What is Hidden Hearing Loss?

How would you feel if you knew you were experiencing hearing loss with signs such as trouble hearing in noisy environments, or frequently mishearing words but were told you had normal hearing? This happens every day for so many people. They recognize the signs of hearing loss, schedule a hearing evaluation, and then are told their results are showing normal hearing.
These days, hearing healthcare providers recognize that there is more to the story than the black and white results of a test. It may be a case of hidden hearing loss.
“Normal hearing” can be misleading
When testing for hearing loss, normal hearing is considered anything that falls within the “audiometric zero” range. This has been defined as the lowest level of sound that people can hear and ranges from 0 dBHL (Decibel Hearing Level) and below to about 20 dBHL and was determined when researchers tested the hearing of thousands of attendees at the 1933 World’s Fair in Chicago. A hearing evaluation tests whether or not hearing falls within this range. Inside the range is considered normal hearing, and outside is diagnosed as hearing loss.

  • Hearing loss of 20 to 40 decibels = mild hearing loss
  • Hearing loss of 41 to 60 decibels = moderate hearing loss
  • Hearing loss of 61 to 80 decibels = severe hearing loss
  • Hearing loss of more than 81 decibels = profound hearing loss

Any loss over 40 decibels is considered a hearing impairment.
This can be misleading, though.
Experts now believe that nearly 26 million American adults diagnosed with “normal” hearing have what has become known as hidden hearing loss.
Recognizing hidden hearing loss
Hidden hearing loss has been known by more than one name over the years, including obscure auditory dysfunction, King-Kopetzky syndrome, even auditory processing disorders. It is now top of mind for many hearing experts working to help patients uncover and treat hearing loss. This includes:

  • A broader view of hearing loss outside the traditional “audiometric zero” range, recognizing that even a subtle loss of 5 dBHL can prove challenging for an individual.
  • More comprehensive hearing evaluation tools that dig deeper into a patient’s hearing in various situations. Some experts recommend enhanced tools such as the Client Oriented Scale of Improvement (COSI) and the Hearing Handicap Inventory for Adults (HHIA).
  • More comprehensive guidance to help patients manage their hidden hearing loss beyond simple physical strategies (lighting changes, etc.) to offer targeted solutions such as hearing aids with programming designed to help with their specific frustrations.

There is no doubt that more research and a better understanding of hidden hearing loss is needed. As more is learned about hidden hearing loss and how best to diagnose and treat it, hearing healthcare providers and patients will both benefit.
If you’re having difficulty hearing conversations, have ringing in your ears or similar signs of hearing loss, contact your hearing health professional today to schedule a hearing evaluation. During the evaluation your provider can evaluate your hearing and determine how best to treat a hearing loss.

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