Quantcast

Anyone else have this?

MartinLogan Owners (MLO)

Help Support MartinLogan Owners (MLO):

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Just curious if anyone else has tinnitus (buzzing, ringing, hissing, humming, noise which can't be attributed to an external source) which interferes with critical listening. Mine used to but I got used to it and it really only bothers me when I go to bed now. I first noticed mine when I was auditioning a pair of Vandersteens (sp?) and I couldn't figure out why they were such noisy speakers - then I realized it wasn't the speakers... :rolleyes:

-D
 
A

ARCVT100

Guest
I have had this for years. I don't think it was caused by my older systems with 2% disortion though. :rolleyes:

The brain is amazing in tuning out things and until you mentioned it i forgot I had it.

At 59 everything starts going south anyways. :D

It is all relative anyway. If i have 90% of my hearing does that mean i still can't enjoy what I do hear?
 
Last edited:

Peter_Klim

Well-known member
Joined
Jan 1, 2005
Messages
358
Reaction score
0
Location
Huntington Beach, CA
Muad'Dib said:
Just curious if anyone else has tinnitus (buzzing, ringing, hissing, humming, noise which can't be attributed to an external source) which interferes with critical listening. Mine used to but I got used to it and it really only bothers me when I go to bed now. I first noticed mine when I was auditioning a pair of Vandersteens (sp?) and I couldn't figure out why they were such noisy speakers - then I realized it wasn't the speakers... :rolleyes:

-D
Mine is only noticeable when I go to sleep, wear earplugs, or lie on one side (ear) like when watching tv on the sofa. It began just under a year ago. Mainly due to listening to car audio after a few months of commuting 4 hours a day round trp to work. To prevent hearing loss, for every 5 db increase in sound, your length of exposure to noise per day decrease by 1/2. It starts at about 85 dbs lasting 8 hours (90 db - 4 hrs, 95 dbs - 2 hrs...). After I started getting these symptoms is when I reashered this and then got a DB meter to measure how loud I was listening at. It was at about 95-100 dbs for 4 hrs a day :( It's worse in the left ear (since the driver side speaker is closer to the left ear). For a few months it was really depressing.

Now I wear custom molded ear plugs in my left ear all day long unless I rent a DVD or listen to music (but only at about 60-62 dbs). If I listen to music louder, then for a few days my ear dum flutters and pops when I talk, or hear loud noises (it literraly just now popped for no reason...maybe because I just finished watching a DVD) such as when dishes clank. Any louder than 62 dbs and my ears feel itchy inside, warm and sometimes tingly (part of it may be my imagination?). Switching to a tube amp about a month ago has helped, to a degree.

When it first started happening I got the sensations of a wet willy, and thought that my car's titanium dome tweeters were to harsh. Then, in my second car, I uses my roto-zip to create spacers for my speakers, and the roto-zip was louder than usual. When I used it, I got my realy close to it to blow the saw dust out to see the penciled line I was sawing at. So I think that was the final straw that ruined my ears. Luckily, my ears were tested to be still in the normal range, but my left ear borderline close to being in the "slight-hearing loss" range at 4kHz.

So now I have to keep it down, and keep a safe distance away from the speakers (man, I miss near-field listening :( ...I miss playing it above 62 dbs..). I can't even listen to rock anymore, so now I started to listen to jazz (but saxaphones are the worst)...anyway, enough of my blabbling...I'm really thankful to God for what I do have...sight, health, friends, a job...

I'm only 35, so, I hope my story can be an example preventing this from happening to other people.
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
ARC - I doubt it was caused by your last system.... :D And no, just because you lose something doesn't mean you can't enjoy listening - I still do. It just gets in the way in the really quiet passages. And as a by the way, hearing loss isn't measured in %ages.

Peter - I doubt the asymmetry is from the distance to the speaker although it's possible I guess. Do you drive with your window cracked open? That can cause it. I've seen a few truck drivers who had asymmetries presumably caused by rolling down their window a small amount while driving because their AC was busted.

Do you have sinus problems or allergies? That could cause the popping in your left side. Does it happen when you drink? Is your tinnitus louder in one side than the other? What's it sound like? You have a history of ear infections as a kid? Ever get any drainage presently? Lastly do you ever have any balance problems?

Mine is because I was stupid and worked for a DJ for a few years and before that I worked construction for many years. Construction is difficult for OSHA to mandate as far as hearing health care because it's mostly impact noise which breaks the 90dB TWA - although they're working on it. Also I've done some shooting without earplugs which didn't help anything. Now I spend my days in a sound booth so I think I'm probably going to be ok from now on :rolleyes:

-D
 

Sky Saw

Well-known member
Joined
Jan 1, 2005
Messages
97
Reaction score
0
Location
Toronto, Canada
I thought everyone had some tinitus to some degree. Mine is worse when I have a lot of caffeine. I was a professional classical musician for 14 years, which is what did it to me. Sitting 10-15 ft in front of a brass section is very bad for hearing. Despite wearing custom earplugs, which make playing very challenging, it was one of the factors that caused me to get out of the profession - it just takes too much of a toll on the body! During a rehearsal of the Verdi Requiem I pulled out my Radio Shack Db meter and measured a steady 110Db from my seat - of course, that's 10ft from 8 trumpets blowing full-out.
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Sky Saw said:
I thought everyone had some tinitus to some degree. Mine is worse when I have a lot of caffeine. I was a professional classical musician for 14 years, which is what did it to me. Sitting 10-15 ft in front of a brass section is very bad for hearing. Despite wearing custom earplugs, which make playing very challenging, it was one of the factors that caused me to get out of the profession - it just takes too much of a toll on the body! During a rehearsal of the Verdi Requiem I pulled out my Radio Shack Db meter and measured a steady 110Db from my seat - of course, that's 10ft from 8 trumpets blowing full-out.
Most people have intermittent tinnitus but without heavy noise exposure, it rarely becomes permanent.

Yes, caffeine aggravates it. Actually just about everything can irritate it.

By the way, I would have been one of those trumpet players :D

-D
 

Peter_Klim

Well-known member
Joined
Jan 1, 2005
Messages
358
Reaction score
0
Location
Huntington Beach, CA
Muad'Dib said:
Peter - I doubt the asymmetry is from the distance to the speaker although it's possible I guess. Do you drive with your window cracked open? That can cause it. I've seen a few truck drivers who had asymmetries presumably caused by rolling down their window a small amount while driving because their AC was busted.

Do you have sinus problems or allergies? That could cause the popping in your left side. Does it happen when you drink? Is your tinnitus louder in one side than the other? What's it sound like? You have a history of ear infections as a kid? Ever get any drainage presently? Lastly do you ever have any balance problems?
-D
I've seen an ENT doctor and did all sorts of test and thye've rules out any kind of infections/drainage/balance/pressure problems. I have what is called "Recruitment" ear damage.

The fine hair like thingies in my cochlea that senses the region of sound centered around 4Khz have died and fallen out. So, the hair that is still alive the can sense the sound below and above 4kHz have been recruited to sense it and the frequencies that they are designed to sense - causing an overload which causes the tingly, warm, itchy sensation when that music is to loud.

This is from going to concerts one weekend after another 15 summers ago, and 15 years of having a loud car stereo. Unfortunately it has nohing to do with something that is reversable. But I truely do appreciate your sincere concern :)
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Peter_Klim said:
I've seen an ENT doctor and did all sorts of test and thye've rules out any kind of infections/drainage/balance/pressure problems. I have what is called "Recruitment" ear damage.

The fine hair like thingies in my cochlea that senses the region of sound centered around 4Khz have died and fallen out. So, the hair that is still alive the can sense the sound below and above 4kHz have been recruited to sense it and the frequencies that they are designed to sense - causing an overload which causes the tingly, warm, itchy sensation when that music is to loud.

This is from going to concerts one weekend after another 15 summers ago, and 15 years of having a loud car stereo. Unfortunately it has nohing to do with something that is reversable. But I truely do appreciate your sincere concern :)
Glad you've seen a doc about it. I'm getting my doctorate in Audiology so I thought I'd throw the important questions out on the board in case you hadn't been to a doc yet.

Recruitment is technically the abnormal return to normal loudness levels. Basically means that with reduced hearing thresholds, a 70dB sound will have the same intensity to me as it would to you. Hence a reduction of dynamic range. As you have the problem, you're obviously more than familiar with this.

There are two types of hair cells - actually they're cilia and not hair cells, but whatever - in the inner ear. With the majority of insults - noise, acoustic trauma, ototoxicity, etc. - the first type of hair cells to go are the "outer hair cells." These comprise the "cochlear amplifier" which is essentially a non-linear amplifier - off topic, but it suffers from the same problems all non-linear amplifiers suffer from, including cubic distortion which is something that we use clinically to measure quantity of outer hair cell function (I can elaborate further if anyone is interested) - which is what you're losing. Not lost. If you're threshold is boarderline mild hearing loss then it means you're around 25-30dB threshold around 4kHz. This means essentially nothing as there is very little important ambient noise in this area. Normal conversational speech is well above this level. The second type of hair cells are the "inner hair cells" and very basically, these are the cells we need. They are the ones that provide the "fine tuning" when looking at i/o curves and frequency specificity. You won't lose these cells til you get down into the 60+dB thresholds, at which point people often complain that they don't hear pure tones, but buzzing in the affected area (caused by the elicitation of neighboring frequency regions on both sides of the "cochlear dead region.").

That said, I wouldn't worry too much about your hearing aside from the popping sound - which is probably your eustacian tube opening to relieve pressure in the middle ear. Granted, it may be uncomfortable, but listening to music at non-rediculous levels should be ok for you.

I think this is the most I've ever written on a board before. :D Guess I can be rather longwinded :eek:

-D
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Sky Saw said:
...typical of a trumpet player. Although the graduate school thing is not ;) .
:D

I'm the complete package - come with the ego to match too :cool:

-D
 

Peter_Klim

Well-known member
Joined
Jan 1, 2005
Messages
358
Reaction score
0
Location
Huntington Beach, CA
Muad'Dib said:
Glad you've seen a doc about it. I'm getting my doctorate in Audiology so I thought I'd throw the important questions out on the board in case you hadn't been to a doc yet.

Recruitment is technically the abnormal return to normal loudness levels. Basically means that with reduced hearing thresholds, a 70dB sound will have the same intensity to me as it would to you. Hence a reduction of dynamic range. As you have the problem, you're obviously more than familiar with this.

There are two types of hair cells - actually they're cilia and not hair cells, but whatever - in the inner ear. With the majority of insults - noise, acoustic trauma, ototoxicity, etc. - the first type of hair cells to go are the "outer hair cells." These comprise the "cochlear amplifier" which is essentially a non-linear amplifier - off topic, but it suffers from the same problems all non-linear amplifiers suffer from, including cubic distortion which is something that we use clinically to measure quantity of outer hair cell function (I can elaborate further if anyone is interested) - which is what you're losing. Not lost. If you're threshold is boarderline mild hearing loss then it means you're around 25-30dB threshold around 4kHz. This means essentially nothing as there is very little important ambient noise in this area. Normal conversational speech is well above this level. The second type of hair cells are the "inner hair cells" and very basically, these are the cells we need. They are the ones that provide the "fine tuning" when looking at i/o curves and frequency specificity. You won't lose these cells til you get down into the 60+dB thresholds, at which point people often complain that they don't hear pure tones, but buzzing in the affected area (caused by the elicitation of neighboring frequency regions on both sides of the "cochlear dead region.").

That said, I wouldn't worry too much about your hearing aside from the popping sound - which is probably your eustacian tube opening to relieve pressure in the middle ear. Granted, it may be uncomfortable, but listening to music at non-rediculous levels should be ok for you.

I think this is the most I've ever written on a board before. :D Guess I can be rather longwinded :eek:

-D
Can you write some more? ;)
 

Peter_Klim

Well-known member
Joined
Jan 1, 2005
Messages
358
Reaction score
0
Location
Huntington Beach, CA
Seriously, can you write some more?

You've written more than my ENT told me about. After he analyzed my test results, he left me a message voice telling me I was normal and that nothing was wrong, and to give him a call if I had questions. How can nothing be wrong when I wasn't like this about a year ago? And I'm in the same condition?

This is my audiogram reading (left/right ear):
250Hz -10/10 db
500Hz - 15/15
1K - 15/15
2K - 5/5
3K - 5/5
4K - 15/5
4.7K(?) - 10/0 (not usre what Fr was scribbled on the audiogram)
8K - 5/5


So I decided to make another doctors appointment to speak to him in person. I asked if I had recruitment and he was suprised that I knew the term. Then he finally told me I had it. He didn't have much to say. He never said anything about the popping, and it never made sense that it had anything to do with inner ear damage. What can I (or doctors) do to help out with the popping?

BTW- Thanks, "cilia" was the word I was looking for (like on a paramecium):

 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Peter -

whatever you tried to attach is not working for me. Link me again.

I'll explain whatever you would like to know next time I'm sober. I will say though that your hearing is perfectly normal - the cutoff is 25dB and you're above that.

By the way, ENT's shouldn't be tellin you a damn thing about your hearing because that's not their job. The can give you medical advice/intervention, but describing an audio and telling you what to do (non-medically) for it is out of their scope of practice.

-D
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
4.7 should be 6kHz. We typically test from 250Hz up to 8kHz (in mostly octave intervals) to give a broad idea of how someone is hearing across the spectrum. Testing above 8kHz is rare as there is very little speech information that is contained in that area and "we are primarily concerned with communication abilities" of our patients. Bull shit as far as I'm concerned. I happen to be one of the few people in the field who believes that more testing should be performed - given my obsession with "high end audio" (ok fine, high end for MY budget), it is no wonder that I am livid re: modern day hearing aids and their sound quality. This is in some way, shape, form going to be my research topic although I don't have an official question yet.

The cochlea is tonotopically arranged (arranged by frequency) starting at the apical end of the cochlea. It begins at the higher frequencies and goes to the lower frequencies. Average range of hearing is 22/20kHz down to roughly 20Hz with frequencies down to about 15Hz being somewhat detectable, although not officially "audible." Even if the noise is primarily low frequency, it still has to travel through the high frequency portion which is part of the reasoning behind why higher frequencies are affected by noise first. As an aside, noise induced loss is typically 1/2 to 1 octave above the frequency of the noise and then spreads from there over a great deal of time due to the resonance of the ear canal.

As I already talked about the cochlear amplifier, I will continue from there very briefly. Medial to the cochlea, the auditory nerve caries information up to the cortex - for simplicity sake, I'm skipping A LOT here. The nerve is also tonotopically arranged, as is the cortex when signals finally arrive. When I mention that I'm skipping things, let me just say that the auditory system is the only system in the body that can take a finite set of stimuli and produce infinite outcomes - mostly cause of the stuff I've skipped.

Going back to the outer hair cells very briefly, as I think I mentioned before, they are essentially a non-linear amplifier controlled by the efferent nerve system. Their direct function can be measured through what is called, "Otoacoustic Emissions," or OAE's, which occur as a bi-product of introduced sound to the ear. Basically the sound comes back OUT of the ear around 50-70dB below the input sound - which can be either clicks or tones. Clinically Distortion Product OAE's are used most often (as they can be elicited with a slightly higher degree of hearing loss). They are the cubic distortion product of the input tones. Formula: 2f1 - f2 = CD. Things preventing sound from coming back out of the ear - debris, ear infection, etc - will affect OAE measurement.

When testing ones hearing, we test through air conduction - the little insert earphones placed in your ears - and through bone conduction which is a big black object placed behind your ears. When doing this, we are essentially skipping the outer and middle ear to measure hearing sensitivity through direct stimulation of the cochlea. Things which will cause differences between the two results include: middle ear infections, middle ear tumors, shit stuck in peoples ears - pencil erasors, M&M's, marbles, etc.... You'd be surprised as to how many of the later we see with kids. The middle ear cavity has an opening which "dumps" to the back of the throat known as the eustacian tube. This tube acts to relieve pressure buildup of the cavity.

Aside from hearing sensitivity tests, we test the middle ear reflex which will give an idea as to the condition of the stapedial (one of two muscles of the middle ear) reflex. This test is the tell tale sign of a recruiting ear. The principle of the reflex is basically:
1. loud sounds activate an action potenial up the 8th cranial nerve
2. from here it can go one of three places:
1. ipsilateral superior olivary complex
2. contralateral superior olivary complex
3. contralateral facial nerve nuclei
3. down from any of these sites to either the ipsilateral or contralateral stapedius through the 7th cranial nerve.

If there is an ilicitation of the reflex below 65dB(Sensation Level), then it is considered to be a recruiting ear. I've seen people with hearing thresholds down to 45dB who had reflexes at 110dB which means they were not recruiting. Recruitment really only kicks in when the outer hair cells are on their way to completely gone. If I had to put a percentage for your audiogram, I'd say 0-2% gone depending on earphone placement/debris (as described briefly next paragraph). Have you ever had any IV antibiotics (answer this in a private message if you'd like) as these can be ototoxic and can cause loss different than what is initially seen in an audiogram. If this is the case, OAE monitoring should be performed to measure hair cell (dis)function prior to it appearing on your behavior audiogram.

Looking at your audio, there is absolutely nothing wrong with your hearing. Hate to tell you this. The 10dB asymmetry in your ears in the high frequencies is probably due to placement of the insert earphones, or can even be caused by debris if it was occluding your ear canal. I've experienced this myself and I can hear a difference between ears - sounds a little muffled. But people are remarkably plastic (adaptable) and you'd get over it pretty quick. Presumably, reflexes were done on you, in which case, you either have or don't have a recruiting ear(s). Whether or not you have the results of the entire test battery I don't know - although if you do I'd be happy to discuss them with you in a private message as I don't want to discuss your medical history more in public. You can also call the doc and request that he give you all the information, at which time I'd also be happy to discuss it with you in private.

As to the popping, this is overstepping my scope of practice as I am not a medical doctor, but you could probably try some over the counter allergy meds to see if that makes a difference. This will decrease the swelling of your sinuses and presumably alleviate the popping sensation that arrises when the E-Tube opens.

As a rather random aside, I'm curious where you came up with the 62dB number? The reason I ask is that 60dB is not loud at all. In fact, long term average speech falls within 55-60dB(SPL) with a crest factor of 30dB (peaks and valleys around +12 and -18dB respectively) which would mean that you're ear drum flutters as you put it all the time.

If I were you, I'd find an audiologist who didn't work for an ENT and have a full evaluation, including reflex, tympanometry, OAE, and diagnostic hearing test.

That explained, I can elaborate on anything that anyone is interested in....

-D
 

Jeff Zaret

Well-known member
Joined
Jan 3, 2005
Messages
1,214
Reaction score
1
Location
Lancaster,Ca
WOW!

A very techinical explanation but very informative. I for one thank you. I have always been concerned about my hearing. I have always have had very "acute" hear as a youngster and throughout my teens. As I age I know this has changed. How much I am not sure I would imagine that there is some loss of high frequency recognition (?) that comes with age. Also, too many long hours in a computer room doesn't help as well as plenty of hours in front of guitar amps in highschool and college too. :eek:

Thanks again


Jeff
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
Jeff Zaret said:
WOW!

A very techinical explanation but very informative. I for one thank you. I have always been concerned about my hearing. I have always have had very "acute" hear as a youngster and throughout my teens. As I age I know this has changed. How much I am not sure I would imagine that there is some loss of high frequency recognition (?) that comes with age. Also, too many long hours in a computer room doesn't help as well as plenty of hours in front of guitar amps in highschool and college too. :eek:

Thanks again


Jeff
You're quite welcome. Like I said, if you've got specific questions I'd be happy to answer them.

For what it's worth, I'd say the computer room was probably not an issue, but the guitar amps were :) Yes, chances are you're losing/lost some of your high frequency resolution. Happens to most everyone at some point in their lives.....

Breaking HIPPA (privacy acts) with this, I had a patient today who just had his 40th birthday and in slightly over a years time period lost ALMOST ALL OF HIS hearing. As in I put him in the test booth with a loaner pair of power hearing aids at max output below 2kHz (b/c above this the aids will feedback) who had an aided threshold (threshold is the level at which you correctly hear a tone 50% of the time) at 85-90dB!!! These hearing aids are putting out approximately 135dB gain!!!!! And he's young too. Some sort of strange genetic mishap. Makes you happy for what you DO have left.

-D
 

Jeff Zaret

Well-known member
Joined
Jan 3, 2005
Messages
1,214
Reaction score
1
Location
Lancaster,Ca
At the time I was aware that the guitar amps would hurt my ears so I tried to be as careful as I could. I would say that just by the natural aging process I may have lost some of the "youthfullness" of my hearing. Being in my early 50's I would assume this to be somewhat accurate and normal. I still believe I have good hearing. I have always had good hearing and I can remember in highschool that I could not have a can of coke in the room if it had any coke left because I could hear the "fizz". I used to be able to hear some store alarms because their frequency they were at were probably just too low and it would be sharp and disturbing. I do hear when it is quiet I guess you would call it ringing but I would describe it more like "noise" white or pink not sure but the higher of the two. I have CRS too. Cant Remember Shit, but I think I got that from my kids. :D

Thanks

Jeff
 

Peter_Klim

Well-known member
Joined
Jan 1, 2005
Messages
358
Reaction score
0
Location
Huntington Beach, CA
Muad'Dib said:
4.7 should be 6kHz. We typically test from 250Hz up to 8kHz (in mostly octave intervals) to give a broad idea of how someone is hearing across the spectrum. Testing above 8kHz is rare as there is very little speech information that is contained in that area and "we are primarily concerned with communication abilities" of our patients. Bull shit as far as I'm concerned. I happen to be one of the few people in the field who believes that more testing should be performed - given my obsession with "high end audio" (ok fine, high end for MY budget), it is no wonder that I am livid re: modern day hearing aids and their sound quality. This is in some way, shape, form going to be my research topic although I don't have an official question yet.

The cochlea is tonotopically arranged (arranged by frequency) starting at the apical end of the cochlea. It begins at the higher frequencies and goes to the lower frequencies. Average range of hearing is 22/20kHz down to roughly 20Hz with frequencies down to about 15Hz being somewhat detectable, although not officially "audible." Even if the noise is primarily low frequency, it still has to travel through the high frequency portion which is part of the reasoning behind why higher frequencies are affected by noise first. As an aside, noise induced loss is typically 1/2 to 1 octave above the frequency of the noise and then spreads from there over a great deal of time due to the resonance of the ear canal.

As I already talked about the cochlear amplifier, I will continue from there very briefly. Medial to the cochlea, the auditory nerve caries information up to the cortex - for simplicity sake, I'm skipping A LOT here. The nerve is also tonotopically arranged, as is the cortex when signals finally arrive. When I mention that I'm skipping things, let me just say that the auditory system is the only system in the body that can take a finite set of stimuli and produce infinite outcomes - mostly cause of the stuff I've skipped.

Going back to the outer hair cells very briefly, as I think I mentioned before, they are essentially a non-linear amplifier controlled by the efferent nerve system. Their direct function can be measured through what is called, "Otoacoustic Emissions," or OAE's, which occur as a bi-product of introduced sound to the ear. Basically the sound comes back OUT of the ear around 50-70dB below the input sound - which can be either clicks or tones. Clinically Distortion Product OAE's are used most often (as they can be elicited with a slightly higher degree of hearing loss). They are the cubic distortion product of the input tones. Formula: 2f1 - f2 = CD. Things preventing sound from coming back out of the ear - debris, ear infection, etc - will affect OAE measurement.

When testing ones hearing, we test through air conduction - the little insert earphones placed in your ears - and through bone conduction which is a big black object placed behind your ears. When doing this, we are essentially skipping the outer and middle ear to measure hearing sensitivity through direct stimulation of the cochlea. Things which will cause differences between the two results include: middle ear infections, middle ear tumors, shit stuck in peoples ears - pencil erasors, M&M's, marbles, etc.... You'd be surprised as to how many of the later we see with kids. The middle ear cavity has an opening which "dumps" to the back of the throat known as the eustacian tube. This tube acts to relieve pressure buildup of the cavity.

Aside from hearing sensitivity tests, we test the middle ear reflex which will give an idea as to the condition of the stapedial (one of two muscles of the middle ear) reflex. This test is the tell tale sign of a recruiting ear. The principle of the reflex is basically:
1. loud sounds activate an action potenial up the 8th cranial nerve
2. from here it can go one of three places:
1. ipsilateral superior olivary complex
2. contralateral superior olivary complex
3. contralateral facial nerve nuclei
3. down from any of these sites to either the ipsilateral or contralateral stapedius through the 7th cranial nerve.

If there is an ilicitation of the reflex below 65dB(Sensation Level), then it is considered to be a recruiting ear. I've seen people with hearing thresholds down to 45dB who had reflexes at 110dB which means they were not recruiting. Recruitment really only kicks in when the outer hair cells are on their way to completely gone. If I had to put a percentage for your audiogram, I'd say 0-2% gone depending on earphone placement/debris (as described briefly next paragraph). Have you ever had any IV antibiotics (answer this in a private message if you'd like) as these can be ototoxic and can cause loss different than what is initially seen in an audiogram. If this is the case, OAE monitoring should be performed to measure hair cell (dis)function prior to it appearing on your behavior audiogram.

Looking at your audio, there is absolutely nothing wrong with your hearing. Hate to tell you this. The 10dB asymmetry in your ears in the high frequencies is probably due to placement of the insert earphones, or can even be caused by debris if it was occluding your ear canal. I've experienced this myself and I can hear a difference between ears - sounds a little muffled. But people are remarkably plastic (adaptable) and you'd get over it pretty quick. Presumably, reflexes were done on you, in which case, you either have or don't have a recruiting ear(s). Whether or not you have the results of the entire test battery I don't know - although if you do I'd be happy to discuss them with you in a private message as I don't want to discuss your medical history more in public. You can also call the doc and request that he give you all the information, at which time I'd also be happy to discuss it with you in private.

As to the popping, this is overstepping my scope of practice as I am not a medical doctor, but you could probably try some over the counter allergy meds to see if that makes a difference. This will decrease the swelling of your sinuses and presumably alleviate the popping sensation that arrises when the E-Tube opens.

As a rather random aside, I'm curious where you came up with the 62dB number? The reason I ask is that 60dB is not loud at all. In fact, long term average speech falls within 55-60dB(SPL) with a crest factor of 30dB (peaks and valleys around +12 and -18dB respectively) which would mean that you're ear drum flutters as you put it all the time.

If I were you, I'd find an audiologist who didn't work for an ENT and have a full evaluation, including reflex, tympanometry, OAE, and diagnostic hearing test.

That explained, I can elaborate on anything that anyone is interested in....

-D

WOA Muad’Dib!! That is a ****LOAD of info!! Some of it is pretty new to me. I am surprised my ENT and Audiologist didn’t tell me this stuff. Thank you soooo much for being so informative!! : )


Questions about what you wrote:

“As to the popping …you could probably try some over the counter allergy meds to see if that makes a difference”

Yes, my ENT did give me a steroid nasal spray and some allergy pills. All it did was give me nose bleeds. This was last spring so I’d assume by now it would have been cured. (Just so that you know, it’s been exactly 1 year now that I’ve had all these symptoms. But some started 1 ½ year ago)


“we test the middle ear reflex which will give an idea as to the condition of the stapedial (one of two muscles of the middle ear) reflex.” Is this the same as when a pressure test is made (sorry I don’t have the correct terminology; I’m at work and my audiogram is at home). If not, then I don’t think this was ever conducted on me : ( Reading over you post again, I think the test was called “tympanometry”.


Do you know anything about nerve damage? Sometimes when listening to music, my left outer ear (the bad one) and the cheek area near it feels funny for a second or two, like it’s becoming numb. And at times, a small spot in the center of my ear lobe (both sides but never at the same time) pops. If I run my finger nail in there, I think there is a little wrinkle where the pop may be originating from.

“As a rather random aside, I'm curious where you came up with the 62dB number?”

I use a Radio Shack SPL meter at C weight (the one that displays the higher reading), and if the music reaches above 62 dBs for a few songs, then for the next few days my ear drum pops and sometimes flutters when I hear things like the clanking of dishes or when I am on the telephone (even when I use my good ear. I need to plug my bad ear to avoid the popping). If it’s a fast paced song, I need to lower it. That is why I don’t listen to Rock anymore, but instead jazz.

“The reason I ask is that 60dB is not loud at all. In fact, long term average speech falls within 55-60dB(SPL) with a crest factor of 30dB (peaks and valleys around +12 and -18dB respectively) which would mean that you're ear drum flutters as you put it all the time.’

Yeah, I don’t get it either? Maybe because vocals don’t have the same bandwidth as music, so there is less recruitment (fewer cilia need to jump in to help)? When I speak or someone else does, I get a reading in the 70’s.

Oh, and check out this link I found today about some recent advancements in hearing loss. It’s about turning on a gene that allowed cochlear cilia to regenerate in a guinea pig!!


Cochlear cilia regenerated
 

Muad'Dib

Well-known member
Joined
Jan 6, 2005
Messages
83
Reaction score
0
I'm not surprised the ENT and Audiologist didn't tell you all this. Most people don't need to know it. I probably wouldn't have gone into it either unless there was a reason to.

Tympanometry is basically a pressure test, yes. It starts off by presenting a continuous tone and then puts negative pressure in the ear canal. It starts at -400da/Pa (if I remember right - it's been awhile since I've actually used this as my recent patient population has mostly been longstanding geriatric hearing aid users) and goes to + 200da/Pa. By doing so, it tests the mobility of the TM to determine where it is most compliant. Normal is typically +/- 100da/Pa.

Acoustic Reflexes are only mildly related to tympanometry insofar that there needs to be normal tymps to obtain reflexes. Typically this test is located fairly near the tymps on the audiogram sheet if you want to look for it. It will have two sets of 4 numbers - ipsilateral/contralateral at 500, 1k, 2k, and 4kHz per side. Reflex patterns can tell a lot of infomation - from brainstem site of lesion to middle ear infection depending on the other test results. Tell me those results if they were tested (should have been in an ENT's office) and I will interpret and explain them for you.

As to the nasal spray, if it caused nose bleeds, I'd avoid it. I'd try some over the counter antihistamines. Ask your local pharmacist for help in choosing one. I think this is probably your problem as far as the physical sensation goes.

I know a lot about "nerve damage." But "nerve damage" will have no effect on your outer ear. By your audio, you also have nothing wrong with your auditory nerve although you have not had a definitive workup on this (I assume you haven't had an ABR or MRI). Given your audio I wouldn't have recommended an ABR and I have no authority for recommending MRI's. You can have your hearing rechecked and if you feel your left ear has continued to worsen and then things might be different.

Do you have any problems with your teeth/jaw?

Are you on any medications? Answer in private messages if you are. Different meds can have different effects on your hearing.

Did anything preceed your subjective change in hearing? Without a baseline audio I'm hesitant to call it a hearing loss and because the asymmetry is only at 1 frequency, I'm not overly concerned with it.

The last three questions should have been discussed with your ENT and/or Audiologist.

***EDIT***
Oh, and unfortunately we're a long way from hair cell regeneration in humans.

-D
 
Top