Chirp-Evoked Electrocochleography and Speech-in-Noise Performance in Normal-Hearing Individuals With Tinnitus

Both tinnitus and poor hearing-in-noise performance have been proposed as perceptual consequences of cochlear synaptopathy, which can occur in the absence of significant hearing loss. However, to date, no study has investigated chirp-evoked electrocochleography (ECochG) measures or examined the relationship between action potential (AP) amplitude and speech perception in noise (SPIN) performance in normal-hearing...

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

If chirp-evoked electrocochleography findings support cochlear synaptopathy as an underlying mechanism linking tinnitus and speech-in-noise difficulty in normal-hearing individuals, clinicians should consider synaptopathy screening in tinnitus patients who complain of poor speech-in-noise performance despite normal audiograms.

✦ Why It Matters ✦

Establishing cochlear synaptopathy as a shared mechanism for tinnitus and speech-in-noise deficits in normal-hearing individuals could reshape how audiologists assess and counsel this underserved patient group.

✦ Key Points ✦

01Participants had clinically normal audiograms but reported tinnitus, representing a 'hidden hearing loss' population.
02Chirp-evoked electrocochleography was used to probe cochlear synaptopathy (damage to nerve connections in the inner ear).
03Speech-in-noise performance was measured alongside electrocochleographic responses.
04The study tests whether tinnitus and speech-in-noise difficulty share a common cochlear origin.
05Published in Journal of Speech, Language, and Hearing Research (JSLHR), a high-quality audiology peer-reviewed journal.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Cochlear synaptopathy may be a shared underlying mechanism for tinnitus and reduced speech-in-noise performance in normal-hearing individuals.

studypartially supported

Chirp-evoked electrocochleography can detect cochlear synaptopathy in individuals with normal audiometric thresholds.

studyunclear

✦ Research metadata ✦

PMID: 42616476
DOI: 10.1044/2026_JSLHR-25-00605.
Journal: Journal of Speech, Language, and Hearing Research
Publication type: research_article
Evidence level: 2b
Population: Normal-hearing individuals with tinnitus
Intervention: Chirp-evoked electrocochleography
Comparator: Normal-hearing individuals without tinnitus (assumed)

Primary outcomes

Electrocochleographic measures of cochlear synaptopathy; Speech-in-noise performance scores

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