Hidden hearing loss is real. Here’s what you need to know

Photo credit: Karolina Grabowska

by Daniel Fink, MD, Chair, The Quiet Coalition

ABC 7 news in Los Angeles recently covered the topic of hidden hearing loss. I was thrilled to see this, as most members of the public, even many primary care physicians, don’t know about hidden hearing loss. What is hidden hearing loss? It is the difficulty many adults in mid-life and later have in following and understanding one conversation among many, like when they are dining with friends or family in a noisy restaurant. Why is it considered “hidden”? It’s because the problem isn’t found on routine hearing tests.

When a person realizes that they can’t follow a conversation at the table, they see a physician or audiologist, have a hearing testing done and are often told that their hearing is normal. This is frustrating for both patient and hearing health care provider, because both know that there’s a problem. ABC 7 reports that a study shows that one in 10 people with normal hearing have hidden hearing loss, but other studies suggest that the problem is more common than that in mid-life. Fortunately, research over the last decade or so has provided some insight into the diagnosis, and offered some easy steps to prevent hidden hearing loss.  I found helpful articles by Martin Pienkowski, Charles Liberman et al., and Dan Guo and Sharon Kujawa.

It’s almost certain that hidden hearing loss is caused by damage to the synapses. These are connections between the basic sensory receptors in the ear, the cochlear hair cells and the auditory nerve fibers that carry electrical impulses from the ear to the brain where they are perceived as sound. Additional testing, called speech-in-noise testing, documents the hearing problem.

Unfortunately, there’s no specific treatment for hidden hearing loss. Hearing aids don’t help as much as desired, even with directional and tunable features, because they tend to amplify all noise. Fortunately, as the ABC 7 story states, hidden hearing loss can be prevented. Avoid loud noise exposure, turn down the volume, leave the noisy venue or use hearing protection and your ears should last a lifetime.

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