Question: I have been pondering this question lately after something another poster said, as it's not something that ever came up in my admittedly brief conversations with various audiologists over the years. If there is constant low-level tinnitus in the background, will this interfere with discrimination of speech? It's like having constant static in the background and I know that radios are unpleasant to listen to when the station comes in poorly, I just never thought of it happening when it came to tinnitus.

Answer: An interesting question. There are two general types of tinnitus, objective and subjective. Objective tinnitus is a physiological sound made somewhere in the vicinity of the ear, such as a clicking (from myoclonus e.g.) or a swishing (from arterial sources) or the tuning process of the inner ear which is measured by OAEs, etc. These sounds can be heard by others, sometimes. They can interfere with the perception of other sounds.

The more common tinnitus is subjective tinnitus. It is a response of the ear which is a signal sent to the central auditory system (the brain) which is interpreted as sound. It is not actual sound, but is like the flashes of light you see when you press on your eyeball; they are not light, they are the neural reprsentation of light to the brain. Subjective tinnitus is the representation of sound to the brain from a signal sent by the ear, such as a pain signal or a "I'm damaged" signal. When these impulses use the auditory nerve to reach the brain, they are interpreted as sound. Therefore, to answer your question, no, subjective tinnitus does not interfere with hearing speech. It is a symptom that there is some sort of process going on in your ear which results in the hearing loss as well as the tinnitus. The reduction in speech discrimination would be the same whether there was tinnitus or not. BTW, the level of the tinnitus may represent the amount of the hearing loss, but that is not always the case. It is true with my tinnitus, however. The hissing I constantly hear is about 50 dB, which is the same level as my hearing loss at 4KHz.