International Journal of Otorhinolaryngology


Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Research Article |

Frequency of Hidden High Frequency Hearing Loss in Patients with Idiopathic Tinnitus

Tinnitus is a hallucination of sound, usually described as ringing and buzzing in the ears. Many factors are known to cause tinnitus but sensorineural hearing loss (SNHL) was found to be the most common. The objective of this study is to determine the actual frequency of idiopathic tinnitus and frequency of hidden SNHL in patients presenting with idiopathic tinnitus without hearing loss. This cross sectional study was performed at PAF Hospital Islamabad between December 2018 to Dec 2022. All the patients that presented with tinnitus without any subjective complaint of hearing loss were included in the study. All the possible causes of tinnitus were ruled out before labelling it idiopathic tinnitus. PTA was performed in all patients. The number of patients was calculated who had tinnitus without hearing loss on PTA. These were the patients with idiopathic tinnitus (GHi). Then these patients were tested for hearing loss on PTA in frequencies higher than 8000 Hz to find out hidden hearing loss. In these patients, the number of patients having hearing loss in frequencies higher than 8000 Hz (GH) was calculated. These patients (GH) were removed from the list of idiopathic tinnitus and were the patients with hidden SNHL. In this way the actual frequency of idiopathic tinnitus (Gi) was calculated. The results were tested biostatistically using SPSS 20. Chi-square, simple t test and Fisher’s exact test were applied. The significance of results was calculated. Out of 100 patients, 65 were female and 35 were male. The mean age was 28.9±11.7 years. On audiometry only 10% patients had hearing loss in frequencies usually tested during audiometry (500Hz- 4000Hz), Gs. All of these were males (100%). Routine audiometry was normal in the remaining 90% of patients (GHi). When these patients were tested in frequencies higher than 8000 Hz, out of these 90% patients, 55% of the patients had high frequency hearing loss (>8000 Hz), (GH); this is the hidden hearing loss. P values were < 0.001and 0.75 on Fisher’s exact and Chi-square tests, the results were found to be significant. It is often seen that patients with idiopathic tinnitus develop SNHL later in life. Therefore, tinnitus can be considered as an early symptom of hearing loss. The actual frequency of idiopathic tinnitus (Gi=45%) is far less than documented, in most of the cases there is hidden SNHL.

Idiopathic Tinnitus, Hearing Loss, Sensorineural

APA Style

Najeeb, T., Bilal, A., Ahmed, S., Siddiqui, N. (2023). Frequency of Hidden High Frequency Hearing Loss in Patients with Idiopathic Tinnitus. International Journal of Otorhinolaryngology, 9(2), 30-34.

ACS Style

Najeeb, T.; Bilal, A.; Ahmed, S.; Siddiqui, N. Frequency of Hidden High Frequency Hearing Loss in Patients with Idiopathic Tinnitus. Int. J. Otorhinolaryngol. 2023, 9(2), 30-34. doi: 10.11648/j.ijo.20230902.14

AMA Style

Najeeb T, Bilal A, Ahmed S, Siddiqui N. Frequency of Hidden High Frequency Hearing Loss in Patients with Idiopathic Tinnitus. Int J Otorhinolaryngol. 2023;9(2):30-34. doi: 10.11648/j.ijo.20230902.14

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Francesco Martines, Daniela Bentivegna, Enrico Martines, Vincenzo Sciacca & Gioacchino Martinciglio. Assessing audiological, pathophysiological and psychological variables in tinnitus patients with or without hearing loss. European Archives of Oto-Rhino-Laryngology volume 267, pages1685–1693 (2010).
2. Min-gon kim, ChoYong-woo, KimJeong-ryong. Hanyang University Auditory Data Pattern Analysis for Differential Diagnosis of Hidden Hearing Loss. GRADUATE SCHOOL. DEPARTMENT OF HUMAN-COMPUTER.
3. Francesco Martines, Daniela Bentivegna, Enrico Martines, Vincenzo Sciacca, Gioacchino Martinciglio. Characteristics of tinnitus with or without hearing loss: Clinical observations in Sicilian tinnitus patients. Auris Nasus Larynx Volume 37, Issue 6, December 2010, Pages 685-693.
4. Heller AJ (2003) Classification and epidemiology of tinnitus. Otolaryngol Clin N Am 36: 239–248.
5. Davis A, El Rafaie A (2000) Epidemiology of tinnitus. In: Tyler RS (ed) Tinnitus handbook. Singular Publishing Group, San Diego, pp 1–23.
6. Jastreboff PJ (1990) Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res 8: 221–254.
7. N. Weisz et al. High-frequency tinnitus without hearing loss does not mean absence of deafferentation. Hear Res (2006).
8. Ravina J. Tanna; Jerry W. Lin. Sensorineural Hearing Loss; Orlando De Jesus. Last Update: October 17, 2022.
9. Christopher J Plack 1, Daphne Barker 2, Garreth Prendergast. Perceptual consequences of "hidden" hearing loss. Affiliations expand PMID: 25204468 PMCID: PMC4227662 DOI: 10.1177/2331216514550621.
10. CJ Plack. Perceptual consequences of "hidden" hearing loss – PubMed National Institutes of Health.
11. RJ Tanna Sensorineural Hearing Loss – Hearing loss is a common complaint for which referrals are frequently made to secondary care for an otolaryngologist's attention. PubMed. National Institutes of Health.
12. A Shulman. Subjective Idiopathic Tinnitus and Palliative Care. ScienceDirect 2009 › science › article › pii idiopathic tinnitus from 2009 Cited by 41 — In this article, the term tinnitus refers to subjective idiopathic tinnitus of the severe disabling type (SIT).
13. Shelesko EV, Chernikova NA, Fomochkina LA, Lebedeva MA, Nikonova SD, Doronina VA, Zinkevich DN. Zh Nevrol Psikhiatr Im S S Korsakova. [Principles of diagnosis and treatment of tinnitus]. 2021; 121 (11): 99-105. doi: 10.17116/jnevro202112111199. PMID: 34932294 Russian.
14. Osuji AE. Tinnitus, Use and Evaluation of Sound Therapy, Current Evidence and Area of Future Tinnitus Research. Int Tinnitus J. 2021 Mar 1; 25 (1): 71-75. doi: 10.5935/0946-5448.20210014. PMID: 34410083.
15. Byung In Han, MD, a Ho Won Lee, MD, b Tae You Kim, MD, c Jun Seong Lim, MD, d and Kyoung Sik Shin, MD Tinnitus: Characteristics, Causes, Mechanisms, and TreatmentsJ Clin Neurol. 2009 Mar; 5 (1): 11–19. Published online 2009 Mar 31. doi: 10.3988/jcn.2009.5.1.11. PMCID: PMC2686891.
16. Nondahl DM, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study. J Am Acad Audiol. 2002; 13: 323–331. [PubMed] [Google Scholar].
17. Berrios GE. Musical hallucinations: a statistical analysis of 46 cases. Psychopathology. 1991; 24: 356–360. [PubMed] [Google Scholar].
18. S Y Yang, H Liu, B Wang, W Zhang, B Zhao. Research progress of idiopathic tinnitus. 2019 Aug; 33 (8): 785-789. [Article in Chinese] PMID: 31446743 DOI: 10.13201/j.issn.1001-1781.2019.08.027.