Older adults often complain about having difficulty understanding speech in noise, despite clinically normal hearing (D-SiN-NH). Two otopathologies known to decline with age and that are not reflected in the conventional audiogram are extended high-frequency (EHF) hearing impairment and cochlear synaptopathy (CS), both hypothesized to be responsible for D-SiN-NH....
Extended high-frequency audiometry and cochlear synaptopathy measures may help explain speech-in-noise difficulties in patients with normal standard audiograms, but routine clinical adoption requires further validation before practice change is warranted.
This study advances understanding of why patients with clinically normal audiograms still report hearing difficulties, potentially reshaping how audiologists evaluate and counsel this population.
- 01Targets adults with normal conventional audiograms who nonetheless experience hearing difficulties.
- 02Examines the role of cochlear synaptopathy (hidden nerve damage) alongside age-related factors.
- 03Includes extended high-frequency (EHF) hearing measures beyond the standard audiogram range.
- 04Speech-in-noise perception is a core outcome, reflecting real-world hearing challenges.
- 05Published in Hearing Research, a peer-reviewed audiology journal.
Age, speech-in-noise perception, extended high-frequency hearing, and cochlear synaptopathy are interrelated in adults with normal audiograms.
studypartially supportedCochlear synaptopathy contributes to hearing difficulties in individuals who pass standard audiometric screening.
studypartially supported- PMID
- 42284997
- DOI
- 10.1016/j.heares.2026.109706.
- Journal
- Hearing Research
- Publication type
- research_article
- Evidence level
- 2b
- Population
- Adults with clinically normal audiograms
- Intervention
- Assessment of age, extended high-frequency hearing, and cochlear synaptopathy measures
Primary outcomes
Speech-in-noise perception; Extended high-frequency hearing thresholds; Cochlear synaptopathy markers