Auditory brainstem response distinguishes occasional and constant tinnitus | Hacker News Reader

Auditory brainstem response distinguishes occasional and constant tinnitus

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106 pointsTomte45 comments

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

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.

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.

> 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.

the "maladaptive plasticity" framework for thinking about tinnitus is certainly a fairly convincing one.

Do these results suggest no treatment will be possible?

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.

1) and 2) sound a bit like covid / long covid symptoms.

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-tinnitus-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.

Anecdotally, some people find magnesium supplements helpful.

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?

i am an audiologist and that sounds like TMJ https://www.tmjtreatmentsc.com/blog/explaining-tinnitus-ear-... ..so yes, it is possible.

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?!?

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.

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?

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.

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.

It was for me.

Have your SO look into botox for TMJ. It is pricey but life changing.

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.

perhaps her tensor tympani is tensing, causing the ear rumble

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.

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.)

That the tinnitus is on the side of th TMJ is interesting.

Can you change the frequency/intensity of your tinnitus by changing pressure in the ear with fingers or by moving your jaw?

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.

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?

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.

Are there cures for TMJ? It really kills me

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)

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?

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.

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.

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.

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.

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.

No difference for me, in frequency or volume.

No change.

However, some of my migraines lower the noise, some anti migraine medication raises it (Elavil).

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.

Interesting, my tinnitus increased recently and I started vit k again.

I'll see if stopping helps.

Thanks

for me, pressure increases the frequency. also high jaw muscle tension increases the frequency in a similar way.

Doesn't do anything for me.

nope

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.

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.

35 sounds pretty impactful though. The physical limit of ear plugs COMBINED with ear muffs is 36db NRR.

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.

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