If you hear well in a quiet room, or when talking one-on-one with a friend or family member, but have problems hearing when the television is on in the background, or you’re trying to carry on a conversation in a crowded restaurant, you may actually have a condition that’s recently been described as hidden hearing loss, or HHL.
Why HHL Is So Hard to Diagnose
“As audiologists, patients often come to us because th
ey have problems hearing in noisy environments,” explained Tim Steele, Ph.D., FAAA, President, Associated Audiologists. “This may be their first symptom of hearing loss. But, sometimes when we test their hearing using an audiogram, the gold standard for hearing testing, their hearing test appears to be normal.”
Though the audiogram results may be correct, they may not tell the whole story. Individuals with hidden hearing loss may not be able to hear certain sounds, and the audiogram may not be sensitive enough to detect the hearing loss, resulting in a normal hearing evaluation.
“When someone with HHL is in a quiet environment, they don’t have problems hearing,” Dr. Steele said. “The problem is when a noisy background is added to the listening experience.”
What Causes Hidden Hearing Loss?
We aren’t sure. With hidden hearing loss, the damage is likely located in the nerve cells that connect the cochlea in the inner ear to the brain. The nerve cells lose their connections, or ability to communicate with the hair cells, so they cannot send information to the brain. As a result, the brain receives lesser and poorer quality information from the ear, causing the listener to struggle to hear and to interpret the information correctly.
Because hidden hearing loss doesn’t affect a person’s ability to hear quiet sounds and usually cannot be detected using standard hearing tests, it may be significantly under-diagnosed.
We are still learning about hidden hearing loss, but it does look like loud noise may be a culprit, as well as damage to nerve cells in the inner ear are at least partially responsible for the problem. Wearing hearing protection and limiting exposure to loud noises may be one key to reducing the risk of hidden hearing loss.
Take This Test to See if You Have Hidden Hearing Loss
You can test how well you understand speech in a noisy environment using a special online exercise prepared for the Associated Press in conjunction with the Mailman Center for Child Development at the University of Miami.
To take the test, click here. You will be asked to repeat a series of sentences. The exercise begins in quiet, but then slowly introduces background noise. The noise comes in six levels, faint at first but eventually louder than the words. People with hidden hearing loss will start to have some trouble understanding the words at the second or third level, the AP reported.
Get a Comprehensive Hearing Exam
If you think you may already have hidden hearing loss, you should see an audiologist and tell them about your problems hearing. It’s important to have a comprehensive hearing examination for two reasons:
First, a hearing evaluation establishes a baseline so that we know how well you are hearing at a specific point in time, and we can compare future exams to this test.
Second, you may not have hidden hearing loss. Instead, you may have noise-induced or measurable high-frequency hearing loss, and may benefit from wearing hearing aids. Or, you could have conductive hearing loss which is usually associated with a medical issue that needs to be addressed, such as impacted earwax.
