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Larry Davidson - 09 Feb 2004 04:38 GMT

I posted a few weeks ago about a mild T case that turned sever recently. An
ENT attributes it to nerve hearing loss (this has been previously diagnosed,
so the loss is not a surprise). He did, however, recommend waiting a couple
of weeks, seeing if it persisted and then perhaps trying an AB-R test to
rule out a growth of any sort.

It's been a week+ and the T has actually subsided a bit. It comes and goes,
still sometimes loud, but overall it isn't terribly noticable anymore. Hard
to say why that's the case, but I'm happy about that of course.

My new question is about the AB-R test. I've seen a few things that say this
could worsen tinnitus, but nothing I read sounded terribly clinical. The ENT
claims it's not invasive or problematic. Any opinions here?

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Oregon7 - 10 Feb 2004 03:19 GMT

Most people can tolerate the ABR unless they have a severe loss of tolerance
for sound, i.e., severe sensitivity.

The ABR test involves a small plug that goes into one ear and emits a little
buzzing sound and then some electrodes are glued onto your skin to 'read' the
electrical patterns of the nerve action.

Takes about 45 minutes and sometimes people just fall asleep...this is pretty
common as the room is dark, the sound is rather boring, and you lie down.

I would say it is about a 3 out of 10 for tests. I personally would rate an
MRI as a 8/10 for tests, just to give some perspective.

THe audiologist stays in the room the whole time and this is also reassuring.

Hope you can make your way through this test. Let us know how you do.

Marsha Johnson, MS
AUdiologist

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Stephen Nagler - 10 Feb 2004 03:32 GMT

>I posted a few weeks ago about a mild T case that turned sever recently. An
>ENT attributes it to nerve hearing loss (this has been previously diagnosed,
[quoted text clipped - 9 lines]
>could worsen tinnitus, but nothing I read sounded terribly clinical. The ENT
>claims it's not invasive or problematic. Any opinions here?

.................

It is my understanding that many authorities do not do ABRs anymore in
tinnitus work-ups - because they tend to miss smaller acoustic
neuromas (and can sometimes miss larger ones as well). I think that
the current "gold standard" is an MRI with and without gadolinium. If
an ABR is suggestive of an acoustic neuroma, that's the next step in
the work-up anyway. And if an ABR is unremarkable, you really haven't
ruled it out! So, since eirther way the result does not contribute to
a clinical decision, why do the ABR at all?

If a person has significantly asymmetrical tinnitus or unilateral
tinnitus, and there is any doubt whatsoever about the cause -- a lot
of docs would go directly to the MRI with and without gadolinium.

Just my $0.02 ...

smn

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Pete C. - 10 Feb 2004 15:41 GMT

> >I posted a few weeks ago about a mild T case that turned sever recently. An
> >ENT attributes it to nerve hearing loss (this has been previously diagnosed,

> If a person has significantly asymmetrical tinnitus or unilateral
> tinnitus, and there is any doubt whatsoever about the cause -- a lot
[quoted text clipped - 3 lines]
>
> smn

This is precisely what my ENT explained to me when I presented with
unilateral tinnitus. He prescribed an MRI w/wo contrast. It's also
important to note that the lack of hearing loss does not negate the
presence of a nueroma. I have mild hearing loss at upper frequency
bilaterally. My insurance company would not approve the MRI without
the audiology test even though a negative result does not preclude
nueroma. I took the audiology test which proved to be unremarkable.
My ENT sent an appeal after my insurance company again disaproved the
MRI. Finally, the insurance company approved after the appeal. My
MRI turned out to be negative for acoustic neuroma (thankfully). My
ENT regards the tinnitus as a result of upper frequency hearing loss
(possibly age related - 47 yo male). I am now dealing with the
tinnitus which fortunately in my case is mild. Very loud at night
though and quite annoying when trying to sleep. High pitch ring
continuous 24/7.

Pete C.

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ENTconsult - 11 Feb 2004 06:02 GMT

I have never heard of anyone getting ABR and having their tinnitus get worse.
I know of no such reports in the literature.
Murray Grossan, M.D.
http://www.ent-consult.com

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