The Relevance of the High Frequency Audiometry in Tinnitus Patients with Normal Hearing in Conventional Pure-Tone Audiometry

Abstract

Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics. Subjects and Methods. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset. Results. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus. Conclusion. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.

Reduced sound-evoked and resting-state BOLD fMRI connectivity in tinnitus

“…High-SR AF contribute to the threshold of the summed auditory nerve activity ( Liberman and Kiang, 1978 ) and only when a critical degree is lost, would lower the threshold of the compound action potential threshold of the auditory fibers, reflected in ABR wave I ( Bourien et al, 2014 ). Thereby, a differential degree of high-SR AF loss could explain the observation of reduced ( Milloy et al, 2017 ) and unchanged ( Paul et al, 2017 , present findings) ABR wave I amplitude in tinnitus, as well as the differences in high-frequency hearing loss in tinnitus ( Vielsmeier et al, 2015 ).…”

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

“…And many tinnitus patients with normal or nearly normal hearing thresholds in the pure tone audiogram exhibit cochlear damage (Shore et al, 2016). Hair cell loss at frequencies between the tested frequencies (“dead regions”) (Weisz et al, 2006) or at high frequencies (Vielsmeier et al, 2015) have been observed in tinnitus patients with normal standard audiograms. There is also evidence for damage of high-threshold auditory nerve fibers in tinnitus patients with normal standard audiograms (Schaette and McAlpine, 2011).…”

Zusammenhang zwischen Tinnituston und Frequenzbereich des Gehörverlusts

“…Es wurde lediglich der Standardbereich bis 8 kHz gemessen, was nach meiner Erfahrung insbesondere bei Einschluss jüngerer Probanden (der jüngste Kandidat in dieser Studie war 18) dem möglichen Bereich des Hörverlustes und auch der Tinnitusfrequenz nicht gerecht wird. Ich plädiere aus diesem Grund dafür, die Hochfrequenzaudiometrie (bis 20 kHz) in die Standardabklärung jüngerer Tinnituspatienten einzubeziehen [4].…”