Tinnitus can occur in individuals with clinically normal audiograms, suggesting that conventional threshold-based measures may not capture subtle auditory-system differences. This study aimed to characterize peripheral and subcortical auditory function in tinnitus using a multidomain, exploratory multivariate framework.
✦ The floor
Discussion
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Including extended high-frequency audiometry (testing above 8 kHz) in tinnitus evaluations may reveal subtle cochlear differences missed by standard audiograms, though routine adoption awaits further validation in larger prospective studies.
Demonstrating measurable auditory-system differences in 'normal-hearing' tinnitus patients challenges the assumption that a normal audiogram rules out cochlear pathology, potentially reshaping tinnitus assessment protocols.
- 01Tinnitus patients with clinically normal audiograms still show multidomain auditory differences detectable with extended testing.
- 02Extended high-frequency (EHF) hearing thresholds (above 8 kHz) revealed subtle deficits not captured by standard audiometry.
- 03Multiple auditory domains (e.g., threshold, temporal processing) were examined to characterise the differences.
- 04Results suggest the standard audiogram is insufficient to fully characterise auditory function in tinnitus.
- 05Findings support using EHF audiometry as part of tinnitus workup to detect subclinical cochlear involvement.
Tinnitus patients with clinically normal standard audiograms exhibit measurable auditory differences across multiple domains when extended high-frequency hearing is assessed.
studysupportedExtended high-frequency audiometry detects subclinical auditory abnormalities in normal-audiogram tinnitus patients that standard testing misses.
studysupportedA clinically normal audiogram does not rule out underlying cochlear pathology in tinnitus patients.
studypartially supported- PMID
- 42862891
- DOI
- 10.1044/2026_JSLHR-26-00071.
- Journal
- Journal of Speech, Language, and Hearing Research
- Publication type
- research_article
- Evidence level
- 2b
- Population
- Adults with tinnitus and clinically normal audiograms
- Intervention
- Multidomain auditory assessment including extended high-frequency audiometry (above 8 kHz)
- Comparator
- Standard audiogram findings / control participants without tinnitus
Primary outcomes
Auditory thresholds across standard and extended high-frequency ranges; Multidomain auditory differences between tinnitus and non-tinnitus groups; Detection of subclinical auditory-system abnormalities