[HN Gopher] Auditory brainstem response distinguishes occasional...
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       Auditory brainstem response distinguishes occasional and constant
       tinnitus
        
       Author : Tomte
       Score  : 94 points
       Date   : 2022-08-29 11:43 UTC (11 hours ago)
        
 (HTM) web link (www.jci.org)
 (TXT) w3m dump (www.jci.org)
        
       | ibejoeb wrote:
       | Maybe useful for someone: I developed SSHL and I have tinnitus
       | mostly in my left ear, which is profoundly deaf. I use Bose noise
       | cancelling earbuds, and, for some reason, it relieves the
       | tinnitus and also allows me to do common things like make phone
       | calls or listen to audio with the remaining frequencies I hear in
       | my right ear.
        
       | TekMol wrote:
       | What I noticed when talking to people with tinnitus:
       | 
       | For some people, putting fingers in their ears and altering the
       | pressure alters the frequency of their tinnitus. For others, it
       | does not.
       | 
       | Could it be that this makes it possible to differentiate between
       | two different types of tinnitus?
       | 
       | For the HN readers with tinnitus - does it alter the frequency
       | for you, when you put fingers in your ears and move the fingers
       | into different directions?
        
         | seri4l wrote:
         | I'm not a physician or neurologist, but I read a lot about this
         | when I started suffering from tinnitus. There are indeed
         | multiple types.
         | 
         | - Hearing loss related: the tiny hairs in the inner ear that
         | transform vibrations into chemo-electric signals get damaged
         | and start sending the wrong signal.
         | 
         | - Cardiovascular: a pulsatile rumbling that varies with heart
         | rate. It's the sound of the blood flowing through some artery
         | near the inner ear. I remember reading that it was caused by
         | loud arteries and that it could be detected with very sensitive
         | microphones.
         | 
         | - TMJ/cervical/postural: I think this one was about motor
         | system or pain signals leaking to the ear circuit, but I'm not
         | sure.
         | 
         | - Timpani related: wax buildup, tensor muscle acting funny...
         | 
         | This rough classification only deals with the "input" part,
         | though. It doesn't explain how these bad inputs reach conscious
         | hearing, causing distress. As a general rule, over time extreme
         | pain becomes just pain, torrid heat becomes just heat, blue and
         | red can be seen as white depending on the lighting conditions,
         | even hunger and thirst are modulated by the nervous system.
         | Eventually one learns to cope with tinnitus, but it's kind of
         | fishy that this isn't filtered upstream by the auditory system,
         | before it reaches conscious hearing.
        
           | Arisaka1 wrote:
           | I have pulsatile tinnitus for the last 12 years, however it's
           | also accompanied with a CONSTANT sensation of pulse, as if I
           | can feel my arteries dancing, all around my scalp.
           | 
           | To this day, the doctors have been unable to find the root
           | cause for either. I eventually learned to live with both and
           | came to terms with the idea that I will never find out why
           | this happens.
           | 
           | With that being said, I want to pursue a diagnosis for
           | curiosity's sake as soon as my financial situation allows it.
        
         | TwoNineA wrote:
         | No change.
         | 
         | However, some of my migraines lower the noise, some anti
         | migraine medication raises it (Elavil).
        
           | tunap wrote:
           | To add to that, a K1/K2 'Super K' supplement I was taking
           | amplified my tinnitus within a couple days of taking it(I
           | didn't make the connection, initially). Early in 2020 when I
           | ran out & could not resupply, my tinnitus reduced > 50%
           | within a week or two of abstaining. When I did get another
           | bottle, the tinnitus increased almost immediately. I did
           | multi-weeks on/multi-weeks off testing 4 times that year and
           | the results were the same: the 'Super K' triggered it & it
           | waned within 2 weeks of desisting. YMMV.
        
         | Zardoz84 wrote:
         | nope
        
         | jFriedensreich wrote:
         | for me, pressure increases the frequency. also high jaw muscle
         | tension increases the frequency in a similar way.
        
         | clsec wrote:
         | For me, putting my finger in my ear only slightly mutes the
         | higher frequencies. I can change pitch a tiny bit by clenching
         | my jaw. But the real big changes in volume and pitch come when
         | I push my tongue onto the roof of my mouth.
        
         | [deleted]
        
         | ktkoffroth wrote:
         | For me, it doesn't seem to alter the frequency of the
         | underlying tinnitus "signal", but it does add some lower
         | frequency rumbling, which I believe is my tensor tympani
         | response.
        
         | IsopropylMalbec wrote:
         | No difference for me, in frequency or volume.
        
         | brobinson wrote:
         | Doesn't do anything for me.
        
         | eezynow wrote:
         | i am an audiologist and that sounds like TMJ
         | https://www.tmjtreatmentsc.com/blog/explaining-tinnitus-ear-...
         | ..so yes, it is possible.
        
           | magicalhippo wrote:
           | Oh wow, my SO has had sleep issues over a long period of
           | time, where she claims there's a low rumbling noise, like a
           | truck idling far away, preventing her from falling asleep.
           | She's talked with her doctor about it but so far nothing.
           | However she is being treated for having a clenched teeth
           | while sleeping...
           | 
           | Just the other day, she noticed that tilting her head in a
           | particular way made the rumbling go away. To us both this
           | indicated that the rumbling must be coming from within, and
           | not an external thing.
           | 
           | Could it all be her jaw?!?
        
             | Teever wrote:
             | It was for me.
             | 
             | Have your SO look into botox for TMJ. It is pricey but life
             | changing.
        
               | magicalhippo wrote:
               | Thanks, I'll make sure she follows up on that lead. Price
               | is relative to having frequent nights with very poor
               | sleep, so yeah, doesn't take much to be worth it.
        
             | PcChip wrote:
             | perhaps her tensor tympani is tensing, causing the ear
             | rumble
        
             | YeahNO wrote:
             | I have muscle tremors that sound like a fluttering or low
             | rumbling at night that sounds very much like this. It's an
             | occasional thing that sounds similar to what I hear when I
             | yawn deeply.
        
             | theplumber wrote:
             | It could be related to blood circulation so investigations
             | in that sense may help. Tilting her head in a particular
             | way may relieve some blood vesels.
        
             | cecilpl2 wrote:
             | Many people are able to voluntarily control the tensor
             | tympani muscle, which causes a low-pitched rumbling sound
             | in the ears. https://old.reddit.com/r/earrumblersassemble/
             | 
             | Maybe she has twitches or involuntary tension there?
        
               | magicalhippo wrote:
               | She's generally very tense in the upper back and neck
               | region as well, so involuntary tension seems indeed
               | likely. Thanks for the link, appreciated.
        
           | whitepirate20 wrote:
           | Are there cures for TMJ? It really kills me
        
             | Teever wrote:
             | Botox is a very effective but expensive treatment for TMJ.
             | 
             | I've had 3 treatments that last about 4-5 months and it has
             | significantly improved my quality of life.
             | 
             | It's been over a year since I've had one and the symptoms
             | have started to creep back, but they're mostly induced by
             | alcohol and caffeine (which I've mostly cut out.)
             | 
             | Just knowing that there's a treatment that I can get if the
             | pain gets too bad is a huge psychological relief.
        
             | Broken_Hippo wrote:
             | Sometimes!
             | 
             | I'm a layperson, so you know, verify my stuff with an
             | actual doctor.
             | 
             | On to cures: A common first thing is a mouth guard that you
             | wear at night. The one my dentist offered (if mine gets too
             | bad) aligns the teeth, hopefully giving some relief to the
             | joint.
             | 
             | My mother gets relief if she makes sure to keep anxiety
             | under control (with medication): Her TMJ will trigger
             | cluster headaches, so this is fairly important for her.
             | 
             | Some folks wind up having surgery, but this is a last
             | resort for most folks.
             | 
             | And as a sidenote: TMJ is often used to be covered under
             | regular health insurances, though sometimes it is difficult
             | to get it covered (Been a while since I lived in the US,
             | and am unsure of extent of Norwegian coverage)
        
             | vorpalhex wrote:
             | It depends on why you have TMJ. The first step is to talk
             | to your dentist and get your bite checked, especially if it
             | occurs on a specific side.
             | 
             | The second thing is to check your sleep situation, both
             | physical and mental. Is your pillow the correct height and
             | angle? Are you sleeping in a good posture or are you trying
             | to curl into a tiny ball? Are you going to bed relaxed?
        
           | seti0Cha wrote:
           | Interesting. I don't hear a single frequency, I often, but
           | not always, hear two or more. I wasn't aware until today that
           | this is called double tinnitus and is rare. I have TMJ and
           | tinnitus. I always thought my tinnitus was from going to
           | really loud music shows, but now I'm wondering whether it
           | doesn't have multiple causes, which perhaps explains the
           | different frequencies. Does this seem plausible?
        
           | TekMol wrote:
           | Interesting. People with TMJ seem to suffer from tinnitus
           | more than twice as often as other people:
           | 
           | https://pubmed.ncbi.nlm.nih.gov/30125964/
           | 
           | Let's see if there are studies about treating tinnitus via
           | treating TMJ:
           | 
           | https://pubmed.ncbi.nlm.nih.gov/?term=tinnitus+tmj&filter=pu.
           | ..
           | 
           | My reading of it: Two of the 7 found studies seem to be
           | relevant to this question. Both seem to indicate that
           | treating TMJ also treats tinnitus.
        
             | vprcic wrote:
             | My nugdet of experience to add a data point to this claim.
             | I have TMJ and have had it for as long as I can remember
             | (my jaw clicks every time I open or close my mouth). I
             | developed constant tinnitus in one ear (on the side where
             | the clicks happen) in my early 30s, a few years ago. I was
             | SURE the TMJ was causing my tinnitus, but the doctors
             | dismissed it as non-related. Maybe I should have pushed
             | harder. (I also have voluntary control over the tensor
             | tympani muscle, for what it's worth.)
        
             | cjbgkagh wrote:
             | Not sure on the stats here but I'd speculate that a co-
             | occurrence could be down to hEDS. It's not as rare as
             | doctors think and it can cause TMJ and tinnitus.
        
           | clsec wrote:
           | Wow, this TMJ connection isn't something I knew about but it
           | seems to make some sense in my case.
           | 
           | I've had mild tinnitus for 30+ years that got extremely loud
           | the morning after my second mRNA covid vaccination. But with
           | this new (to me) information I'm starting to question other
           | things such as my spinal cord injury and resulting
           | neuropathy. My trigeminal nerve was also damaged during my
           | neck surgery (from the halo they put your head in) which
           | caused neuropathic problems on my scalp and face for a couple
           | years. And finally, I had stopped taking carbamazepine for
           | the peripheral neuropathy I got from my accident right around
           | the same time I got my second mRNA vax. Hmm..
           | 
           | I'm bummed that I have to search these kinds of things out
           | and bring them to the attention of my doctors but I'm also
           | glad to have new information to talk to my ENT about.
           | Hopefully between this info and the head MRI I'm getting next
           | month I can find some relief.
        
       | upsidesinclude wrote:
       | If you are dealing with any kind of tinnitus it is worth trying
       | to massage the mastoid process and mastoid portion.
       | 
       | Just a small circular motion behind the ear accompanied with
       | light pressure.
       | 
       | This has worked to alleviate certain tinnitus.
       | 
       | Before downvoting this, please consider that the causes of
       | tinnitus are not largely understood and alleviating it in any way
       | is hugely relieving.
       | 
       | Also recommend range of motion exercises
        
         | Zebfross wrote:
         | And it could be caused by wax buildup that eventually touches
         | the eardrum, something a doctor can verify and take care of in
         | 15 minutes.
        
           | ghastmaster wrote:
           | When I have wax buildup about once a year, I flush with warm
           | water and a "Monoject 412". I shoot the stream directly into
           | the canal, almost as hard as possible, over and over until it
           | is completely clean. I have been to a physician where a nurse
           | usually does a similar procedure with a machine. They
           | however, leave my ear hurting and have even noticed bleeding
           | after the procedure.
           | 
           | I do not recommend trusting a doctor with this procedure. DIY
           | is safer in my experience. You do not need to stick the
           | monoject in your ear, just get it close and direct the stream
           | into the canal.
        
       | cdjk wrote:
       | I have tinnitus and hearings aids help a lot. I only have mild
       | hearing loss (35db at high frequencies in my worse ear), but it
       | matches the frequency of my tinnitus.
        
         | Traubenfuchs wrote:
         | 35 sounds pretty impactful though. The physical limit of ear
         | plugs COMBINED with ear muffs is 36db NRR.
        
           | cdjk wrote:
           | Well up to 25 dbHL is considered "normal" hearing for an
           | adult. Without a hearing test I wouldn't have known I had any
           | hearing loss.
        
       | ycombinete wrote:
       | > CONCLUSIONS. Our results support the hypothesis that the
       | transition from occasional to constant tinnitus is accompanied by
       | neuronal changes in the midbrain leading to a persisting
       | tinnitus, which is then less likely to remit.
       | 
       | It was actually easier to come to terms with my tinnitus, once I
       | realised that it was never going away.
        
         | hprotagonist wrote:
         | the "maladaptive plasticity" framework for thinking about
         | tinnitus is certainly a fairly convincing one.
        
         | Jordanpomeroy wrote:
         | Do these results suggest no treatment will be possible?
        
           | Traubenfuchs wrote:
           | They simply found evidence that 1) the more often one has
           | occasional tinnitus the more likely it will become permanent
           | and 2) the longer a tinnitus lasts, the more likely it won't
           | go away again and 3) people having permanent tinnitus have
           | neuronal brain changes that can be measured, in contrast to
           | those that only suffer from occasional one.
           | 
           | The only thing treatment related, or "actionable information"
           | one could derive here is that its prudent to aggressively
           | treat those with frequent occasional tinnitus or a tinnitus
           | that already lasts longer than normal but isn't considered
           | permanent yet.
        
             | bredren wrote:
             | 1) and 2) sound a bit like covid / long covid symptoms.
        
           | DoreenMichele wrote:
           | _Anecdotally_ , some people find magnesium supplements
           | helpful.
        
           | jansommer wrote:
           | I have noise induced tinnitus and have found that
           | benzodiazepine makes it completely silent. That silence comes
           | with a pretty steep price though, in regards to the side
           | effects. So there certainly is potential for a cure, and
           | there's always a few trials going on. One that's particularly
           | interesting is https://www.withpower.com/trial/phase-3-tinnit
           | us-6-2021-925a.... I don't remember where I read it, but the
           | reason they're trialing Etanercept is because they tested it
           | on 12 people where I recall 11 of them experienced quieter
           | tinnitus. If it works, then we have an FDA and EMA approved
           | product for treatment.
        
           | layer8 wrote:
           | No.
        
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