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Audiology/Otolaryngology/Sudden hearing loss, tinnitus, distortion

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Expert: Daniel J. Bosnyak, PhD - 11/15/2009


Question
I am profoundly deaf in one ear, and somewhat in the other.  About 3 weeks ago my tinnitus became much worse, and this was followed by a sudden (over 3 days) loss of hearing and especially comprehension with all speakers sounding 'electronically modified' like in a cartoon.  All sounds are distorted and music sounds like didgeridoos. I can't understand the voices on the television or on the telephone. I have been seeing and audiologist and and ENT (this is South AFrica)previously for my (ordinary ?otosclerosis) hearing loss:  If I wear my hearing aid sounds are uncomfortably loud and blaring, if I don't I can't follow any sort of conversation.  My ENT tells me it is recruitment but gives me no treatment.  He did put me on a course of steroids initially, but this has not helped, and the tinnitus is if anything worse.
My audiologist does not explain the tests to me, so I don't know by how much my hearing has worsened, except from my own perception
No-one seems to offer any options other than mild anti-anxiety medication which is not satisfactory.  There have been no tests other than audiology done to ascertain the problems.
Should I push for a neurological investigation?

Thanks for any help - I am feeling pretty desperate.
Saranne

Answer
Saranne,

The fact that sounds are now uncomfortably loud does sound a lot like recruitment. Auditory recruitment is the condition where hearing is abnormally sensitive to changes in the intensity of a sound.  In some cases, sounds that would have been comfortable to listen to before recruitment become uncomfortably loud.  This condition is known as over-recruitment, and shares many similarities to hyperacusis.  I assume that the hearing aid is in the 'somewhat' impaired ear.  

Recruitment is characteristic of 'sensory' hearing loss, that is hearing loss caused by pathology in the inner ear or cochlea.  Hearing loss that occurs at some later stage would be known as retrocochlear or perhaps 'neural' hearing loss.  Retrocochlear pathology would require neurological investigation, while 'sensory' hearing loss would not, so this is probably why the ENT is not going further with this.

It is possible that the increased hearing loss could be a temporary phenomenon, caused by some noise trauma.  In this case other than steroids the only treatment option might be anti-oxidants like vitamin E.  

If it does turn out that the new level of hearing impairment is permanent, there are some experimental treatments that show some promise in helping with the recruitment-induced hyperacusis.  You can read the abstract for one study here:

http://journals.lww.com/neuroreport/Abstract/2007/08060/Enriched_acoustic_enviro...

I am not sure however how you would go about getting such treatment, but the punch line seems to be that shutting off your hearing aid is not the way to go.

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Daniel J. Bosnyak, PhD

Expertise

I am a neuroscientist and experimental psychologist who specializes in the study of Tinnitus (ringing of the ears). Our laboratory focuses on trying to understand what causes the tinnitus sensation, which we believe is an important first step in developing a cure for this debilitating illness. We believe that in many cases the sensation is generated as a result of changes in brain organization resulting from mild or moderate hearing loss, a phenomenon known as 'cortical plasticity' and akin in some ways to phantom limb pain. Although we do not offer treatment for tinnitus patients at this time, I do attend most of the worldwide conferences on Tinnitus and I am aware of most of the recent advances in treatment methodologies. Our research has been supported by the American Tinnitus Association, the Canadian Institute for Health Research and the Tinnitus Research Initiative.

Experience

As a research scientist and Adjunct Assistant Professor in the department of Psychology, Neuroscience and Behaviour at McMaster University I have been studying tinnitus and associated phenomena for several years.

Publications
Bosnyak, D. J., Gander, P. E., & Roberts, L. E. (2007). Does auditory discrimination training modify representations in both primary and secondary auditory cortex. New Frontiers in Biomagnetism. International Congress Series (pp. 25-28). Amsterdam: Elsevier Science. Roberts LE, Moffat G, Baumann, M, Ward LM, and Bosnyak DJ (2007). Residual inhibition functions overlap tinnitus spectra and the region of auditory threshold shift. Journal of Research in Otolaryngology. Roberts, L.E., Moffat, G., & Bosnyak, D. J. (2006). Residual inhibition functions in relation to tinnitus spectra and auditory threshold shift. Acta Otolaryngologica, 126, 27-33 Bosnyak D.J., Leone A.M., Gander P.E., Roberts L.E. (2007). Responses in the primary auditory cortex in tinnitus sufferers after induction of residual inhibition by masking sounds. Annual meeting of the Canadian Association for Neuroscience, Toronto, May 23-25.

Education/Credentials
MCMASTER UNIVERSITY PhD, Psychology, 2003. Hons B.A., Psychology, 1994, Summa Cum Laude

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