by Neil Bauman, Ph.D.
A lady explained:
My audiologist says I have severe recruitment and hyperacusis—sound really hurts my ears.
I’ve worn ear plugs most of my life, not so much to guard my hearing against sounds that would do more damage (though it’s common sense to wear ear plugs during those events that would damage your ears—concerts, air shows, shooting firearms, etc.), but because sound hurts my ears. I’ve “blown the top of my head off” often! The audiologist I had with my last hearing aid trials told me that I needed to expose myself to the sounds that hurt, even though they hurt, to get used to the hearing aids.
Unfortunately, I just couldn’t tolerate wearing hearing aids. My brain would be fried at the end of the day. I always had a headache, was always wincing at sound and my tinnitus would become unbearable. People even commented that I looked distressed. Is there anything you can do for recruitment and/or hyperacusis?
You betcha. It’s not easy, but you can slowly—and I emphasize very slowly—retrain your brain to reduce its sensitivity to sound.
When you have recruitment as I have, or hyperacusis, all or certain sounds seem to “blow the top of your head off”, give you headaches, make you wince or jump and/or make your tinnitus worse as you well know. That’s the bad news. Now for the good news. Such sounds do not physically damage your ears. It just seems like they do.
If a sound is not so loud that people with normal hearing wince, jump, etc. then it almost certainly won’t physically damage your ears either. You won’t lose further hearing from a sound that recruits and sounds dangerously loud because in reality, it isn’t anywhere’s near as loud as you perceive it to be.
My article, “Recruitment from Hearing Loss Explained“, explains why you now perceive normal sounds as much too loud.
When you wear ear plugs when you don’t absolutely need to wear them, especially if you have recruitment or hyperacusis, you are doing yourself a disservice. Here’s why. Your brain wants to hear sounds and when you wear earplugs to block the sounds, your brain turns your internal volume up more to try to hear through the ear plugs. Ultimately, this just makes your hyperacusis worse and worse.
Thus, your audiologist is basically right—you may be overprotecting your ears. The solution is to only wear ear protectors when you really need them. One way to do this is to use your hands—clap them over your ears whenever sounds get too loud for you, but take them away as soon as the sound level drops. You can do this at a railway crossing for example. A train is going by—cover your ears—when the train is past, uncover them again.
You should also carry several strengths of ear protectors, but only use the minimum strength you need at any particular time.
Over time (and this can take a couple of years or more) you will slowly build up your tolerance for louder sounds again. This is what you need to do.
Begin to learn to tolerate sounds a bit louder than you are now—not loud sounds, just a tiny bit louder—and when you can tolerate those sounds, a little bit louder sounds, and so on.
Incidentally, recruitment only affects people with a sensorineural hearing loss. Hyperacusis can affect anyone whether they have a hearing loss or not.
If you have recruitment and wear hearing aids, you need your audiologist to set the maximum output on your aids by frequency. In order to do that, first she has to test you for recruitment by frequency (which audiologists almost never do—they typically use an overall average—and this just doesn’t work well at all) in order to see exactly where your recruitment kicks in. Then she needs to set the compression on your hearing aids a few decibels below that level. If she does this properly, you should be able to stand almost any volume of sound as your aids will keep them all below the level at which they would recruit.
Unfortunately, when you do this, it causes a certain amount of distortion. As a result, you may not understand speech as well as you would otherwise. This is the tradeoff—understand speech better but yank your aids out because certain sounds recruit, or have the compression set so sounds won’t recruit, but not understand speech as well as you should.
I walk a fine line here. I have the compression set on my aids such that they work for me in most normal listening situations but if certain frequencies of noise are present, I have to take my aids off as they still recruit. I then either rely 100% on speechreading or I speechread and use various assistive listening devices.
At the same time, just setting the compression as much as I have costs me 12% in lost discrimination. Thus, when I wear my aids I still have to speechread to try to fill in the “mushy” words I miss. Nothing is perfect, but I’ve found this trade-off typically works for me.
June 2013 suffered Ramsay Hunt right ear. Now profoundly deaf in that ear with tinnitus in both ears and “hyperaccusis” in both ears, different frequencies (with other unfortunate symptoms). My last visit to a an audiologist informed me I had recruitment not hyperacussis. I have done a little self-education and can understand recruitment in the right ear that suffers profound loss, but not the left ear for which the over sensitivity is much worse but has normal hearing, more or less for a 75 year old man. Is there some dissonance here?
The audiologist is proposing hearing aids (not CROS) and extensive training to overcome the symptoms. Not cheap! But I am tempted. I am inclined to ask your opinion after this brief description, but more importantly, where can I learn more to make a more informed decision?
Hi Stephen:
Since recruitment can only occur if you have a sensorineural hearing loss, then I agree with you that you have recruitment in your right ear, but not in your left one (if it doesn’t have any hearing loss). In that case, you’d have hyperacusis in your left ear. You can have both conditions at the same time.
I’m not sure what you are expecting to do with the hearing aids–treat the recruitment/hyperacusis AND the tinnitus AND the hearing loss?
Typically hearing loss and tinnitus and recruitment go together. What kind of treatment is your audiologist proposing?
Let me know so I can steer you in the right direction for more information.
Cordially,
Neil
New conversation with the doctor/audiologist: I have hyperacusis in the left ear, recruitment in the right ear and tinnitus in both ears. Hearing aid (with extensive training) would initially be used for ‘taming’ tinnitus and hyperacusis. At an appropriate moment, amplification of right ear would be turned on to improve somewhat right ear perception of sound and reduce recruitment in that ear. I think I have that (somewhat) correct. Aside from the initial expense for the hearing aids and therapy, there is the travel time for the therapy training sessions which are numerous and distant. That makes me hesitate.
I do not know if there is enough info here for you to offer any comment…
Stephen
Hi Stephen:
Treating tinnitus and hyperacusis is not a quick process. It typically takes a good number of months–up to 3 years or so–so as long as you know you are in it for the “long haul” and are prepared, go for it.
Don’t expect that your tinnitus will go away (ditto for your hyperacusis), but expect that both will be reduced to a level where they will not bother you even though they are still there. That is success.
Cordially
Neil
My son was just diagnosed with recruitment ears and now I’m concerned that he will not be able to play his guitar and sing because of this…is there anything he should do or not do because of this diagnosis…it took this third visit to a doctor for
this information! He is being given medication to try to help . This all started when we attended a concert and the music was too loud, it was the first concert that I actually stuffed my ears with cotton to buffer the sound…I am ok, he is not now…
Donna
Hi Donna:
First, I disagree with a diagnosis of recruitment. He can only have recruitment if he has a significant sensorineural hearing loss.
I’m almost certain he really has hyperacusis. It is somewhat similar to recruitment, but is the result of exposing your ears to excessive sound like he experienced at the concert.
What he needs to do now is protect his ears from loud sounds–that means anything over 80 dB or so. When he is around louder sounds, he should wear ear protectors.
However, there is a caveat. There is a fine line to tread. He must not overprotect his ears or it will make the hyperacusis worse. But he must also always protect his ears from loud sounds.
What drug did his doctor put him on? I haven’t heard of any drugs being good for hyperacusis.
He can continue to sing and play his guitar–BUT if the sound level is “up there” he needs to wear ear protectors. I’d recommend musicians ear protectors as they allow you to hear the properly-balanced sound you need to appreciate music. Regular ear protectors are biased to reducing lower-frequency sounds and thus distort music.
Cordially,
Neil
I have severe tinnitus which is getting worse since I first got it April 2016. My most recent hearing test @ audiologist said I now have recruitment and did not recommend hearings aids. Any suggestions?
Hi Janet:
You haen’t given me many details of your hearing loss to work with.
First, recruitment is a product of a sensorineural hearing loss. Thus if you have any degree of hearing loss you are going to have some degree of recruitment. I’ve got recruitment and have worn hearing aids for more than 50 years so I don’t know what she is talking about. If she is worth her salt, she can set your hearing aids so that no sounds will recruit. It may not be an optimal fitting, but at least you won’t rip your aids off when some sounds recruit.
You haven’t told me anything about your hearing loss so it is hard to say anything concrete. Nor have you told me anything about your tinnitus and why it got bad last year.
Cordially,
Neil
Hallo sir. I have recently been reading about recruitment.
I have had tinnitus for Some six years now when it first happened I noticed some sounds sounding louder but over t8me it seemed to settle down and be so bothersome.
recently exposed to a smoke alarm noise inside a building, for a short period of time and once again some sounds sound higher than others.
I had been under a lot of stress and anxiety before the incident my tinnitus has spiked,
Could you offer and thought please.
thank you.
Hi David:
I don’t think you have recruitment (unless you also have a sensorineural hearing loss which you failed to mention). I think what you are experiencing, besides your tinnitus, is some degree of loudness hyperacusis.
Hyperacusis often accompanies tinnitus and stress/anxiety and makes some or all sounds (especially higher-pitched sounds) seem louder than they really are after exposing your ears to loud sounds.
Typically, things will settle down, but you have to do two things. First, get your stress/anxiety under control. Second, give your ears a rest from loud sounds for a couple of months. Be careful to avoid loud sounds, especially sudden loud sounds like fire alarms. I know they are unexpected so you can’t avoid them, but you can quickly clap your hands over your ears to cut the volume until you can get away from the sound. You can do the same if you are outside and there is a siren nearby or an air horn sounds, etc.
Cordially,
Neil
Is one brand better than another for
recruitment?
Hi James:
I’m sure some hearing aids have better adjustments for recruitment than others–but I’m just as sure that I don’t know which ones do the best job. I can’t really help you with this question. I can just give general principles to apply to any hearing aid to help you deal with your recruitment.
Cordially,
Neil
Hi, One month ago I began experiencing a change in hearing in the Right ear. My hearing test showed drastic reduction in hearing at both ends of the spectrum – lows and highs. I did 2 weeks of Prednisone, orally, and today had the third of 3 intertympanic shots of Prednisone. Hearing test results are fluctuating inconclusively. I have recruitment and Diplacusis, but also signs of Hyperacusis. I’m intrigued by the idea that wearing Plugs is NOT a good idea unless one is in loud situations. I am a professional musician trying to find a middle ground. Should I wear Plugs when performing? Recently ordered Westone plugs that claim about 25dB reduction. I play Upright Bass that I can barely hear, and cringe when I play even with bands that aren’t particularly loud to normal hearers. What should I do? Thanks.
Hi Richard:
What caused your hearing problems a month ago–anyhing you can think of? Exposed your ears to loud sounds? Took any of the hundreds of drugs that can cause hearing loss? Or?
To answer your questions. You should wear ear protection when you are in environments when the sounds are greater than 80 to 90 dB. But you do not want the sounds levels you hear to drop way down either. For example if the sound is 85 dB and you wear ear protectors with a factor of 25 dB, that means you are only hearing at 60 dB. Your brain then may try to turn up its internal volume so you can hear better. Whereas, if the sound levels are around 100 dB where you stand, then 25 dB ear protectors would bring the sound level down to a nice 75 dB level.
I know what you mean when you say you can barely hear your Upright Bass. I’ve often wondered why anyone invented this instrument as I can’t hear it with my low frequency hearing loss.
If the sounds are too loud for you (you cringe), then you should be wearing ear protectors. You should measure the sound levels at your ears and see what the volume you are experiencing where you stand when you play. That is what is important. Then wear ear protectors as needed. You just don’t want to overprotect your ears–which can make your hyperacusis worse.
Cordially,
Neil
Hi Niel ,
I have been in pain for 4 years , I wear Oticon Alta Pros .. jaw pain , ear pain , migraines, and so on .. I was diagnosed verbally that I am suffering with recruitment, for my long complaints of pain ..so they turned down some of my frequencies.. i do feel much better and they want to push me to the Oticon OPN, I feel my aids I have should be sufficient? I read that you said you do not know if there are aids that are better for recruitment and I believe you , I feel as though I am more $$$ to them .. this is very nerve racking.. Is there a test or questions I should ask , also how would I know that they have the qualifications to help me and set my H aids .. Your suggestions are very very much appreciated. I live in Florida..
.Thank you , Shanie
Hi Shanie:
How do you know you have recruitment and not hyperacusis, or have both. I don’t see jaw pain and migraines as having anything to do with recruitment, but they can be associated with hyperacusis.
Headaches, jaw pain and recruitment can be some symptoms that your upper cervical spine–specifically the top two vertebrae are out of proper alignment. Thus, if I were you, I’d go to an upper cervical chiropractor and make sure all is well there before I’d tackle any of the symptoms. You can find one of these special kind of chiropractors at http://www.upcspine.com/ and click on “Practitioners” to find one reasonably near you.
Now, specifically for your ears, you need to find an audiologist that can determine whether you have recruitment (I’m sure you do since you wear hearing aids) AND hyperacusis or not. The treatment for hyperacusis is different from the treatment for recruitment.
I wish you could read the new book I’m woring on that will explain a lot about these two hypersensitivities and how to treat them (plus it will deal with a number of other hypersensitivities as well). Hopefully, I’ll have it out later this year if all goes well–but that was what I said last year too.
I don’t see that changing hearing aids is the answer. For the recruitment part of your issues, then need to turn down the gain on some other frequencies until you feel comfortable. You may need a new audiologist who will do what you ask so your aids do not cause you pain from being too loud.
Cordially,
Neil
Hi Dr Neil,
2016 breast cancer, quimotherapy and radiotherapy up unitl July/2017.
From then up to date Tamoxifen.
Worked on the dental field since 1990. Dentist from El Salvador. Worked as a dental assistant since I arrived to the US in 2013. I started feeling sensitivity to noices but very very mild up to a certain point I completely forgot about it and it was not bothering me.
My levels of stress have gone over the roof since I decided to pursue my dental higienist degree starting 2018 and here is when I started feeling hypersensitivity to noices, specially when they come along with vibrations from the dental equipement, dental lab. I started using ear plugs at the dental office, about 2 months ago and haven’t felt any improvement, but progression of the hypersensitivity. Soon I will be using ultrasonic cavitron or piezo electric hygiene instruments on a daily basis.
Hypesensitivity to clenching knifes or plates, clapping, etc.
My right ear bothers me the most; sometimes it hurts a little bit.
I also feel slight tinitus, probably left ear. Can’t really tell
Though, I had a party at a house last saturday, with 50 people and I had NO discomfort at all with all the noices.
I went to the ENT and audiologist. The audilogist said that comparing an exam I did 4 yrs ago, I have a slight change on my hearing on my left ear (nothing significant, he said), my right ear is the same.
The ENT diagnosed me with recruitment and said there was nothing to do and to continue wearing ear plugs at work.
I’m stressed and depressed since I finished all the requirements to become a hygienist and now I have this issue that is bothering me a lot.
What do you think and suggest I should do?
Thanks a lot
Hi Maria:
Unless you have a significant hearing loss, I disagree with your doctor’s diagnosis of recruitment. From what you have explained, I think you have both hyperacusis and misophonia. That is why you are sensitive to some sounds but not others.
Some people are greatly bothered by ultrasonic equipment. I don’t risk it. I make my hygenist use manual equipment–as I don’t want problems developing.
It’s interesting that you don’t find the ear plugs helping at all. Since they don’t, why do you continue wearing them?
If you can’t deal with the hyperacusis on your own, you need to seek out an audiologist that treats hyperacusis (and misophonia) so you can get this under control so it goes away and doesn’t get worse.
Cordially,
Neil
Dr. Neil,
I have been having problems with sensitivity to loud noises lately: plates clinking, kids screaming, TV is too loud (but only to me). The noises hurt my ears and make me tense and anxious. At the same time, I have a huge problem hearing people in crowded places like restaurants where there is background noise. I have a tendency to stare at peoples mouths when they are talking so I can understand them better. Do I have hidden hearing loss or recruitment or both. I use foam earplugs frequently around the house when my kids are too loud and when I empty the dishwasher. I find myself wanting to use them in public (like at cub scout meetings when the kids are so loud!) but I am embarrassed. I’m 44 years old. Also, I am thinking of purchasing Eargasm earplugs to lower the decibels of sounds but still maintain the quality of sound, at least that is what they purport. Thank you for your help.
Hi Lisa:
You may have hyperacusis as well as recruitment. Having trouble hearing in noise is a sign that you probably have a significant high-frequency hearing loss. Wear your ear protectors when you are around louder sounds, but be careful not to over-protect them or you will make your hyperacusis (if you have it) worse.
What brought on the hypersensitivity to normal sounds? Did you expose your ears to a very loud sound before this began? Kids scream in your ears? Or take any drugs? or what?
The Eargasm ear protectors have a noise reduction rating of 16 dB. The foam ear protectors you can get in any drugstore have a rating closer to 30 dB.
Again, I emphasize that you not wear ear protectors when you don’t really need them, or you can make things worse, not better. But at the same time, you NEED to wear them when around loud sounds–sounds louder than 85 or 90 dB.
Cordially,
Neil
Last year I came off a prescribed benzo and antidepressant . Ever since I have a horrid time with certain sounds in my left ear especially cutlery sounds, my dogs sneezing or anyone sneezing or coughing and other random noises . It is a painful vibratory sensation that vibrates above my left ear .is this what others experience with hypercaucis . I do not experience significant hearing loss . Thank you for your time . Do you see people recover from this kind of damage?
Hi Susan:
What you describe sure sounds like hyperacusis. There are numbers of drugs that can cause hyperacusis. Some while you are taking them, and some when you try to come off of them–especially if you come off of them too fast. When you take psychotropic drugs, you typically have to come off them very slowly–like over a period of 10 to 12 months–not just a fast taper of a month or two–if you want to avoid such side effects.
Yes, people do largely recover from hyperacusis if they work at it and do not treat it as a threat to their well-being. Some of the treatments include relaxation therapy, cognitive behavior therapy (CBT) and listing to low-level constant background sounds such as pink noise.
Cordially,
Neil
Hello, I’ve had menieres disease for about 15 years now. It started with bad tinnitus and vertigo but has since gone into remission. I usually only get about 1 or 2 bad bouts of vertigo a year. I have frequent unsteady days but nothing that stops me from doing daily tasks. Out of the blue one day I noticed my hearing was super sensitive. Music and the television dont seem to bother me at normal levels. However car doors, horns. Velcro, inside doors that click shut, metallic objects, kitchen dishes etc… really seem to bother me now at levels that were far below anything that should bother someone. Any idea what’s going on?
Hi Eric:
You don’t have to put up with Meniere’s disease attacks. You can get rid of them. Read my article at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ to see how. It really works. So far, everyone that has followed this exactly no longer has Meniere’s attacks. This should work for you too.
Now, to answer your question. Things don’t really happen out of the blue–they just seem too, but there has to be an underlying cause whether you can identify it or not.
Let’s go back to that day this happened. How long ago was that? Were you on any medications at that time? Had you recently had any changes to your meds–starting new drugs, changing doses, etc.? Had you exposed your ears to any loud sounds? Did you have any active virus in your body back then–cold, flu, herpes, etc., etc. Did you hearing change back then–lose more hearing? Do you wear hearing aids? Do these “sharp” sounds bother you when you are NOT wearing your hearing aids–but only when wearing them?
There are so many things I need to know in order to try to figure out what is going on. You may have recruitment if you have hearing loss but these “sharp” sounds wouldn’t happen out of the blue, but in unison with losing more hearing.
You could have hyperacusis which is independent of hearing loss, but is often associated with exposing your ears to loud sounds–even just a single, short, loud sound like a gunshot. It could also be the result of taking certain drugs.
So I need more information or your situation.
Cordially,
Neil
Hi Dr. Bauman,
I have high frequency sensorineural hearing loss in left ear which recently got worse, followed soon after by the right ear, marked by tinnitus in both ears (much worse in left, which has more SNHR).
Few weeks after the new tinnitus arrived, I began experiencing the classic symptoms of hyperacusis — glasses clinking or silverware against plates were very, very uncomfortable, as were many different sounds. Piano playing actually sounded distorted at times, even at moderate volume.
I had loudness levels done, and they came back normal, which apparently means it’s not hyperacusis, but perhaps something more like recruitment.
After my loudness levels came back normal, I had a relatively calm week where the sound sensitivity calmed down almost to normal, amazingly. However, once I got back out on the road and working, it came back rather quickly.
So far I’ve been trying not to use musician’s earplugs, except for those times when it’s absolutely necessary, although lately it does seem like even sounds like road noise accumulate and lead to discomfort and pain.
As I figure this all out, I do have a major question: I startle at even the smallest noise (like many with my condition, I have underlying anxiety), and am woken from sleep ridiculously easily. So for several years now, I have been wearing foam earplugs, which enable me to sleep. Is this contraindicated in people with my condition, or does the ear (as one ENT suggested) receive enough auditory stimuli during the day?
Sleep is already very compromised due to the anxiety of all these new symptoms, and I am not quite sure what to do about the tradeoff if earplugs at night is potentially worsening my condition. I’m sure my cognitive behavioral therapist would suggest sleep is the priority, since the anxiety condition is certainly making all my ear symptoms worse. And perhaps that week where it calmed down was due to receiving normal loudness levels — it sure felt like it!
I was using earplugs during that week where the sound sensitivity seemed to get better, though that’s a small set of short-term data, for sure.
Lots of moving parts, but from reading your remarks, it seems more info is better than less 🙂 Very grateful for your thoughts and time.
Ric
Hi Ric:
How were your loudness levels determined to be normal? Were they done by each test frequency, or just turning the volume up overall until speech became uncomfortably loud?
From what you describe, I tend to think you have hyperacusis in addition to recruitment–which you must have since you have a sensorineural hearing loss.
Another reason I believe your problem is mainly hyperacusis is because your sound sensitivity changed for a week. This doesn’t happen with recruitment, but does happen with hyperacusis.
Still another reason is that “sounds like road noise accumulate and lead to discomfort and pain” This is another characteristic of hyperacusis, not recruitment.
Also, your startle reflexes are more sensitive and lead to pain. This too is a kind of pain hyperacusis due to your tensor tympani muscle in your middle ear now being supersensitive–chiefly due to anxiety.
Personally, I wouldn’t wear ear plugs at night as that is a long enough time each day to make your hyperacusis worse. It is the same as wearing ear plugs for 8 hours during the day and not letting sounds in. Your brain turns up its internal volume control to try to hear “normally” and when you take the earplugs out, all sounds are now too loud. That is how you can make hyperacusis even worse.
I don’t see sleep as THE priority–but it is certainly A priority. I think your anxiety is what you need to work on. Get your anxiety under control and things will go better all around.
It is not wrong to wear ear protectors when you are around louder sounds. But you don’t want to wear them around normal everyday sounds that are not loud as this just makes things get worse and worse.
You need to understand and believe that you can take control of your condition and get better again so you can live a normal life again without worrying about the sounds around you. Your ears may always be a bit more sensitive than the average persons ears are, but you are not condemned to a life of unrelenting hyperacusis when you do take control.
Cordially,
Neil
Thank you for the detailed and thoughtful response Dr. Bauman, I’m very grateful.
I’d love to provide some follow-up information as you might find it interesting, as might some readers. Obviously I do not expect an actual diagnosis over the internet but perhaps this info will prove useful in this and/or other cases.
The LDLs were measured at 8 frequencies between 400 and 6000Hz, all at 100dB or above.
For years I have had a hyperactive left side middle ear muscle that audibly reacts to sound. Very strangely, it reacts when sound enters from the _right_ side. For example, I can hold up a noise source directly to the left ear, and there is no muscle reaction. When the same noise is held up to the right ear, the _left_ side reacts strongly to the sound on the right side. I have not met an ENT who could piece that one together, other than to suggest that nerves connect the right and left ears.
This hyperactivity in the middle ear muscle (tensor tympani, by account of the low thumping sound) has been on overdrive since the recent SNHR and tinnitus event. When it’s firing off, it is at best uncomfortable, and I do wonder if it has been contributing to the discomfort.
I tried a little experiment the other day. On a day when my hearing was very sensitive, I tried listening to music through one ear, then the other: seemed fine, very much like the LDL test. But listening with both ears was uncomfortable. How about that! I have an appointment this month with a tinnitus-specialist audiologist and I look forward to investigating this phenomenon. In retrospect I ought to have suggested my previous audiologist administer the LDL in both ears simultaneously, at least to narrow things down.
The sound sensitivity actually calmed down yesterday and is in a moderate state at the moment. I can confirm that while in the acute state, holding my left (worse) ear closer to a computer speaker was yielding a noticeable “cranked up” sound, louder and more distorted than the right ear. In this (somewhat, and thankfully) subdued state, I do not notice this effect. I can’t imagine that recruitment is a phenomenon that could be transient in any way, except perhaps to note that this is just a month and a half after the episode of additional hearing loss — perhaps recruitment doesn’t “settle in” immediately?
Lowered anxiety levels have a dramatic effect on my tinnitus, and they seemed to contribute to the hyperacusis subsiding yesterday. However, anxiety is of course bi-directional, and I might have chilled out following a decrease in the symptoms.
As for the cause of the relatively sudden hearing loss, I am still searching for answers, only because I’d like to know if there’s anything I’m doing, or could do, that might prevent a worsening of the condition. I do take occasional alprazolam 0.25 here and there, but had been doing so periodically for about 10 years for anxiety with no ill effect. I had also been using ibuprofen at about 400mg every couple of days leading up to the episode for neck pain, as well as topical clindamycin for acne for the past few years. I know little about ototoxicity, though these drugs in these doses would seem to present a low risk, unless the effects can accrete over a long period of time.
My parents don’t have hearing loss and I’m 30 years younger than them in any case! The hearing loss is a gradual slope similar to presbycusis, with no evident noise-induced loss. So indeed I asked my ENT if this condition can be brought upon by an anxiety state and he said sure! It seems almost too simplistic to suggest it, but given my state the past few years, I would have no reason to doubt it.
Anyway, please pardon the length of the update, but I thought putting more information out there could only be a benefit. If even one other person recognizes the bizarre switched-sides tensor tympani dysfunction, perhaps it’d be worth it 🙂
With gratitude,
Ric
Hi Ric:
Your loudness discomfort levels don’t suggest loudness hyperacusis as such, but you obviously have some things going on in your ears.
Interesting how you left ear reacts to right ear sounds, but not vice versa. I don’t have any definitive answer. I don’t know of any nerves that connect your ears together. But the auditory circuits in your brain can send responses to either ear. It could also be another nerve that is acting up–not related to your auditory nerve. For example, tinnitus can sometimes result from signals from other nerves getting to the brain where neurons do some double-tasking and end up sending them (wrongly) to your auditory circuits where they are interpreted as tinnitus. So weird stuff can happen.
Stress, as you have discovered, can have an enormous effect on both your tinnitus and hyperacusis. That is why one of the effective treatments is to get your stress under control. So that is something you need to work on.
Taking Ibuprofen just 2 times a week increases your risk of hearing loss between 33 and 61% according to one study of roughly 27,000 men. So that is one thing that jumps out at me regarding your drug use. Hundreds upon hundreds of people have reported to the FDA that they lost hearing from taking Ibuprofen. So you may want to stop taking it.
Clindamycin can also cause hearing loss. So can Alprazolam. But my money is on the Ibuprofen since you seem to be taking it fairly regularly.
Who know how these three drugs may work together synergistically to wreck your hearing?
Ototoxic side effects are affected by your dose, the length of time you take a drug and of course, the ototoxicity of the drug. So in order to prevent ototoxic side effects from showing up, my three rules of thumb are 1) take the least ototoxic drug that will do the job. 2) Take the lowest dose that will do the job. and 3) take the drug for the shortest possible time. When you do this, you can often avoid ototoxic side effects.
Cordially,
Neil
I have Meniere’s and had Endolymphatic sac surgery five years ago. Vertigo stopped and I got used to the constant tinnitus. About a month ago, the tinnitus and recruitment have flared up to make life pretty difficult. Vertigo is still subdued, but this sensitivity to sounds is really bothering me. (I have two boys, 2 & 4, so you can imagine the volume in my house!)
Today, I’m going to ENT to get shot in my ear…I’ve had it before and it didn’t work, so not too optimistic.
What is your suggestion to deal with the recruitment? I seem to have everything else under control, but this noise sensitivity is slowly driving me insane and affecting my quality of life. Appreciate your advice. 🙂
Hi Brent:
I suspect you have loudness hyperacusis and not recruitment. Recruitment should not “flare up” but be constant if your hearing loss is constant. Hyperacusis, on the other hand, can come and go–particularly whenever you expose your ears to loud sounds, like the boys yelling/screaming near your ears.
The best thing is for you to give your ears a rest from louder sounds. One way to do this in your case, is to wear ear protectors while the boys are noisy–but be sure to take them off as soon as the racket dies down or you can make your ears even more sensitive to noise. The same applies to any other noisy situation you find yourself in. It may takes some months for your ears to “heal” and return to their normal.
Cordially,
Neil
Hello there. I recently (six months ago) was struck with sudden hearing loss in my left ear. After MRI scans, Ct scans and visits to the ent, the conclusion is that I somehow contracted a virus that damaged my ear from swelling. When it first happened, the tinnitus set in almost instantly and then a few weeks after, the sensitivity settled in. Now when I hear sounds out of my left ear, voices sound distorted and noise sometimes sounds very high pitched and intolerable. High pitched voices hurt and depending on how tired I am, right before I’m falling asleep, noise startled me like a zap sensation. Do you know if this is hyperacusis or recruitment? I live in a place in British Columbia that is very removed from services so im trying to reach out and find my own information about certain symptoms that come along with shl
Hi Christine:
If you had an active virus of some sort in your body at the time, that could well be the right diagnosis. If you didn’t have any active virus, then there could be other reasons. One of them is if you are taking any drugs or medications that are ototoxic. Some drugs will do this, but doctors typically don’t have a clue about this. Also, did you expose your ears to loud sounds in the weeks before this happened (or since for that matter)?
Since tinnitus almost always accompanies sudden hearing loss, I’m not at all surprised that you now have tinnitus.
Tell me more about your hearing loss. Did you recover some of your hearing, or is it still at the level it was when you lost it? I’m curious why the sound sensitivity took so long to appear. Do you have a copy of your audiogram? You can attach it to an email and send it to me. My email address is at the bottom of every page on the website.
I need more information before I can determine whether you have recruitment or hyperacusis or both. I suspect you have hyperacusis.
When you are falling asleep, certain noises can sound very loud. This is normal and can really startle you. You could also be having a hypnagogic experience where you experience a phantom sound just as you are dropping off.
I’m curious where you live in BC. I lived in BC for 35 years so I know the province south of Prince George pretty well. Never been in the northern part though.
Cordially,
Neil
Hello Neil,
Thank you so much for your response. I’m currently living in Prince Rupert, BC. The day that I lost my hearing, I remember feeling really stuffed up and my eyes felt super itchy. Although, two months prior to the SHL, I took a trip to Belize with my partner and was very sick during the entire trip…lost my voice, and was basically bed ridden the entire trip. I’ve been really active in trying to do my own homework on this and recently got blood work done to see if I had any autoimmune disorders, but nothing has come up in my results. I’m now fitted with a hearing aid and in the high frequencies, sound is very loud and painful. Do you think my audiologist could somehow work her magic to correct the recruitment? I’ve been trying to get my audiologist to send my audio gram results but for some reason, she hasn’t yet. I do have quite significant hearing loss from moderate to profound straight across the chart. It just dips down. As soon as I can acquire a copy of my results, I’d love to send you a copy.
Hi Christine:
I never quite got to Prince Rupert. I think the closest I got was to Kitimat. That was a lifetime ago when I was working in forestry.
Sounds like you might have had a cold virus or some other virus that also attacked your inner ears and took your hearing.
Yes, your audiologist COULD adjust your hearing aids to prevent sounds from becoming too loud and painful. But whether she WILL do it is another matter. You see, audiologists like to set hearing aids to meet your target for “proper” hearing. And in your case (mine too) that makes some sounds–typically high frequency sounds–much too loud and painful due to recruitment.
So what you are asking your audiologist to do goes against her grain, because you are asking her NOT to meet the target. But you are the boss, and you tell her that is what you want. It’s better not to hear as well, but not be hurt by sounds and get headaches from them, than to hear better, but yank your aids out because sounds are too loud and painful.
I try to find a happy medium where MOST sounds are ok, but the aids are not set too far under target. See if you can work out something like that with her. But you INSIST on what you want no matter how much it offends her sensibilities that that is wrong.
Cordially,
Neil
Hi Neil,
Thank you so much for your input. The last time I saw her, it was quite difficult to articulate to her what I was hearing in the high frequency ranges. To be honest, I’m finding the hearing aid to be more of a tinnitus masker than something that I’m using to amplify sound. It’s a mighty expensive way to go about trying to find some sort of relief but I think if she just understands my unique case and the pain that is associated to it, hopefully she will be willing to work with me in finding the comfort level that I can live with. My hearing loss is quite severe in my left ear, and I’m finding that amplification sometimes doesn’t do much but help my brain adjust to some sort of sound input in hopes to reduce the severity of my tinnitus and hearing sensitivity symptoms. It’s worth it to me to try and really, that’s all I can do! Did you also have to get the audiologist to adjust your hearing aids to work around recruitment?
Hi Christine:
Tell her the specific sounds that hurt your ears. She should know how to reprogram your aids to eliminate those problems. Then try your aids out again and see what sounds still cause you problems–and get her to reprogram them. This may take a few tries, but each time, you should notice a positive difference until your painful sounds are all limited.
What is your word recognition score (discrimination) in your left ear. If your score is very low 20% or less, then wearing a hearing aid in that ear can be counterproductive as your brain has to work harder to filter the sounds from that ear out of the sounds from your better ear. So you may find that only one hearing aid is better for you in this case.
You have to decide whether the benefit outweighs the negatives. If there’s not net benefit, then don’t wear the aid.
And yes, I have to tell them what I need. In fact, I programmed my current aids myself with the hearing aid dispenser watching. He was willing to work with me. Sometimes hearing aid dispensers are more open than audiologists. In any case, you need someone that will work with you, not one who thinks she knows it all and she’s going to program your aids the way she thinks they should be, not the way you need them to be. When you encounter such a person–no matter what their qualifications–dump them and find someone who will.
I also have another rare problem in that I have an extreme reverse slope hearing loss, and maybe 2 or 3 audiologists in all of North America have a clue how to program them properly and successfully as programing them for my kind of loss is NOT intuitive. In fact, it seems totally wrong, but ultimately it is right. So I have to tell them how to program them right.
Even so, I’ve never had aids that could be programmed exactly right for me. So I use a lot of assistive listening devices that are easier on my ears than my hearing aids. I use whatever works in a given situation. I have my hearing aids with me at all times, but most of the time they are in my pocket, not in my ears–like right now.
Cordially,
Neil
Hi Neil,
About two years I randomly got tinnitus in both ears. I felt intense pressure in my forehead and sinus area around the time this happened.
And then a cuple months later I had a sudden hearing loss in my right ear overnight.
I make music and I was wearing headphones at the time so I think that could of been the cause.
Since then I get pain/ a stabbing feeling in my ears if I listen to music for too long. if my dog barks I wince and have to cover my ears. The pain can last for days.
The hearing loss seems to have progressed a bit aswell in both ears. I have trouble hearing in grocery stores or if there is any background noise.
All I want to do is to continue to make music as it is the only passion in my life. But I fear that I’m damaging my hearing more when this pain arises.
Can you give me any advice on whats going on with me, is there anything I can do to treat this so I can continue making music? Thanks
Jordan
Hi Jordan:
There is nothing wrong with listening to music or making music. The problem arises when you listen to music at too high a volume. Your ears can only absorb so much abuse before they start to break down.
The right volume to listen to music is the same volume as you hear people talking. Turn the volume down to a comfortable “speaking” level whether wearing headphones or listening via loudspeakers.
You now have a high-frequency hearing loss as evidenced by your having trouble hearing/understanding people in noisier situations. This is one of the first symptoms of high-frequency hearing loss.
You not only have hearing loss, but you also have hyperacusis and tensor tympani syndrome. The former makes many sounds too loud so you can’t stand them such as your dog barking, doors slamming, cutler clinking, etc., and the latter is causing the ear pain you feel. This ear pain isn’t from sounds damaging your ears as such–but is a result of existing ear damage.
Do you still get this pain if you keep the volume of music down to “speaking level”? If not, then you know what you need to do in the future–keep the music volume down to this level and you won’t cause more damage to your ears and you should be able to enjoy making music in the future.
Cordially,
Neil
I have meniere’s in only my right ear with severe sensorineural hearing loss, recruitment and Tuillio syndrome which causes me to go into vertigo. I had 1 gentimacin injection which stopped the severe frequent attacks. Would the surgery they do for Hyperacusis to dampen noise help my severe recruitment and Tuillio syndrome ? I feel I don’t have any options for help. Do you have any suggestions?
Hi MB:
First, if I were in your shoes, I’d head to an upper cervical chiropractor and get your C1 and C2 vertebrae in proper alignment. That will take care of your Meniere’s and maybe some of your other problems. You can read about it in my comprehensive article on the subject at https://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ .
How do you know you have Tullio’s phenomenon? Have x-rays confirmed it? Or is this just a guess?
There are several kinds of hyperacusis and thus surgeries. I assume the surgery you are talking about is to basically put a lump of fatty tissue on both your oval and round windows to dampen sound. This will give you a greater hearing loss, so it’s not the real answer.
Cordially,
Neil
Hi Dr Bauman, I recently exposed my to a very very loud noise and immediately experienced tinnitus (constant for 15 days now). Additionally I felt a clogged feeling, along with sensitivity to certain sounds. I was prescribed Prednisone which helped with the clogged feeling. As time progressed i went from wearing an earplug in the affected ear to not at all. A little about home life, I have a young child who is loud (a typical boy) and has loud toys. None of which affected me the way the sounds do now. Even high pressured running water causes discomfort. I went to see 2 audiologists and the first test came back with no issues. The second test however, taken 3 days after the 1st test indicated normal hearing bilaterally with a 3000-4000 notch in the affected ear. Despite the notch the audiologist said I have great hearing “the hearing of a Dog”. I have been trying to push my limits with the sensitivity of sounds and there has been improvement. I am just worried that I am past the point of any further progress and certain sensitivities will never go away/improve. Also the tinnitus is a constant toll. Do you have any advice/thoughts. I was also curious if I could even be a candidate for a hearing aid despite my hearing still within normal limits.
Hi Rich:
Why would you even want to consider getting a hearing aid since you still have normal hearing? I’m curious. But the answer is no, you don’t want to do this–unless there is some special reason.
You have the common noise notch at 4,000 Hz that indicates you have damaged your ears from exposing them to loud sounds (which you already knew you did).
Your ears received an acoustic shock from that excessively loud noise. Typically, the symptoms you could experience include hearing loss, tinnitus, hyperacusis (sound sensitivity), ear pain and a feeling of fullness in your ears.
It takes time for your ears to recover just like it would take time to recover from a bruise or sprain. So while you are in recovery mode, you need to “baby” your ears a certain amount. You don’t want to push too fast. It takes time to heal. It’s like walking too soon on a sprained ankle–you’ll just do more damage.
When you son is making too much noise so that your ears are uncomfortable, it’s time to wear ear protectors for a bit. You don’t want to expose your ears to louder sounds until they are able to bear it. At the same time, you don’t want to deprive your ears of sound and thus make the sensitivity worse. So wear ear protectors when you need to and then take them off so your brain hears normally again.
You might need to do this for a couple of months or more. This is not a race–take it slow.
Probably your tinnitus will be the last to go (if it ever does). But you can expect it to reduce in volume and slowly fade into the background where it won’t bother you, even if it is there. The key for this to happen is to not think of your tinnitus as a threat to your well-being in any way, but rather consider it a totally useless, unimportant background sound that you can safely ignore–and then ignore it by focusing on the loves of your life.
Cordially,
Neil
Thank you for the extensive response. To answer your curiosity about the use of an aid, I was wondering if an instrument would help improve the hearing decrease specifically where my Notch is. Though within normal limits I still did sustain a loss & have noticed that certain sounds are less sharp. I have also noticed that if I slightly block the NON-affected Ear it diminishes the tinnitus and sensitivity which I find especially curious, almost as if it balances things out. I appreciate the additional feedback. Thanks again.
Hi Rich:
I don’t think a hearing aid would help the existing hearing loss. And besides, your hearing is too good to even try to fit a hearing aid to it. You’d just have other problems.
You are probably right that it helps balance things out.
Cordially,
Neil
I have sensorineural hearing loss in my right ear for about 10 months. about 2 months ago, sounds are getting so loud and almost unbearable. the worst part is I hear loud distorted sound in my right ear when I talk. I don’t have tinnitus , I don’t hear any ringing in my right ear . what can I do ?
Hi WK:
You haven’t told me near enough about your hearing loss for me to know how to help you. For example, what caused your hearing loss? How bad is it? What kind is it? What happened 2 months ago to make sounds louder? What is your real problem–recruitment or loudness hyperacusis? Etc.
Cordially,
Neil
Hi, hope this thread is still going, it’s the only useful information on recruitment I’ve found.
I’ve recently been having a ton of ear issues, but I don’t know if its recruitment or hyperacusis. It started with a feeling of pressure and tinnitus in my left ear that I was told was wax build up, so I had it microsuctioned and the tinnitus went away.
2 days later, it was back… then it spread to the right ear, and built to the point I feel like I have 1000 noises going on from ringing to rumbling to chirping at times, pressure in my ear, a spasm feeling at sounds and a ringing that seems to react to noise, fetting louder with it.
I have also noticed kne other symptom that I haven’t seen mentioned anywhere: shaking. I have been having bouts of shaking or shivering and new clue where it was coming from until one day, I muted the TV and instantly stopped shaking. Turned the volume back on and I’m shaking away again. It’s baffling as I wouldn’t consider the sounds to be super loud. In fact it happens on minimum volume.
I also seem to have a fair bit of hearing loss, though that’s only based on my own tests using youtube videos that I’ve had other people try and found they can hear it clearly, but when I listen on minimum volume I struggle to hear below about 100Hz, then at 4000Hz my ears kind of alternate which can hear (and this has actually gotten worse the last month or so, the hearing loss seems to be progressing to where the gap here widens) and after about 10000Hz I can’t hear it.
More worryingly, I seem to be picking up new tinnitus from my surroundongs: I bought a humidifier, which I now hear even when it’s off.
As for what may have caused the hearing loss, I don’t know. I’ve been wearing headphones for most of the year as the surrounding noise at home started to really wind me up, the loudness could have done it. I remember once feeling like my left ear had lost a lot of volume. I was also using Solpadeine Plus (codeine and paracetemol) for shoulder and neck pain for years as the doctors kept fobbing me off which I have now read it ototoxic. But even last year I can remember finding phone levels a bit too loud. Then there was the microsuction which was quite loud, but didn’t bother me until it felt like a bit of wax got stuck.
I have been waiting months to see an ENT now so figured it would be worth asking here. Does this sound like either? Both? Neither? Hope this thread is still active and look forward to hearing back from you.
Hi Adam:
What you describe isn’t recruitment. Recruitment is where sounds get louder faster than normal and is only caused by a sensorineural hearing loss.
You are describing what could be several conditions including loudness hyperacusis, tonic tensor tympani syndrome (TTTS), acoustic shock syndrome, tinnitus, reactive tinnitus, etc.
The first thing I’d want to know is what caused this in the first place. What happened in the few weeks before you began to have these ear issues? Did you take or change the dose on any drugs or medications? Did you expose your ears to any loud sounds such as night clubs or other sources of sustained loud music, or expose your ears to other loud sounds? Did you experience a sudden loud sound such as a gunshot relatively close to your ears? Were you under a lot of stress or especially anxious or depressed? Etc., etc.
Obviously the wax wasn’t the real problem.
Is this shaking all over your body, or just in your ears, sort of like your eardrum vibrating or fluttering?
Hearing loss by itself shouldn’t cause most of your other symptoms. But it could be part of some other conditions.
At the end of your post may be the key to what is likely happening to you–wearing headphones. Are you wearing them with no sound on just to cut down external sounds, or do you have music playing through them all the time, or what?
If you are wearing earmuffs except when you are in very noisy environments, that could account for your ears becoming more and more sensitive. This is a no no. It causes loudness hyperacusis.
And if you are wearing headphones to listen to music, it could be that you have the volume too high and it is causing tinnitus, and depending on the volume, could cause loudness hyperacusis too.
Taking Paracetamol (Acetaminophen over here) regularly over time can also cause hearing loss and tinnitus, not to mention hyperacusis. All you need to do is take it 2 or more times a week for a year or so to cause problems.
You need to answer my questions and add anything else you think might be relevant and lets see what turns up.
Cordially,
Neil
Hi Neil, thanks for the reply.
I’m not really sure what caused any of it, though with Covid I certainly haven’t been hitting the nightclubs. I have been wearing earphones a lot to watch stuff and play games, never to keep out any normal sound. I generally tried to be really careful with the volume, too. Though I remember back in April or so taking my headset off after several hours and finding my left ear blocked and like the sound had dampened, though that resolved itself. I have also been taking paracetemol several times a week for headaches and pain, before that I was using codeine+paracetemol which certainly could have done it. I stopped taking that around Christmas, and the problems did get somewhat worse.
Regarding sensorineural hearing loss, my hearing does seem to be declining. I had a hearing test back in late November that had my hearing quite good, with my right ear at -10db at 8k, but I had another 2 days ago where it had reduced substantially to -30db. It’s almost like my ears have become sensitive to the point all sound is damaging as I’ve been getting ringing at relatively mundane sounds. Even typing this makes my ears feel quite pressured from the sound of the phone’s keyboard. It often feels like my right ear flutters yes, and I actually noticed this a few times a few months ago, where I would just be playing a game and suddenly feel it come on like I knew something was coming, and then my right ear would spasm. It was very strange but only happened a couple of times.
The shaking is all over, though this seems to come in waves, it hasn’t happened for a few days, though I still get feelings of pressure and ringing at mundane noises.
Thanks for the reply. I guess I will lay off the painkillers for a bit.
Hi Adam:
That April episode tells me that you are listening to your headphones with the volume MUCH too loud–even though you don’t think of it as all that loud. This and your continued use of headphones set too loud for your ears I think has accounted for some of your symptoms including your hearing loss.
Just a point of correction. Hearing loss is measured in db (positive), and not as – db (minus). On an audiogram -30 dB would mean you have hearing ABOVE the 0 dB line–in other words 30 dB better than “perfect” hearing. It doesn’t seem intuitive, but that is how they do it.
The fluttering is a condition called Tonic Tensor Tympani Syndrome (TTTS). It is often caused by exposing your ears to sounds that are too loud or sustained for too long.
So you have some hearing loss, plus loudness hyperacusis and TTTS and some degree of Eustachian Tube dysfunction making your ear feel full. And when your tinnitus gets worse with increasing sounds–that is a combination of tinnitus and hyperacusis–called reactive tinnitus. Often these conditions all occur together to some degree.
You want to be careful of the painkillers so you don’t damage your ears further, but you also want to not expose your ears to sounds at the levels you have been doing in the past. A good volume is to set your headphones to the same level as you hear people normally talking.
Cordially,
Neil
Hey Neil,
Thanks for the reply. A lot of that makes sense. Although on the headphones, I’ve started putting them on the very lowest volume and still getting issues, oddly enough. Thanks for that, I’ll take that all on board.
To make matters worse I saw an Osteopath who says I have some hypermobility, which I think is causing some middle ear issues too, especially from the jaw. Oof. Making it extra hard to go without painkillers, too!
Thanks,
Adam
Hi Adam:
I’d think that the osteopath properly adjusting your jaw/neck would reduce the pain, not increase it.
Cordially,
Neil
How do people with recruirment respond to cochlear implants? Since CIs dont amplify sound in the manner hearing aids do, I am wondering if they are a viable option for people with profound loss and recruitment.
Hi Ron:
Good question. Not too many people ask that one. All people with a sensorineural hearing loss have recruitment to some degree or other. With recruitment sounds get too loud too fast because of a greatly-reduced dynamic range.
When you get a CI, you will still have this reduced dynamic range and over time with each remapping, you slowly expand your dynamic range again. It may never be normal, but it will certainly be much better than what you have now. So, go for it.
Cordially,
Neil
I’m a musician who has tried to take care of his ears for the last decade, but I fear I didn’t do a good enough job. Months ago I started noticing particular high frequencies would bother me, and a couple weeks after mixing an album (and a brief loudness incident with a table saw), I started feeling pain when listening to music at regular (speaking) volumes, the clanking of dishes etc. This was two weeks ago now. My tinnitus that I believe I already had is now much more bothersome, but the worst part of it all is a high pitched distortion sound that accompanies any sound, and is annoying/painful in the case of louder noises. I have a notch at 4000khz but still very normal hearing. Is this hyperacusis or recruitment? and will the distortion effect back off if i’m able to treat the hyperacusis?
Lastly, should I begin TRT right away, or should I wait a couple months to see if my ears are able to heal themselves first?
Thanks so much!
Hi Ian:
Since you have relatively normal hearing, you won’t have much if any recruitment. Thus, the abnormal loudness and distortion are due to hyperacusis.
The noise notch at 4,000 Hz indicates that you have exposed your ears to excessively loud sounds in the past.
I think you have been “skating on thin ice” for a while regarding the amount of sound your ears have been absorbing–and the recent mixing an album and the table saw incident was the “feather that broke the camels back” to mix metaphors.
What I’d do is give your ears a rest as much as is possible for a month or two and let them heal. That may be all you have to do to get your hyperacusis under control.
Personally, I wouldn’t begin TRT just yet. It is primarily for treating tinnitus and needs to be modified to treat hyperacusis. If the TRT professional isn’t used to treating people with hyperacusis, they can make your hyperacusis worse by treating your tinnitus.The primary treatment needs to be for your hyperacusis and only secondarily treat your tinnitus. If they don’t do this it can make your hyperacusis worse.
Cordially,
Neil
Hello doctor,
I am in the day 77th since the onset of SSNHL. And I don’t have much hope for more improvement. At the same time I am so glad it improved so much. I regained my stereo hearing for most of the frequencies, and am not lost in the street anymore. I can also talk to many people at the same time as long as it doesn’t get very loud.
day 2:
https://ibb.co/n11NYz0
day 9:
https://ibb.co/28zmZWJ
day 16:
https://ibb.co/cbwr2tN
day 23:
https://ibb.co/JBtCNFz
day 51:
https://ibb.co/Wx421Dh
I have a big dip in the 1KHZ and 2KHZ frequencies. I used this website https://www.szynalski.com/tone-generator/ to test what exactly my bad ear hears (I pretty much went through every possible frequency, with only one earpod in my bad ear, and covered both ears with noise cancelling headphones so to not let the other ear crosshear) and realized that my hearing loss is from around 700HZ to 3000HZ. Moreover, I realize that in this same region a strange sounds plays on top of the actual frequency. This weird sound is louder than the actual frequency I listen to. I assume this sound is caused by the recruited hair cells. It’s quite disturbing, as I am a musician and for certain loudness and certain frequencies my right ear hear a different frequency. Thankfully, when I play piano it’s less audible, as every piano key is responsible for many frequencies (fundamental and overtones).
I realized that certain piano keys sound very unplesant. I think it’s because of the dissonance that my two ears hear, that is they don’t hear the same frequencies.
Currently I struggle because of:
– constant tinnitus
– recruitment which changes my own voice and makes it impossible to understand people in loud environments (like meetings or cocktail parties)
– hearing loss
My questions:
1. Would a hearing aid help me with speech comprehension? Any sound in the range 700-3000HZ is very distorted, as I described above. My audiograms state that I can hear these frequencies at around 45-60db, but what I hear is mostly this recruited distorted sound. I can’t imagine any hearing aid helping me with speech comprehension. Also, when I go to loud places peoples’ voices are already very unpleasant, I am not sure if it’s due to the recruited loudness or due to the fact that my ears don’t hear the same thing (as with certain piano keys).
2. Would a hearing aid help me with tinnitus?
3. One doctor told me that I should categorically not wear any hearing aid, as it will only make my brain confused. He told my that my good ear is too good to risk it.
4. Will the sound of my own voice improve in the future? Or I’ll just get used to it?
I have read tens of articles ont his page, and I am grateful for your great work. Even though I attended more than 20 specialist, I learnt way more from this website than from them. I wish you had a youtube channel.
Hi Bart:
When testing hearing between ears, if the hearing loss is mild/moderate, just covering one ear to mask the sounds you are testing doesn’t work as your good ear will hear via bone conduction from the sounds presented to the bad ear. However, when you have a moderately-severe or severe hearing loss, this no longer applies as bone conduction isn’t loud enough to let ears hear the sound from the other ear.
There is a dissonance between your ears as your bad ear is now more broadly tuned than your good ear. You can see a graphic display of this in my article at https://hearinglosshelp.com/blog/diplacusisthe-strange-world-of-people-with-double-hearing/ and the section “What Causes Diplacusis?”
Your tinnitus is very likely the result of the hearing loss in your bad ear.
I don’t think it is recruitment that makes it so difficult to understand speech in noisy situations so much as it is the fact that your bad ear isn’t hearing the speech, and trying to understand speech in noise requires two ears to do it effectively.
Listening with two ears makes comprehension go up and the volume needed to understand speech go down, so you are hit with a double whammy. And since you are a musician, you are much more aware of sound differences than is the average person.
Now to answer your questions.
1. A hearing aid should help you, because you will be hearing more balanced speech between your two ears. The exception would be if your word recognition score in your bad ear is less than 40% or so. In that case, all the garble coming into your brain from your bad ear makes it harder for it to extract the sounds you want to hear from your good ear. But be aware that you have a very pronounced dip (a cookie-bite loss) and this can be hard to fit because you basically don’t want your hearing aid to amplify any low or high frequencies–just the mid-tones.
2. Typically, wearing hearing aids gives you back some hearing in the frequencies that you hear your tinnitus. When the neurons have real sounds to process, they don’t produce tinnitus the same as before. So while you are wearing your hearing aid, you may not notice your tinnitus. But when you take it off at night, just as typically, your tinnitus will come back until the next day when you put your hearing aid on.
3. This would be true if your word recognition score is poor in your bad ear. If it isn’t then I don’t see a real problem IF they can fit the hearing aid properly to your hearing loss.
4. It may be some of both. It’s interesting that I have two different voices–one when wearing hearing aids and one when I’m not wearing my aids. Without aids, my voice is much higher pitched, and more normally-pitched when I wear my hearing aids–but I cannot detect this–only people who hear me talking.
Probably, the truth is that I am so deaf that I don’t hear my voice much at all–only the high-frequency component–I just know what I am saying. With hearing aids I can actually hear my voice. In my case this is because I have a low-frequency loss (reverse-slope loss) so only hear high frequencies–so without hearing aids I subconsciously pitch my voice higher so I can better hear it.
Cordially,
Neil