Hearing sounds after they're gone + audiogram
September 27, 2021 11:20 AM Subscribe
My whole life, I've had a problem where I continue to "hear" quiet sounds long after they're gone. I had a hearing test that came up as normal, but I have concerns about how the test was conducted and how it interacts with this problem. I have another hearing test coming up and want to figure out how to verbalize this or if there is an alternate test I can ask for.
Whenever there is a soft, just-perceptible repetitive sound, when the sound stops, I will continue to "hear" it for a while afterwards. So, say there's a very soft beeping and you find the object and turn it off. I continue to "hear" it for a few minutes afterward. This happens most commonly with sirens outside, where they fade away in the distance but I continue to hear them (softly) after they are long gone.
A couple years ago I had an audiogram because I mentioned that I had tinnitus (I've had it my whole life and always assumed it was normal) and the urgent care doctor said I should get my hearing tested. Hearing test showed perfect hearing, they evaluated the tinnitus and determined it was a brain issue (I don't remember the term--but essentially nothing in my ears is causing the tinnitus, brain is just making up sound) and prescribed me some sound therapy, which I did for a while and then dropped because my tinnitus has never really bothered me.
I've had some concerns about the hearing test, though. The way it was conducted, tones were played at exactly the same amount of time apart, getting quieter each time. I was to click the button if I heard any sound. The audiologist explicitly instructed me to click the button even if I wasn't sure I heard the sound, or if I just "felt something funny" in my head. I'm worried that because the sounds were spaced identically apart, that my brain made up the remaining sound even though I wasn't hearing them--if the length between tones had varied I wouldn't be concerned, but they were identical. Hence, it seems possible that I was clicking the button at the right time but only because my brain continued to "hear" the sound even though my ears weren't. I've always felt like I have more trouble hearing than the average person, so the audiogram results felt off to me, but I accepted them.
Fast forward a few years and my physical therapist is noticing that I have some vestibular issues that seem related to my left ear, which (as seen in a previous question) is the ear I've always had various issues with (on-and-off pain, muffling, itchiness). He recommended I see an ENT, which I never actually have before (I mentioned my ear pain and muffling to two doctors and the first audiologist and none of them seemed concerned). When I called to schedule the appointment, they said that because I'm reporting ear pain I need to have another audiogram before the appointment.
That's tomorrow, and I'm still not sure how to verbalize this issue to the audiologist, or if it's even a legitimate concern. Is there a term for this phenomenon? Are there other tests I can ask for them to use that vary the tone? And if there's not... is there a way to express that I think the audiogram will be a waste of time and money because I don't think it can test me properly? Or am I just being a special snowflake here?
Whenever there is a soft, just-perceptible repetitive sound, when the sound stops, I will continue to "hear" it for a while afterwards. So, say there's a very soft beeping and you find the object and turn it off. I continue to "hear" it for a few minutes afterward. This happens most commonly with sirens outside, where they fade away in the distance but I continue to hear them (softly) after they are long gone.
A couple years ago I had an audiogram because I mentioned that I had tinnitus (I've had it my whole life and always assumed it was normal) and the urgent care doctor said I should get my hearing tested. Hearing test showed perfect hearing, they evaluated the tinnitus and determined it was a brain issue (I don't remember the term--but essentially nothing in my ears is causing the tinnitus, brain is just making up sound) and prescribed me some sound therapy, which I did for a while and then dropped because my tinnitus has never really bothered me.
I've had some concerns about the hearing test, though. The way it was conducted, tones were played at exactly the same amount of time apart, getting quieter each time. I was to click the button if I heard any sound. The audiologist explicitly instructed me to click the button even if I wasn't sure I heard the sound, or if I just "felt something funny" in my head. I'm worried that because the sounds were spaced identically apart, that my brain made up the remaining sound even though I wasn't hearing them--if the length between tones had varied I wouldn't be concerned, but they were identical. Hence, it seems possible that I was clicking the button at the right time but only because my brain continued to "hear" the sound even though my ears weren't. I've always felt like I have more trouble hearing than the average person, so the audiogram results felt off to me, but I accepted them.
Fast forward a few years and my physical therapist is noticing that I have some vestibular issues that seem related to my left ear, which (as seen in a previous question) is the ear I've always had various issues with (on-and-off pain, muffling, itchiness). He recommended I see an ENT, which I never actually have before (I mentioned my ear pain and muffling to two doctors and the first audiologist and none of them seemed concerned). When I called to schedule the appointment, they said that because I'm reporting ear pain I need to have another audiogram before the appointment.
That's tomorrow, and I'm still not sure how to verbalize this issue to the audiologist, or if it's even a legitimate concern. Is there a term for this phenomenon? Are there other tests I can ask for them to use that vary the tone? And if there's not... is there a way to express that I think the audiogram will be a waste of time and money because I don't think it can test me properly? Or am I just being a special snowflake here?
The same thing happens to me and I do have some hearing loss. When I’ve mentioned it, the people doing the testing would vary the timing, tones, do multiple beeps, etc, much more reliably. (FWIW, even with the phantom tones, my graph turned out pretty similar compared to single beeps. I don’t think my phantom hearing is as smart as I give it credit for.)
posted by tchemgrrl at 1:30 PM on September 27, 2021
posted by tchemgrrl at 1:30 PM on September 27, 2021
I have something similar, including the assumed-it-was-normal-never-really-bothered-me tinnitus, to the point that I can't always immediately tell if the sound's actually stopped or not. For what it's worth, I always assumed it was something to do with my auditory processing disorder. I also have mild vestibular stuff.
I've never had a hearing test, but my own perception is that my hearing's actually quite acute but I basically function like someone who is slightly HOH because my brain doesn't process the sound. I think I'm right in thinking you're not neurotypical - any chance something like that could be going on with you?
posted by BlueNorther at 3:26 PM on September 27, 2021
I've never had a hearing test, but my own perception is that my hearing's actually quite acute but I basically function like someone who is slightly HOH because my brain doesn't process the sound. I think I'm right in thinking you're not neurotypical - any chance something like that could be going on with you?
posted by BlueNorther at 3:26 PM on September 27, 2021
Response by poster: Oh yeah, I didn't mention--I'm autistic, I definitely assume it's something to do with that! My therapist has already said I'm far from her first autistic client with ear issues, tinnitus, and balance problem. I've never actually been diagnosed with auditory processing disorder, though, and the audiologist didn't refer me for any further testing even though I mentioned difficulty understanding and focusing on speech when there's background noise. Unsure if the tests they did would screen for that or not, or if I need to be referred somewhere else?
I think it's unlikely I have any hearing loss, but I wasn't thrilled at the idea of spending the time and money on a test that I have done before and which may not even be able to detect hearing loss in me (possibly my grumpiness is influenced by their only availability being 8am). However it sounds like it's unlikely that this issue interferes, and/or I can ask them to vary the tones more, which is good to know, thanks Lutoslawski and tchemgrrl!
posted by brook horse at 3:50 PM on September 27, 2021 [1 favorite]
I think it's unlikely I have any hearing loss, but I wasn't thrilled at the idea of spending the time and money on a test that I have done before and which may not even be able to detect hearing loss in me (possibly my grumpiness is influenced by their only availability being 8am). However it sounds like it's unlikely that this issue interferes, and/or I can ask them to vary the tones more, which is good to know, thanks Lutoslawski and tchemgrrl!
posted by brook horse at 3:50 PM on September 27, 2021 [1 favorite]
I have almost no inner eye - can't visualize for shit - but my inner ear is pretty much permanently on; it's incredibly rare that it's actually quiet in here and, like you, I cannot often distinguish the exact point at which a quiet external rhythm actually stops repeating.
If I were having the kind of threshold-of-perception test you're talking about, then in order to be confident about the results I'd want each new tone to be played with a different rhythm, and my test response to involve tapping that rhythm out with my fingers.
I've never been diagnosed as exhibiting any of the colours of the autism spectrum, fwiw.
posted by flabdablet at 9:59 PM on September 27, 2021
If I were having the kind of threshold-of-perception test you're talking about, then in order to be confident about the results I'd want each new tone to be played with a different rhythm, and my test response to involve tapping that rhythm out with my fingers.
I've never been diagnosed as exhibiting any of the colours of the autism spectrum, fwiw.
posted by flabdablet at 9:59 PM on September 27, 2021
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tones were played at exactly the same amount of time apart, getting quieter each time.
Ideally, audiologists are not supposed to do this. We are trained to vary the time between presentations. Audiologists get lazy though and get into a rhythm.
But - it really probably doesn't matter that much. The audiologist is testing you in such a way that they find the level that you respond to 50% of the time. It's actually pretty hard to fool or beat the test. The procedure is robust to false positive responses from the patient. In short -- it's unlikely that the timing issue resulted in a very inaccurate test. I personally would not worry about the validity of the test based on this.
To your bigger issue - this sort of phantom sound perception is not particularly abnormal, but it's also not understood. It definitely is a central issue, meaning it's in your brain rather than your ears per se. The audiogram is specifically measuring the quietest sounds you can hear and whether they are normal or not. It is a test of ear function, rather than sound perception in the brain. It doesn't have anything to say about these more brain-related, central sound processing issues. In short, the continuing to hear sounds after they have passed is not related to what they are measuring on the audiogram. It is very common for people to have normal audiograms but still have tinnitus or other auditory processing abnormalities. The issue your perceiving doesn't sound pathological to me, but it is something you may bring up to the audiologist and the ENT.
You should however see an ENT for your vestibular issues and any ear pain. You may want to see an audiologist who specializes in vestibular assessment. Many (even most) vestibular issues are unrelated to the ear, but it's always good to know for sure.
Hope this helps.
posted by Lutoslawski at 1:06 PM on September 27, 2021 [7 favorites]