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Thread: Can exostoses be the reson for my low frequency loss?

  1. Default Can exostoses be the reson for my low frequency loss?

    My hearing has been OK (not great but not enough loss to justify HAs) until a left ear infection then I noticed a greater loss and visited an audi who referred me to an ENT.

    I have
    exostoses in both canals with my left being the worst.

    My ENT said the exostoses are not worth operating on and will not affect my hearing as my canals are not completely blocked. He did recommend HAs though due to my HF loss.

    I have since visited another audi and he thought the exostoses could be the cause of the loss at low frequencies and suggested I make another referral to see the ENT.

    I am currently waiting for HAs - getting Phonak Brio R-312T from Costco but have been told they may be difficult to program for my hearing profile (this advice was not from Costco - it was another audi who suggested Siemens Pure Micon 7mi would suit me better... at around FOUR times the price of the Phonaks!).

    Not sure what/who to believe?

    Thanks, Tom.
    Hz 250 500 1k 2k 4k 8k
    L 55 20 15 30 55 55
    R 50 20 10 15 65 60
    SRT:@40db, L=70% - R=90%


    My Audiogram
    0250Hz R-45 L-50
    0500Hz R-15 L-15
    1000Hz R-15 L-15
    2000Hz R-15 L-35
    4000Hz R-50 L-55
    8000Hz R-80 L-70

  2. Default

    What are your bone conduction results? This will indicate whether your hearing loss is conductive or sensorineural.

  3. Default

    Thank you, I will check that later. Sorry don't have the result to hand at the moment.
    My Audiogram
    0250Hz R-45 L-50
    0500Hz R-15 L-15
    1000Hz R-15 L-15
    2000Hz R-15 L-35
    4000Hz R-50 L-55
    8000Hz R-80 L-70

  4. Default

    With your particular audiogram, hearing aids will only provide amplification in the high frequencies (2K and above), so speech will sound clearer, but not necessarily louder. All hearing aids roll-off the gain below 500Hz in order to prevent upward spread of masking.

  5. Default

    Quote Originally Posted by rasmus_braun View Post
    With your particular audiogram, hearing aids will only provide amplification in the high frequencies (2K and above), so speech will sound clearer, but not necessarily louder. All hearing aids roll-off the gain below 500Hz in order to prevent upward spread of masking.
    Thank you. My speech discrimination scores were stated as "excellent at most comfortable hearing levels of amplication" so I guess the HAs are only going to benefit me at the higher frequencies?

    - - - Updated - - -

    Quote Originally Posted by rasmus_braun View Post
    With your particular audiogram, hearing aids will only provide amplification in the high frequencies (2K and above), so speech will sound clearer, but not necessarily louder. All hearing aids roll-off the gain below 500Hz in order to prevent upward spread of masking.
    Thank you. My speech discrimination scores were stated as "excellent at most comfortable hearing levels of amplication" so I guess the HAs are only going to benefit me at the higher frequencies?
    My Audiogram
    0250Hz R-45 L-50
    0500Hz R-15 L-15
    1000Hz R-15 L-15
    2000Hz R-15 L-35
    4000Hz R-50 L-55
    8000Hz R-80 L-70

  6. #6
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    Default

    Exostoses (which are bony mushroom like growths in the canal) can impact on your loss, but usually only if they are causing a blockage or physically preventing the ear-drum from moving properly. This can happen if they grow in front of the ear-drum and cause material to build up in-between their surface and that of the ear-drum or they actually grow from the side wall of the canal that supports the annular membrane of the ear-drum.

    Given you have (a possibly conductive) LF loss I would suggest that the 'travel' of the ear-drum is possibly being impacted as it's not being allowed to move freely with the incoming sounds. As pointed out above accurate BC results would give a better indication of the actual cochlear performance and allow the full effect of the dysfunction to be measured.

    That said the amount of speech information (rather than loudness information) at 250 Hz and below is minimal, so the aim to 'fix' the upper frequencies is entirely appropriate and should help a lot - even if the aids sound pretty tinny at inception.

    Get your Audiologist to keep an eye on the Exostoses as surgery may be needed if they start to occlude the canal. Also get some custom made ear-plugs for cold water exposure to keep them in check. Although wetsuits mean that you can tolerate the cold water considerably longer, your ears haven't made the necessary evolutionary changes to keep up.
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  7. Default

    Thank you for the helpful replies. Seems to me from what has been said that my LF loss will not affect conversation listening but I enjoy listening to music so I am hoping HAs are going to benefit me at both ends of the scale.

    I have my audiometry report in front of me and don't understand how to read the BC results - all I can see is the BC symbol at 1KHz is at the zero decibel point on each graph.

    There is another line on both graphs, near the bottom - each ear showing the same. Are these the test results for loudness tolerance? If so, I am confused why this was performed and how the results were measured. I was told to indicate if sound became too uncomfortable but I didn't indicate at all although I was on the point of doing so before she stopped.

    Hz Db
    500 110
    1K 120
    2K 120
    4K 115

    I can ask my Audi to explain it to me when I go for the fitting next week. Have to say, whilst I love their prices, I was not impressed by the Audi at my Costco. Seemed very rushed and didn't give me much of an opportunity to ask questions. I am considering going back to my ENT although as the consultation fee is quite costly I am wondering if it will be worth it if all he is going to say is the same as last time.

    As for cold water exposure, yes I probably developed the exostoses when I used to windsurf in the UK in the 80s and 90s.

    I am living in Queensland, Australia now - the water is a lot warmer
    Last edited by Grey Wolf; 12-11-2014 at 12:21 AM.
    My Audiogram
    0250Hz R-45 L-50
    0500Hz R-15 L-15
    1000Hz R-15 L-15
    2000Hz R-15 L-35
    4000Hz R-50 L-55
    8000Hz R-80 L-70

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