Margaret Mugo

Hidden Hearing Loss: A Step Beyond Traditional Audiometric Tests When you report a hearing problem to a healthcare provider, they will probably ask about your noise exposure and examine your ears as part of routine care. It is not uncommon for people to have their hearing tested and told it is normal, yet they continue to suffer from an undiagnosed hearing problem.  The NIDCD or National Institute on Deafness & Other Communication Disorders denotes that 15% of American adults, approximately 37.5 million people, have hearing difficulty. The statistics further reveal that speech-frequency hearing loss occurs in about 18% of Americans aged between 20 and 69. Here, we shall define hidden hearing loss and highlight three different ways to diagnose it. Definition Hearing loss that is not detected by a standard audiogram is called hidden hearing loss. If you have this condition, the audiogram will represent a normal hearing curve. There are several causes of hidden hearing loss and the most common are aging, noise exposure, peripheral neuropathy, and ototoxicity. How to Detect Hidden Hearing Loss Knowing what conventional audiometric tests look like will help you better understand hidden hearing loss. Traditional exams mainly focus on tympanometry, pure-tone audiometry, air conduction and bone conduction, and speech-in-quiet. They never detect peripheral hearing loss (lack of detection of sound), yet, you'll continue enduring hearing difficulty in noisy places. Listening and concentrating can be difficult sometimes. So, what approaches can be used to diagnose hidden hearing loss?   I.    Extended High-Frequency Audiometry  The normal range of hearing is 20 hertz to 20,000 hertz. Standard audiogram scores are plotted between 250 and 8,000 Hz. However, through extended (ultra) high-frequency audiometry, we can test up to 20,000 Hz to see if there's a deficit or a reason behind the underlying issue. II.    Speech-in-Noise Testing Speech-in-noise is the ability to grasp a message and repeat it despite background noise. When you visit Comprehensive Hearing Solutions, we test your ability to perceive speech in noisy environments. There will be background noise, so we shall ask you to identify spoken words. Note that the hearing process starts with awareness in Erber's Hierarchy of Auditory Skills, i.e.  1.    Awareness 2.    Discrimination 3.    Identification 4.    Comprehension The continued hearing difficulty usually comes in somewhere between the identification and comprehension stage.  III.    Auditory Processing Tests Depending on the results of the speech-in-noise testing, we might consider checking your ears for other hearing problems. In this approach, we look at:  •    Your ability to extract a message from a complex environment •    We also look for abnormalities after introducing rapid speech, muffled speech, speech with noise, or different speech in each ear at the same time •    Any auditory processing disorder  That said, it is advisable to consult an audiologist who will examine your ears beyond the routine tests to figure out if you have any hidden hearing loss. Contact us if you are in Houma, LA, and the surrounding boroughs. We also treat patients throughout the state. Might you be experiencing hidden hearing loss? Don't hesitate to call Comprehensive Hearing Solutions. Our specialists are ready to resolve any dilemma you may have.   When you report a hearing problem to a healthcare provider, they will probably ask about your noise exposure and examine your ears as part of routine care. They may refer you to a specialist even if your audiometric thresholds are within the normal range. Standard hearing tests do not show any sign of hidden hearing loss. Most people fall in the normal audiogram category, yet they endure continued hearing difficulty. The NIDCD or National Institute on Deafness & Other Communication Disorders denotes that 15% of American adults, approximately 37.5 million people, have hearing difficulty. The statistics further reveal that speech-frequency hearing loss occurs in about 18% of Americans aged between 20 and 69. Here, we shall define hidden hearing loss and explain the different ways to diagnose it. Definition Hidden hearing loss is when you have a hard time understanding speeches in noisy environments, even though you have a normal hearing ability. The condition is undetectable through typical audiometry exams. In that case, the audiogram will represent a normal hearing curve. There are causes of hidden hearing loss and the most common are aging, noise exposure, peripheral neuropathy, and ototoxicity. How to detect hidden hearing loss Knowing what conventional audiometric tests look like will help you better understand hidden hearing loss. Traditional exams mainly focus on tympanometry, air conduction and bone conduction, and speech-in-quiet. They never detect peripheral hearing loss (lack of detection of sound), yet, you’ll continue enduring hearing difficulty in noisy places. At Comprehensive Hearing Solutions, the majority of patients we see have difficulty listening and concentrating. Here are some approaches we use to diagnose hidden hearing loss. I. Extended high-frequency audiometry The normal range of hearing is 20 hertz to 20,000 hertz. Standard audiogram scores are plotted between 250 and 8,000 Hz. However, through extended (ultra) high-frequency audiometry, we can test up to 20,000 Hz to see if there’s a deficit or a reason behind the underlying issue. II. Speech-in-noise testing Speech-in-noise is the ability to grasp a message and repeat it despite background noise. When you visit Comprehensive Hearing Solutions, we test your two ears separately using speech as the background noise. As you repeat the speech, we also examine your signal-to-noise ratio (SNR) and compare it to the ideal hearing ability. Note that the hearing process starts with awareness in Erber’s Hierarchy of Auditory Skills, i.e. 1. Awareness 2. Discrimination 3. Identification 4. Comprehension The continued hearing difficulty starts somewhere between the identification and comprehension stage. Depending on the results of the speech-in-noise testing, we might consider testing your ears for other auditory processing tasks. I. Auditory processing tests In this approach, we look at: Your ability to extract a message from a complex environment We also look for abnormalities after introducing rapid speech, muffled speech, speech with noise, or different speech in each ear at the same time Any auditory processing disorder That said, it is advisable to consult an audiologist who will examine your ears beyond the routine tests to figure out if you have any hidden hearing loss. Talk to us if you are in Houma, LA, and the surrounding boroughs. We also treat patients throughout the state.