here through Medicare (our NHS) and Private insurers won't touch it.

 

[Michael Leigh]

Sounds like a variant of grief counselling. You were lucky to have it through your NHS. Would you still get it that way these days? You don't get it here through Medicare (our NHS) and Private insurers won't touch it.

It is still available through the NHS but at certain hospitals. Some hospitals do not follow the TRT protocol to the letter but results can still be good. They have adapted the treatment ie: issuing a patient with one or two white noise generators. Perhaps not giving counselling. This treatment is expensive. Not everyone will need tinnitus counselling.

It is for this reason I don't recommend anyone new to tinnitus to start TRT until at lest 6 months. Tinnitus can be very traumatic and a person needs time to get used to this. Often people habituate to tinnitus within the first 6 months sometimes a little longer without any treatment at all.

Please do not listen to people that dismiss TRT or CBT as nothing and that it is voodoo, because I assure that they are not.
Michael

 

[Sen]

If we strictly subscribe to Liberman's theory, how could you have improved so greatly that first time?

People with meniere's disease can eventually stop experiencing vertigo even though their vestibular system has been permanently damaged.

I don't believe symptomatic improvement is evidence that something hasn't been damaged.

 

[glynis]

When Menieres Disease reaches burnout after stage one stage two and stage 3 our vertigo stops and we have to use our eyes for balance and have problems in the dark as our vestabular system is damaged and not repaired as it's a progressive disease also leading to sever tinnitus and hearing loss that might be mild or medium loss or profound.....lots of love glynis

 

[Canador]

I completely agree with Libermans theory 100%,it makes perfect sense when you sit back and think about it,it's logical and he has good evidence to back it all up.

Bill,

With all due respect to Charles Liberman's work, it seems there may be additional factors at work.

There are famous musicians who've stood in front of blasting speakers for 50 years, and they are not all bed-ridden with hyperacusis. And there are people from noisy vocations who've spent their entire careers in loud racket, and they are not disabled with severe tinnitus. The more I read these forums, and compare the people here to those with "normal" hearing, it makes me think this: the people who get hit with rare problems--may have a rare *combination* of causes.

If we simply accept Lieberman's theory of damage from loud sound, and conclude that hyperacusis is usually caused by this alone, we may overlook other key factors that could help us improve.

 

[Canador]

I don't believe symptomatic improvement is evidence that something hasn't been damaged.

I wasn't suggesting that *no* damage is present. I was pointing to the idea that there may be other factors--besides permanent damage--at work. Either that or the damage isn't so permanent as generally thought.

 

[japongus]

I completely agree with Libermans theory 100%,it makes perfect sense when you sit back and think about it,it's logical and he has good evidence to back it all up.

I fail to see what evidence Liberman has presented if he didn'take the middle ear into account, which he didn't, no one ever does.

I went to a concert, and yet I have thumps and vibrations so similar to sxs denounced by lib and joem and astrid over at chat-h. Some had successful tenotomies, others had bad ones or useless ones. But doesn't it say a ton that I from a concert can have such similar symptoms to other people that were successfully went under tenotomy, that it's not a cochlear issue at all, that it's not about hidden hearing loss?

And why if it's about cochlear hidden hearing loss etc are people showing success when Silverstein just messes about a bit with the oval or round window, or with the stapes?

Another one is Tim Hain, who's done a couple of grommets on patients and their H went away.

At most they're all making the argument that less sound enters the brain but we know that's bs, as the improvement in H is greater than the deafening from these procedures, so we know that the issue was in the ear all along.

None of that makes sense in Jastreboff's or Libermann's world.

 

[japongus]

Counselling is very important in tinnitus and it's something that many people do not realize, and are often far too quick to dismiss it as nothing. It is the negative thinking that is often associated with tinnitus that can affect many people being unable to habituate to their tinnitus and lead a normal life. It is for this reason, many of my posts in "started threads" I advise people to PRINT and refer to them often.

Wow I hate these expressions of ''negative thinking'' and other shrink talk. This is the real world and it's called skeptical thinking, or growing up, or being real, or having balls the size of tits. I argued about this recently at chat-h. I got Jastreboff's book out and quoted him directly describing the middle ear. I contrasted it with how other people had had real issues in the middle ear on things Jastreboff himself would have claimed the patients had no issue in the middle ear. It was a disgrace. All this ''negative thinking'' talk from a clinician who isn't a neurotologist is the reason why we have to sit around waiting for Silverstein or Harold Kim's statements and debate about who's going to be the first guinea pig.

 

[SilverSpiral]

I fail to see what evidence Liberman has presented if he didn'take the middle ear into account, which he didn't, no one ever does.

I went to a concert, and yet I have thumps and vibrations so similar to sxs denounced by lib and joem and astrid over at chat-h. Some had successful tenotomies, others had bad ones or useless ones. But doesn't it say a ton that I from a concert can have such similar symptoms to other people that were successfully went under tenotomy, that it's not a cochlear issue at all, that it's not about hidden hearing loss?

And why if it's about cochlear hidden hearing loss etc are people showing success when Silverstein just messes about a bit with the oval or round window, or with the stapes?

Another one is Tim Hain, who's done a couple of grommets on patients and their H went away.

At most they're all making the argument that less sound enters the brain but we know that's bs, as the improvement in H is greater than the deafening from these procedures, so we know that the issue was in the ear all along.

None of that makes sense in Jastreboff's or Libermann's world.

You have very interesting and well researched posts. I've read through some of your posts, but I didn't come across one where you outlined your situation exactly. If it's not too much trouble could you explain your symptoms, their onset/cause/progression, what you think is causing the symptoms, and what treatment methods you've tried (any success), and if you have anything that shows up on audiogram or the usual crappy audiologist tests? Thanks. Your views are particularly interesting to me since you have noise induced condition like me.

 

[Michael Leigh]

Wow I hate these expressions of ''negative thinking'' and other shrink talk.

You are entitled to your opinions and also to air them but that doesn't make them correct neither do mine. Speaking as someone that has had tinnitus for many years and helped and corresponded with people that have tinnitus, I agree with Jasterboff's statement. "Negative thinking" is often associated with tinnitus; simply because of the way it can affect a person's state of mind when it is loud and intrusive. You may not like to hear this but I believe it to be true. Just read some of the posts in this forum from people that are in distress because of it. However, with time and treatment many people learn to habituate to tinnitus and are able carry on with their life.

Michael

 

[Juan]

I fail to see what evidence Liberman has presented if he didn'take the middle ear into account, which he didn't, no one ever does.

And why if it's about cochlear hidden hearing loss etc are people showing success when Silverstein just messes about a bit with the oval or round window, or with the stapes?

Another one is Tim Hain, who's done a couple of grommets on patients and their H went away.

None of that makes sense in Jastreboff's or Libermann's world.

Probably there are several types of H. What you are describing would be somewhat peripheral or conductive H, if there are issues in the middle are or problems conducting sound. As we move towards the cochlea or up from there (acoustic nerve, brain etc) the issues would be more "central", related to the central processing of sound, interpreted and filtered by the lymbic system and the nervous system.

Playing with stapes, grommets, etc may work for some, but is probably very unlikely to work if H was caused by an accoustic trauma. Grommets are typically used to fix the conduction of sound, hampered by a bad nose, large turbinates, stuff like that..

 

[GregCA]

"Negative thinking" is often associated with tinnitus; simply because of the way it can affect a person's state of mind when it is loud and intrusive.

I think the issue is when we start hypothesizing that "negative thinking" is what makes T bad vs T being bad causing the "negative thinking". In other words, the causality direction.
The former, which we often hear from "professionals" (and not so professionals), makes one believe that all you have to do to tame your T is get rid of the negative thinking. After all, you have control over that, don't you? That's like saying you have control over the screaming when I stab you in the hand, so stop screaming, and you'll see, the stabbing will be much easier to manage. The reality is that it makes it easier to manage for everyone around you, because you stop complaining. That's something that happens naturally anyways: once you see that your distress signals (screaming, asking for help, crying, etc) are unanswered (not because they don't want to help you - they just can't), then you slowly stop using them as they are useless. And then people around you think you're doing better, because "you look good!".

The other complication is that the "negative thinking" vs T directionality is a bit of a chicken and egg. I think it does start from T to NT (I've never heard of any reported case of the opposite), but NT creates conditions that exacerbate the perception of T, which creates the NT to T causality, and the amplifying infinite loop is thus created. That is to say that managing anxiety (and negative thinking) does have some benefits (so these professionals do have a point after all).

It's obvious that T leads to negative thinking, just like any stress stimulus: we are hardwired to react this way.
If you're thinking "but I've seen guys firewalking through mind tricks, it's obviously possible to control our reaction", then learn that there are reasons for it to be possible without creating a pain stimulus on the walker. You'll also realize that they do it very very quickly (and for a good reason!). If T was as short as the fire walk, we wouldn't be having this conversation.

 

[japongus]

You have very interesting and well researched posts. I've read through some of your posts, but I didn't come across one where you outlined your situation exactly. If it's not too much trouble could you explain your symptoms, their onset/cause/progression, what you think is causing the symptoms, and what treatment methods you've tried (any success), and if you have anything that shows up on audiogram or the usual crappy audiologist tests? Thanks. Your views are particularly interesting to me since you have noise induced condition like me.

1999 concert. high pitched tinnitus and low pitched rumble. rumble only comes when there's external sound. the high pitched tinnitus was lowered by trimetizidine. maybe the low pitched rumble only disappeared during external sound with trimetazidine too but can't remember exactly.

2000 night club. high pitched t gets louder and trimetazidine no longer useful. besides later on it was found out to have links to parkinsons so fuck that. low pitched rumble becomes permanent and louder. and since then i am sensitive to all sound. the slightest sound causes a third tinnitus that is reactive and felt as a thumpish vibration, until the external sound stops. the thump is strongest at the start of every new sound. i don't have to use ear plugs on the street even though it's very bothersome, and i don't have pain after sound like others here. what i do have though is so deadly because the slightest of signs over noise make my ears vibrate too much and thump. So whereas other sound sensitivities are deadly in the long range u could say mine is deadly in the short range.

ofc i've been dxed with misophonia, hyperacusis, anxiety and all the nonsense in the mainstream otology tradition. but this stinks of an issue in the cochlear or eustachian tube causing a chain reaction somewhere.ç

What about you, what are ur sxs?

 

[SilverSpiral]

1999 concert. high pitched tinnitus and low pitched rumble. rumble only comes when there's external sound. the high pitched tinnitus was lowered by trimetizidine. maybe the low pitched rumble only disappeared during external sound with trimetazidine too but can't remember exactly.

2000 night club. high pitched t gets louder and trimetazidine no longer useful. besides later on it was found out to have links to parkinsons so fuck that. low pitched rumble becomes permanent and louder. and since then i am sensitive to all sound. the slightest sound causes a third tinnitus that is reactive and felt as a thumpish vibration, until the external sound stops. the thump is strongest at the start of every new sound. i don't have to use ear plugs on the street even though it's very bothersome, and i don't have pain after sound like others here. what i do have though is so deadly because the slightest of signs over noise make my ears vibrate too much and thump. So whereas other sound sensitivities are deadly in the long range u could say mine is deadly in the short range.

ofc i've been dxed with misophonia, hyperacusis, anxiety and all the nonsense in the mainstream otology tradition. but this stinks of an issue in the cochlear or eustachian tube causing a chain reaction somewhere.ç

What about you, what are ur sxs?

https://www.tinnitustalk.com/threads/hearing-distortion-recruitment-reactive-tinnitus.19449/

Got it from one show without plugs.

The most plausible cause for my symptoms I can find is "synaptopathy" though I find your ideas interesting and possibly applicable to my situation. I do have some stapedial/TT action going on sometimes, but it's not my primary concern at all. If there's any way that sort of stuff can actually affect your hearing of outside sounds in the way I describe, then I'd want to know more of course.

 

[japongus]

https://www.tinnitustalk.com/threads/hearing-distortion-recruitment-reactive-tinnitus.19449/

Got it from one show without plugs.

The most plausible cause for my symptoms I can find is "synaptopathy" though I find your ideas interesting and possibly applicable to my situation. I do have some stapedial/TT action going on sometimes, but it's not my primary concern at all. If there's any way that sort of stuff can actually affect your hearing of outside sounds in the way I describe, then I'd want to know more of course.

So this loud microphone is it ''recruitment''? I managed to get Peter Franz on the phone a few months ago thinking he'd have something to say about tenotomies for ''hyperacusis''. But I'm quite sure he said no he encountered meniere's symptoms, as in recruitment not hyperacusis. He's the author of two papers on tenotomy of the middle ear muscles for meniere's which you can find at pubmed and libgen. His reasoning wasn't really that the muscles were actively involved but they were merely responding to an enlarged cochlear aqueduct, if I understood it correctly.

Mine is on the frontier of all sorts of different diagnosis. Sure I have sensitivity to sound, but it's also a distortion. So maybe mine is a distortion in a frequency place that because of the sound it evokes means sensitivity to sound as it's a thump vibration. But my distortion doesn't get loud and go over external sound like in recruitment. I was also told directly on a forum pm by a Harold Kim patient that the middle ear was at least involved in this sort of distortion/diplacusia or whatever.

 

[japongus]

Never mind it's not recruitment, that sounds more like reactive tinnitus.

Nevertheless, distortion and clusters of muscles in the ear itself have been associated with a mimesis of external sound. So similar comments of this reactivity appear in my sxs, in vasilia's, in lib's, in astrid's...

 

[japongus]

You are entitled to your opinions and also to air them but that doesn't make them correct neither do mine. Speaking as someone that has had tinnitus for many years and helped and corresponded with people that have tinnitus, I agree with Jasterboff's statement. "Negative thinking" is often associated with tinnitus; simply because of the way it can affect a person's state of mind when it is loud and intrusive. You may not like to hear this but I believe it to be true. Just read some of the posts in this forum from people that are in distress because of it. However, with time and treatment many people learn to habituate to tinnitus and are able carry on with their life.

Michael

Positive thinking doesn't cure a broken leg or a broken ear. Just like praying to Fappy the Anti Masturbation Dolphin or to Jesus doesn't cure cancer. Further, when sound therapy claims to habituate to T while curing H, when all its ''cures'' are patients that saw both disappear or lessen, none are cases where the T is still as strong as ever while the H is gone, is highly suspicious given how some of us suspect it's their T that is the cause of their H.

 

[SilverSpiral]

Never mind it's not recruitment, that sounds more like reactive tinnitus.

Nevertheless, distortion and clusters of muscles in the ear itself have been associated with a mimesis of external sound. So similar comments of this reactivity appear in my sxs, in vasilia's, in lib's, in astrid's...

I'm really not sure what term is best used to describe the issues with hearing I have, "hearing distortion" seems to be the broadest and most accurate one. "Reactive Tinnitus" seems to be used most commonly to refer to constant tinnitus which raises in volume when exposed to noise. I'm still not exactly sure what recruitment is either.