What is hidden hearing loss and how do you tell if you have it?

Photo credit: Helena Lopes

by Daniel Fink, MD, Chair, The Quiet Coalition

“What is hidden hearing loss and how to tell if you have it?” is the title of this well-written article by reporter Kacie Goff on the CNET site. I’m glad this little-known but quite common auditory disorder is getting some attention. 

Hidden hearing loss manifests as difficulty following one conversation among many in a noisy environment, like in a restaurant. It is called hidden hearing loss because when the patient seeks professional attention for this annoying problem, the audiogram is normal. Noise-induced damage to the connections between cochlear hair cells, the basic sensory organs for hearing, and the nerves leading to the brain is the likely cause of hidden hearing loss.

Goff refers to this new report from researchers at the Massachusetts Eye and Ear Infirmary, which found that about 10% of adults seen there had hidden hearing loss. That number seems low to me. I have seen other reports estimating that 20-40% of middle-aged adults have this condition. This article from the same institution is also a good resource, as is this older one by Martin Pienkowski at Salus University in suburban Philadelphia.

Goff offers a few suggestions, including asking to be seated in a booth when in a noisy restaurant. She then notes that hearing health professionals have little to offer those with hidden hearing loss. Hearing aids generally don’t help because even newer digital hearing aids with directional features amplify too much background sound to allow one to follow a single conversation among many.

Like many adults, I have trouble hearing what my dining companions are saying in noisy places. High ambient noise levels are a disability rights issue for those with auditory disorders and a senior rights issue due to the high prevalence of hearing loss in older people. Sometimes my requests to turn down the volume from rock-concert levels to background-music levels are successful, but sometimes not. Even if the volume of the music is lowered,  the din of happy diners talking, reflected from walls and ceilings, is too loud anyway.

Designing an acoustically pleasing restaurant is a difficult task. The ambient noise must be sufficient to mask conversations at other tables, but not so loud as to make it difficult to hear what people at your table are saying. Regardless, lower ambient noise levels in restaurants and other public places will benefit everyone, from those of us with hidden hearing loss to parents trying to understand what their toddler is saying.

A quieter world will be a better and healthier world for all.

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