Hidden Hearing Loss
What it is and how to help patients who maybe struggling.

What is it?
Hidden hearing loss (HHL) is characterized by an audiogram that reflects normal hearing sensitivity across all frequency ranges but speech-in-noise tests reveal a deficit. In the case of HHL, the stereocilia are healthy but auditory nerve fibers are damaged, resulting in a compromised connection between the ears and the brain. Patients will report difficulty understanding others.

What causes it?
Damage to the nerve fibers, usually from noise exposure, often combined with aging. HHL is caused by a problem in the peripheral auditory system, whereas an auditory processing disorder is due to a deficit in the central auditory system.

Hidden Hearing Loss: In a study of more than 100,000 patient records over a 16-year period, approximately 10% of patients who visited the study’s specified audiology clinic received normal audiograms, despite hearing complaints.

What are the symptoms?

  • Hearing people incorrectly
  • A preference for conversations in quiet settings
  • Feeling easily distracted or unable to focus in noisy settings
  • A strong sense that you have hearing loss, even after passing a hearing test

How do you test for it?
HHL can be revealed by additional testing, so we encourage a referral to an Audiologist.

What treatments are available?
Patients can benefit from state-of-the art hearing aids that have “speech in noise” settings, which use directional microphones to pick up the signal in front of the patient and reduce sound behind them. Research is also underway to find medications that would prompt neurons to grow new synapses – providing a direct solution. We also encourage patients to take advantage of ADA-required assistive listening devices in theaters, places of worship, airports and other public spaces.

Like any kind of hearing loss, HHL can have an effect on a patient’s mental state an psyche, creating avoidant behavior and/or social anxiety. “Our goal is to help patients hear to the best of their ability, and we take time to address each individual’s symptoms in order to diagnose and offer them the best treatment available.” says Dr. Sophia Escobar, Director of the Florida Center for Hearing Health – a division of Florida E.N.T. & Allergy.