by Neil Bauman, Ph.D.
A man wrote:
I have mild to moderate hearing loss, bilateral tinnitus and some hyperacusis. There’s no rhyme or reason to the hyperacusis. Some days it’s stable and other days it gets worse. Likewise with my hearing loss—it fluctuates—sometimes in the morning I feel I can hear fine and after a busy day at work or home life, I feel cotton got into my ears and my hearing is worse at night as well as the tinnitus—like I used my ears to much during the day. That type of feeling.
My problem is what can I do about telephone use. It seems that whenever I talk on the phone my tinnitus gets worse after I hang up. I started using my cell phone with the speaker, so my ear is not against the phone itself. But it still increases the level of my tinnitus after the phone call.
This is baffling me because I really enjoy speaking with people, but now I cut my calls short for fear of the intensity of the tinnitus later on. I wish there was some solution for phone use. I think that my response is hyperacusis after using the phone.
Is there any solution to this, or do I just suffer with it? I am trying to protect my hearing. I have nerve damage and this close noise bothers it. Recovery usually takes a few hours back to the same level.
You are not alone in this. My tinnitus gets worse from using the phone too. I wonder if your problem is the same as mine.
Incidentally, I think you have recruitment rather than hyperacusis.
For me, the louder parts (spikes) of each syllable are too loud and cause my recruitment to kick in, which aggravates my tinnitus. However, if I turn down the volume so these spikes do not recruit (and aggravate my tinnitus), then I can’t hear the softer parts of the syllables and thus don’t understand what the person on the other end is saying. It’s sort of a Catch-22 situation.
That is part of the problem. In addition, I need enormous amplification in order to hear the other person (I have an 80 dB loss right where our voices are pitched). Since the phone’s side tone amplifies my own voice even more than the other person’s voice, my voice in the handset is then much too loud for me. However, if I turn down the volume, then I can’t hear the other person, and if I speak softer, the other person can’t hear me. The result is that after talking on the phone for a while (and I often am on the phone for an hour or more at a time), my tinnitus is louder for 10 or 15 minutes after I hang up.
The obvious solution to this problem is to wear hearing aids that have their compression set such that no louder sounds can reach your recruitment threshold. Then, since no sounds will recruit, it won’t aggravate your tinnitus. (At least, that’s my theory.) The compression not only keeps the lid on the louder sounds, but at the same time, it increases the volume of the softer parts of speech so you can hear and understand the other person.
Since I don’t like wearing my hearing aids for phone use (never have, but that’s me), part of my solution was to get a binaural headset so both ears can hear at once. The advantage of hearing with both ears at the same time is that you can cut the volume in half and still understand the other person as well as before with one ear and twice the volume. By cutting down the volume, my own voice isn’t as loud and thus much easier on my ears (which is a blessing). It’s not the perfect answer, but is much, much better than before.
You can get this binaural advantage by wearing two hearing aids in t-coil mode and plug a neckloop (amplified or bluetooth) or T-links into your cell or landline phone. Then you can turn the volume down and yet still hear clearly since both ears are working together now. If you have the Oticon Epoq or Phonak Exelia (or equivalent) hearing aids with their remotes, you can use bluetooth phones and the sound will be piped into both your hearing aids automatically.
In summary, wearing two hearing aids with sufficient compression to control your recruitment would be the best solution to prevent your recruitment from kicking in and aggravating your tinnitus while on the phone (or anywhere else for that matter). Second best is to do what I do and wear a binaural headset. The wonderful binaural headset I use (for landline phones only) is found here.