Got tinnitus. Any other testing apart from pure tone?

I recently developed tinnitus and I went through a couple of hearing tests. In NHS, Audiologists used “pure tone testing”, and both tones in pure tone testing overlapped with my tinnitus sound especially in high frequency. Audiologists suggest that I may have sensorineural hearing loss at high frequency. I did some online testing afterwards based on voice recognition in a noisy environment. They seem to suggest that I don’t have hearing loss. I am in late 30s and I have never had problem with hearing. Can anyone suggest that if there is any other testing apart from pure tone is available to know whether I have hearing loss? Doctors are investigating hearing loss in my new born. They seem to conclude that it is a genetic condition.

No, hearing loss is diagnosed by using pure-tone audiometry, and you should trust that result over any “online hearing test” you find. You could perform a test of otoacoustic emissions to see if there is damage to the outer hair cells, but that wont tell you much more than the pure-tone audiometry. Why do you doubt that result?
Also, having a tinnitus with a frequency that matches your hearing loss is not unusual, as the lack of normal hearing in that area is probably what caused the tinnitus in the first place.

1 Like

I have tinnitus and was tested with both pure tones and warble tones. Warble tones indicated about 5-10 dB less hearing loss because they have less tendency to be masked by the tinnitus. Take a look at this scientific paper.

I have tinnitus 24/7/365 since November 1975, the only way that my Audi has ever been able to do me any good has been to use a combination of true and Warble tones, and my word recognition scores. Also everyone raves about REM test on hearing aids, that is just a test to see if the hearing aids meet the standards for me, once my Audi does the REM test then he starts doing the real adjustments to get my aids so I can understand speech. My Audi also said that he can only use a baseline testing most of the time because of my white noise tinnitus. I do every now and then have a tone in my tinnitus but normally is is just white noise or pink noise.

1 Like

Warble tones under-estimate sloping hearing loss because of off-frequency listening, regardless of whether you have tinnitus, and should be avoided. Pulsed is fine, as that paper suggests.

2 Likes

My tinnitus is mild but I do check the TinnitusTalk forums for news on developments in hearing resoration research. The people there are big on doing extended frequency testing ie frequencies above those normally tested by audiologists. No doubt the audiologists will be along to comment- probably debunk, but you asked, so…

Doing high-frequency testing is fine, doesn’t hurt. But what is the point? Those frequencies are outside what a hearing aid can give amplification to, so what do you do with the information? A more useful way to spend your time would probably be to do tinnitus frequency matching and pitch matching (find the loudness and frequency of your tinnitus), so you can give the person a masking signal at the same frequency.

The online hearing in noise tests are only a very rough guide, mainly because you’ve self selected the listening environment, the hardware, the subject, the person performing the test, the source material and the volume level. There couldn’t be a less objective way.

If you’ve got Tinnitus, then the level you heard the Tones at IS, for all intents and purposes, the level that you are initially determine incoming sounds at with your Tinnitus in place, which is accurate as an overall measure. It’s true that it doesn’t necessarily represent your absolute threshold of hearing, with your tinnitus reduced, but that’s not your real (ambient) listening state anyway. The only slight caveat here is if you have ‘white coat fear/test apprehension’, where your tinnitus is particularly raised at the point of testing.

You might not want to hear this, but your post reads a lot like denial too. You’ve been told that you actually have a loss, you know there is Tinnitus present, but you seem to be trying to construct a set of evidence around your belief that the test was inaccurate.

2 Likes

Not arguing with you on this, but many tinnitus sufferers seem to have a need to prove to the world that what they experience is ‘real’ ie there is a physical cause. On the TinnitusTalk forums, they pay microscopic attention to developments in hair cell regeneration as something to pin their hopes on. To many, proof of their hearing loss means greater hope that future treatments will help them. In particular Frequency Therapeutics’ FX-322 seems likely to be most efficaceous at the higher frequencies, so high-frequency testing is often sought out if a normal audiogram doesn’t show damage.

1 Like

Thank you for all replies. Apologies, I didn’t share my audiogram before. My hearing is at 5db in low and medium frequencies. However, I am at 30db in 3000hz, 60db in 4000hz, 40db in 6000hz and 20db in 8000hz. As you see, I am gaining back my hearing towards 8000hz. It is different from normal hearing loss. Pure tone is overlapping with my tinnitus around 4000hz. Have you ever seen similar graph?

Yes, classic noise damage has a tick profile usually with the trough at 4kHz. Part of the reason for your tinnitus is the degree of difference between adjacent frequencies. It’s a log scale, so each relative 3dB represents a halving of sensitivity or power. A 15dB difference is roughly equivalent to a 30x difference in power, while a loss difference of 30dB is roughly equivalent to 1000x difference in power.

Broadly speaking, your 4KHz hearing needs massive amounts of cochlear tuning (or may have a dead region) and what you’re hearing is the overtuned adjacent areas or the poor response of that area. The tinnitus is a function of the system struggling to cope with that difference.

4 Likes