Dissertations, Theses, and Capstone Projects

Date of Degree

9-2023

Document Type

Capstone Project

Degree Name

Au.D.

Program

Audiology

Advisor

Donald Vogel

Keywords

hidden hearing loss, cochlear synaptopathy, King Kopetzky Syndrome, speech in noise, normal hearing adults

Abstract

Background: Adults reporting speech in noise difficulties yet have audiometrically normal hearing is a common finding in the audiology clinic and are a subject of a recently popular and expanding area of research. Yet, there is still no clear and decisive test battery to diagnose, validate, and manage this disorder in the adult population. The lack of a clear protocol can cause dissatisfaction for both the patient and the clinician.

Objective: The objective of this study is to comprehensively review the existing literature on Hidden Hearing Loss (HHL) in audiology. The study aims to address the lack of consensus and guidance on the assessment and management of HHL. By synthesizing available research, this review seeks to provide audiologists with a consolidated source of information for effectively managing individuals with HHL. Additionally, the study endeavors to shed light on the current diagnostic methods and tools used by audiologists to assess HHL, explore available treatment options, identify gaps in the existing research, and outline research priorities for the future advancement of the field.

Methods: A scoping review was conducted through a comprehensive search using The CUNY Graduate Center Library OneSearch tool which encompasses a wide range of databases. Key words such as “hidden hearing loss” and “speech in noise difficulty,” etc., were used. Inclusion v criteria were articles related to HHL published from 2010 until present. Articles were then reviewed in full to determine their relevance to diagnosis and management of HHL.

Results: Thirty-four sources were identified to meet the inclusion criteria. Of the 34 articles, twenty-four articles related to diagnosis of HHL and seven related to the management and counseling of HHL. The diagnostic tools mentioned were auditory brainstem response, speech in noise testing, high frequency audiometry, SP/AP ratio of electrocochleography, frequency-following response, middle ear muscle reflex, thresholds in noise test, tests of central auditory processing disorder, tests of binaural listening, self-report questionnaires, cognition assessment, high-definition audiometry, digits in noise test, and gap detection test. The management tools mentioned included the use of hearing aids, auditory training, and counseling.

Conclusions: The review demonstrated that limited research exists on diagnosis and management of HHL in the clinic. Various diagnostic tools have been explored, each with strengths and weaknesses. To address HHL's complexity, a multi-test battery approach is recommended. While hearing aids and auditory training show potential, a standardized HHL management protocol, paralleling CAPD, remains an essential research need.

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