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Do you struggle to hear in noisy environments or while watching TV with background music? Have you ever been SURE there is something wrong with your hearing only to be told after a hearing test that your hearing is “normal”, or that your hearing is “just fine”?

This can be a very confusing experience, because obviously SOMETHING is going on. So what could it be?

We call this phenomenon “Hidden Hearing Loss” or Cochlear Synaptopathy

Hidden hearing loss refers to hearing damage within the cochlea (inner ear) that is minimal . In other words, a person does have some damage to their inner ear structures, but not enough to affect how softly they can hear a sound. As a result, while the volume of the sound they are hearing is unaffected, the clarity of the sound is compromised. This type of hearing loss is coined “hidden” because it is not detectable with traditional hearing testing and must be further evaluated with other types of audiometric testing.

If you suspect that you may have hidden hearing loss and have had a “normal” hearing test report, it may be worth asking your audiologist to add one or both of the following tests to your test battery to determine if there could be some hidden hearing loss present: 

1) Otoacoustic Emissions (OAEs)

OAE testing evaluates the structural integrity of the hearing organ (the cochlea). It’s quick and requires no participation on behalf of the person being tested; you simply need to sit still and quiet for about 1 minute per ear. OAE testing cannot tell us specifically how a person hears each frequency on the test, but it can help us identify damage to the Outer Hair Cells (OHC) in the Cochlea. A person could have up to 40-50% OHC loss at a particular hearing frequency before any hearing loss were to show up on a traditional hearing test! This amount of lost input could be a reason for distortion of clarity of speech sounds when in the presence of background noise. 

2) Speech in Noise Testing (i.e., SIN, Quick-SIN, AzBio) 

Speech in Noise testing is essential in helping to understand the level of difficulty a person has when in an environment like a restaurant or other social outing where there is a lot of background noise. Speech in Noise testing is set up where the patient is asked to repeat short sentences in the presence of competing background noise. The volume level of the background noise increases as the sentences continue, and the clinician is measuring the Signal-to-Noise Ratio at which the person is no longer reliably able to repeat the sentences. The measurement is then compared to normative data to determine the level of potential hidden hearing loss. 

What to do about hidden hearing loss

Get a comprehensive hearing evaluation from an audiologist. This is a must-do! Understanding your level of hearing difficulty is key. Are you struggling to hear in noisy environments because you have Hidden Hearing Loss OR do you have a traditional loss of hearing? This will help determine treatment outcomes later on.

Be sure to (1) ask when scheduling your hearing test if the clinic offers additional testing like OAEs or Speech in Noise testing and (2) make sure to have those tests performed during your visit. 

If your test results reveal traditional types of hearing loss:

  1. Discuss with your audiologist the appropriate types of hearing aids which might benefit you to assist with improvement in clarity of speech sounds…like Eargo!

If your test results reveal normal hearing with reduced OAEs and difficulty on the Speech in Noise testing:

  1. Protect your hearing when you are around loud noise since there is now established data showing some minor damage to your cochlea. Help to reduce future damage by avoiding exposure to loud noises or utilizing hearing protective devices (i.e., earplugs) when appropriate.

  2. Improve communication strategies with friends and family (i.e., reduce background noise, minimize distance between the speaker and listener, have clear visual of the speaker’s mouth, good lighting and have the speaker talk at a slower rate rather than a louder volume)

  3. Consider low-gain amplification/hearing aids for situations where you are struggling to hear (i.e., restaurants/TV/social outings)...yes, Eargos may help here, too!

Hearing aids for “hidden” hearing loss

If you have perceived mild to moderate hearing loss associated with “hidden” hearing loss, low gain hearing aids help to improve your Signal-to-Noise Ratio by amplifying the speech signal and applying noise reduction technology to reduce competing background noise. This can significantly help reduce the distortion of clarity a person with hidden hearing loss may be experiencing. 

Noise reduction technology can be automatically applied in a hearing aid with Eargo’s Sound Adjust (Eargo 6) and Sound Adjust+ (Eargo 7) technology—as well as manually adjusted with the use of app controls! This allows the hearing aid user to select when they may need more or less noise reduction to assist their hearing ability in specific environments.

Other app controls, like volume control, may also be helpful for those with hidden hearing loss to maintain comfortable levels of amplification of sounds in the environment. 

Eargo 5, Eargo 6, and Eargo 7 are over-the-counter (OTC) hearing aids that are self-fitting with our Sound Match technology. That means that there are no traditional in-office visits required to fit or adjust them. You can do it all from home, in about 15 minutes. These FDA-cleared hearing aids account for the wearer’s ability to hear soft sounds without over amplifying sounds in the environment in order to maintain safe and comfortable listening levels. The settings continue to offer assistance for improving clarity of speech.

Those with hidden hearing loss would likely NOT need to wear hearing aids full time, but could benefit from them in situations where they are struggling to hear speech clearly (i.e., restaurants, social outings, movies etc.). And with our virtually invisible, comfortable design, a lower-cost hearing aid option like Eargo is a great choice over a traditional BTE (behind-the-ear) hearing aid!

All Eargos come with a 45-day risk-free trial period and free lifetime support from our team of hearing professionals. That includes a 1-on-1 Welcome Call to help you get set up, answer any questions that you have, and ensure that you are set up for hearing success.

Questions? We’d love to answer them for you. Give us a call at 1 (800) 903-6883.