Ping Tinnitus Survey
Tinnitus (or 'ringing in the ears') describes the general sensation of noise which is only perceived by the individual experiencing it. There are various categories of tinnitus. It may be continuous, like an unbroken sound (analogy the sound of cicadas), or to some extent pulsating (as if triggered or modulated by periodic heart beat, having complex sound patterns).

This questionnaire is concerned with another class of aural sensation which is not generally continuous, nor strictly periodic. It appears as one-off events, which may even occur relatively frequently and may be accompanied by non-audible sensations. Rather than being too specific we are trying to allow for respondees to define such a sensation from their experience. By all means submit further responses if you have more considered views to add.

This form of tinnitus has been coined the name "Ping" tinnitus (also known as Spontaneous tinnitus) is like other forms of tinnitus, since it is heard without there being an actual sound in the environment. Being short-lived, the Ping mostly does not cause the kind of trauma that some tinnitus sufferers report. It seems to be experienced by people with and without other types of tinnitus. Indeed many people reading this may only now recognise "ping" tinnitus as something they have experienced, but ignored, for years. Although it is a common painless experience, there is much which we could still learn about the phenomenon, particularly the mechanisms which give rise to it. Please work through the questions, making selections or comments as required, and when you are satisfied, press the submit button.

Your response is completely anonymous unless you choose otherwise. However, if you would like to receive the results of the survey when they are published, or if you would be willing to participate in a more detailed survey, you can leave a name and email address. Your survey responses will still be treated in complete confidence.

Eric L. LePage, Ph.D. Research Scientist


[The format and general content of this survey received Ethics Committee approval at National Acoustic Laboratories, 2003. In this 2011 revision, all Yes/No answers are treated as "No" unless "Yes" is chosen. ]
Is this the first time you have responded to this questionnaire? *
DEMOGRAPHICS
Your Age *
Gender *
Occupation
Country *
ZIP / Postal Code
Why PING tinnitus?
Why do we make a distinction between tinnitus which is more or less continuous and transient type
Is the idea of ping tinnitus new to you? *
i.e. ping tinnitus being temporary vs continuous tinnitus
About how often do you register hearing a Ping? *
Does the ping seem to happen in episodes or clusters - more at some times than others? *
Contributing factors to Episodes/Clusters
If Yes, please describe any factor (e.g. a sound, state of health or tiredness) you think may have contributed ?
Which Ear? *
Ear exclusivity: How often does the ping occur in both ears simultaneously? *
What Sound? *
How long does it last? *
What's the longest duration you can recall? *
Numbness or temporary deafness
Is there feeling of numbness or slight deafness before the Ping? *
Duration before?
If Yes, describe for how long the numbness or slight deafness lasts before the Ping
Is there feeling of numbness or slight deafness during the Ping? *
Duration during?
If Yes, describe for how long the numbness or slight deafness lasts during the Ping
Is there feeling of numbness or slight deafness after the Ping? *
Duration after?
If Yes, describe for how long the numbness or slight deafness lasts after the Ping
Do these pings occur without any such early warning sign? *
Does the brief numbness ever occur without the ping? *
Do you often experience more prolonged feelings of fullness in one or other ear? If so, please describe.
e.g. the feeling of pressure as if water is trapped in your ear.
General health
What is your general state of health? *
Please rate your general stress level *
On average how much exercise do you do? *
e.g. general level of fitness, including walking, gardening
Do you experience giddiness? *
Including faintness, dizziness, loss of balance, vertigo
Sound exposure
Please rate your life-long level of noise/music exposure *
e.g. industrial noise, heavy music exposure, headphone/button earphones
Classes of medications used over last ten years
Please indicate if you use blood pressure medication *
Please indicate if you use medication for central nervous system *
e.g. Epilepsy, Memory loss
Please indicate if you use oral medication for ear *
Please indicate if you use medication for pain and consciousness *
Looking to roughly assess both frequency and extent
Please indicate if you use medication for endocrine management *
e.g. hormone replacement or supplement
Please indicate if you use medication for reproductive or urinary system *
Including diuretics and prostate treatments
Please indicate if you currently use medication for infections, inflammation *
e.g. antibiotics, nsaids
Please indicate if you currently use medication for allergies *
Please rate your level of exposure to toxic substances *
e.g. industrial solvents, heavy metals
Hearing history
Do you have any hearing loss in your left ear? (If yes, describe)
Do you have any hearing loss in your right ear? (If yes, describe)
Do you experience any constant degree of tinnitus? (If yes, describe)
Please make any comments or ask questions which you feel might be useful
How did you learn of this survey?
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Please enter approximate number of minutes taken to fill out this questionnaire
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OPTIONAL
I indicate below my position in regard to further research on this question
Name
Email Address
Please notify me when the results of this survey are published
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I am available to be approached for more details on any answers I have given
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I would like to participate in a more detailed survey designed for auditory specialists and trained musicians
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