> Date: Mon, 10 Sep 2012 10:03:24
                                -0500
                                > From: 
flatmax@xxxxxxxxxxx
                                > Subject: Re: [AUDITORY] Tinnitus
                                and a dip in the audiogram
                                > To: 
AUDITORY@xxxxxxxxxxxxxxx
                                > 
                                > Your second point here is one I
                                like. However it may also be the same as
                                
                                > your first point :)
                                > 
                                > Our mixed-mode Cochlear amplifier
                                supports your hypothesis.
                                > 
http://adsabs.harvard.edu/abs/2011AIPC.1403..611F
                                > 
                                > The general idea is that certain
                                types of Cochlea damage enhance the 
                                > peripheral hearing circuit.
                                > 
                                > For example, consider this thought
                                experiment based on our mixed-mode 
                                > Cochlear amplifier model :
                                > 
                                > Imagine that your stereocillia are
                                lopped off in a small region of inner 
                                > hair cells - the same can be said
                                for outer hair cells. This may happen 
                                > due to ageing or damage.
                                > In this case assume that the
                                stereocillia resistance is reduced - due
                                to 
                                > gaping open ion channels - and
                                ionic currents into the cell (potassium)
                                
                                > and our from the cell (sodium) are
                                enhanced ... the hair cell now 
                                > experience a depolarisation. This
                                depolarisation generates more 
                                > spontaneous neurotransmitter
                                release.
                                > The neurotransmitters generate more
                                synaptic transmission in the 
                                > cochlear nerve.
                                > The cochlear nerve excites the
                                superior olive and this not only 
                                > generates perception of the tone,
                                but sends signals back to the Cochlear 
                                > over the lateral and medial
                                efferents.
                                > The medial efferents stimulate the
                                motors in the outer hair cells and 
                                > they in turn generate movement at
                                the inner hair cells which start the 
                                > process again ... over and over
                                again ... the end result is a 
                                > mecho-neural standing wave ... or
                                'tinnitus'.
                                > This type of tinnitus masks low
                                level sound heard through the ear ... 
                                > however if the external sound gets
                                loud enough, then it masks the tinnitus
                                !
                                > 
                                > What do you think ?
                                > 
                                > Matt
                                > 
                                > On 09/10/2012 08:22 AM, Matt Winn
                                wrote:
                                > >
                                > > Mark and everyone,
                                > >
                                > > Although I am not a tinnitus
                                researcher, I have had lots of
                                experience 
                                > > with patients with tinnitus in
                                the audiology clinic. Generally, we try
                                
                                > > to avoid the confusion of
                                tinnitus with testing tones by using
                                pulsed 
                                > > and/or warbled tones. As you
                                point out, this doesn’t always work out
                                
                                > > perfectly.
                                > >
                                > > It has been my experience that
                                dips in the audiogram are indeed 
                                > > frequently accompanied by
                                tinnitus. having measuring hearing at
                                the 
                                > > VA, this connection might be
                                limited to hearing loss that is 
                                > > noise-induced. The two most
                                common explanations I have heard for
                                this 
                                > > are 1) damage to the auditory
                                system at the site of the hearing loss 
                                > > underlies both the threshold
                                elevation and improper firing by damaged
                                
                                > > nerves, and 2) tinnitus that
                                exists in the region of the dip is not 
                                > > masked out by external
                                stimulation because the external sounds
                                are 
                                > > less audible; thus rendering
                                tinnitus more noticeable. This latter 
                                > > explanation accounts for the
                                relief from tinnitus experienced by many
                                
                                > > people who use hearing aids.
                                Specifically, tinnitus isn’t “cured,”
                                but 
                                > > it is masked out by the
                                amplified input, and then the tinnitus
                                returns 
                                > > after the hearing aid is
                                removed.
                                > >
                                > > Returning to the point of
                                tinnitus without apparent hearing loss,
                                I 
                                > > have found that salt intake
                                and stress level are two (among many) 
                                > > contributing factors to and my
                                own tinnitus, and I don’t have hearing 
                                > > loss. The dependence of OHCs
                                on metabolic factors underscores this 
                                > > connection, which seems
                                anecdotally to be exacerbated in
                                patients with 
                                > > Ménière’s.
                                > >
                                > > Matt
                                > >
                                > >