Some cases of hearing loss can be more difficult to detect and diagnose than others. This can make the problem of hearing loss more frustrating for individuals that have engaged in a standard hearing test but have been confused by the results. You or a loved one may have partaken in a standard hearing test and been told that hearing abilities are “within normal limits”, but hearing issues are still persisting.
What is Hidden Hearing Loss?
Hidden hearing loss refers to any type of hearing loss that is not detectable through routine diagnostic testing. The results of the audiogram may even show normal hearing sensitivities at all frequencies. Typical hearing loss often revolves around damage to the hair cells in the inner ear which are responsible for detecting sounds to be passed on and interpreted by the brain.
When hidden hearing loss occurs, the hair cells in the ear are generally unharmed which is why the audiogram comes back normal. Instead, the damage is to the auditory nerve fibres responsible for carrying sound messages to the brain.
Signs of Hidden Hearing Loss
Hidden hearing loss can be quite difficult to recognize due to the fact that it generally does not show up during standard testing. While there is no official set of fixed symptoms that occur with hidden hearing loss, there are some common signs to be on the lookout for.
- Being easily distracted or having difficulty focusing in busy environments
- Feeling more comfortable in quiet surroundings for social interaction
- Difficulty interpreting speech or mishearing words and sentences
- Belief that hearing loss is an issue even after passing standard testing
Causes of Hidden Hearing Loss
Persistent exposure to loud noise, advanced age, or a combination of the two is typically the culprit of hidden hearing loss. Even prolonged exposure to low-level noise can result in hidden hearing loss. Brain injuries and head trauma can also be contributing factors. Autoimmune disorders that cause damage to neuronal axons and auditory nerves can also have an impact.
Whatever the external factors may be, the end result is damage to the nerve cells in the ear. This makes it challenging to discern specific sounds in noisy or active environments. Nerve cells lose their connection to hair cells in the ear disrupting the path of communication. This broken path results in incomplete information reaching the brain, making accurate interpretation of the sounds more difficult.
Diagnosing Hidden Hearing Loss
The first step is to take a standard hearing test to make sure the results indicate that hearing abilities fall “within normal limits”. The next step involves testing for speech detection in noisy settings, as wells as audiometry and high-frequency testing. These tests often involve repeating back statements given in varying levels of background noise. Hidden hearing loss may also be detected with an Auditory Brainstem Response test (ABR).
Treating Hidden Hearing Loss
Once hidden hearing loss has been accurately diagnosed by a professional, there may be a few options for treating the problem. The most widely used treatment is hearing aids. In particular, hearing aids with noise reduction capabilities and speech-in-noise settings are the most effective. Hearing aids with speech-in-noise settings use directional microphones to focus on sound signals close to you while reducing background noise. Assistive listening devices also may be helpful, such as a personal FM system or a mobile app that provides live captioning for active conversations.