OBJECTIVES: To evaluate speech-in-noise and spatial listening performance in patients with tinnitus by examining the potential contributions of top-down and bottom-up processes.
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists should assess both peripheral hearing function and cognitive/attention factors when evaluating speech-in-noise difficulties in tinnitus patients, as this study reinforces that top-down processing deficits contribute independently of audibility.
Distinguishing the relative contributions of bottom-up and top-down auditory processing in tinnitus helps explain why some patients struggle in noise even with near-normal audiograms and may guide more targeted rehabilitation strategies.
- 01Tinnitus patients showed speech-in-noise and spatial listening deficits beyond what audiograms predict.
- 02Both top-down (cognitive/attentional) and bottom-up (peripheral auditory) processes contributed to difficulties.
- 03Published in Ear & Hearing (2026); adds mechanistic detail to existing tinnitus-cognition literature.
- 04Spatial listening performance was also evaluated, broadening the scope beyond standard SIN tests.
- 05Findings suggest tinnitus rehabilitation may need to address cognitive load, not just amplification.
Individuals with tinnitus show impaired speech perception in noise due to both top-down and bottom-up auditory processing deficits.
studypartially supportedSpatial listening performance is reduced in tinnitus patients.
studypartially supported- PMID
- 42878672
- DOI
- 10.1097/AUD.0000000000001896.
- Journal
- Ear and Hearing
- Publication type
- research_article
- Evidence level
- 3
- Population
- Individuals with tinnitus compared to normal-hearing controls
- Intervention
- Assessment of speech-in-noise and spatial listening performance in tinnitus
- Comparator
- Normal-hearing controls (implied)
Primary outcomes
Speech perception in noise performance; Spatial listening performance; Relative contributions of top-down and bottom-up auditory processing