Tag Archive: Massachusetts Eye and Ear Infirmary

Why can’t you hear?

Photo credit: Helena Lopes from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece in the Canadian edition of Psychology Today asks “Why can’t you hear?,” but a better title might be “Why can’t you understand speech in a noisy room?”

This problem is known in audiology circles as the “speech in noise” problem. People can understand what someone is saying just fine in a quiet room, but can’t follow a conversation in a noisy one. The problem has been known for decades, but now it is thought that the cause is cochlear synaptopathy, also called hidden hearing loss because hearing test results–technically known as pure tone audiometry–are normal despite the patient’s complaints of not being able to hear.

The problem can be assessed clinically by a number of tests, including the Hearing in Noise Test and the QuickSIN test. Now researchers at the Massachusetts Eye and Ear Infirmary have developed two tests, one measuring pupillary responses and the other recording electrical signals from the ear drum.

The inability to understand speech in noise is a frustrating one. Hearing aids usually don’t help much, although newer digital hearing aids with special features claim to do better.

Much better than any hearing aid, though, is preserved natural hearing. Protect your ears. If something sounds too loud, it is too loud. Turn down the volume, use hearing protection, leave the area, or you might have speech n noise difficulty later.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

A test for hidden hearing loss?

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from Science Daily discusses research at the Massachusetts Eye and Ear Infirmary, trying to find a test that will diagnose hidden hearing loss. Hidden hearing loss is hearing loss not detected by routine pure-tone audiometry, so patients complain of being unable to understand speech in normal environments but their hearing test is normal.

Right now, testing for hidden hearing loss is not clinically available, so any test that may help diagnose this common condition would be welcome.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Can’t Hear in Noisy Places? There a reason for that:

Melinda Beck, writing for the Wall Street Journal, examines hidden hearing loss, a condition where people have trouble understanding conversations in noisy situations.  Beck looks at how it differs from traditional hearing damage, reporting that:

[T]here’s growing evidence that the causes of problems processing speech amid noise are different than the causes of problems hearing sound. Scientists believe exposure to loud noises can erode the brain’s ability to listen selectively and decode words, without causing traditional hearing damage. Difficulty understanding speech amid noise can set in long before traditional hearing loss.

The researchers at Massachusetts Eye and Ear Infirmary who discovered hidden hearing loss in mice in 2009 have recently shown that damage occurs in humans as well.  “Exactly how such damage, called cochlear synaptopathy, compromises the ability to understand speech amid noise isn’t fully understood,” writes Beck, but “researchers think cochlear synaptopathy may help explain tinnitus, the persistent buzzing or ringing some people hear, as well as hyperacusis, which is an increased sensitivity to unpleasant sounds such as a baby crying or a siren.”

Apparently many people who may have hidden hearing loss also have traditional hearing loss.  Sadly, there isn’t enough information yet for hidden hearing loss to be part of routine diagnosis of hearing problems, but the research continues.  Until then, audiologists suggest patients who have speech-in-noise difficulties consider hearing aids and other assistive listening devices.

Thanks to Charles Shamoon for the link.