The Relation Between Cochlear Neuropathy, Hidden Hearing Loss and Obscure Auditory Dysfunction Sensorineural hearing loss is typically defined by threshold elevation, often resulting from dysfunction of cochlear outer hair cells. Damage can occur as a result of ageing and noise exposure, reducing auditory sensitivity, and allowing detection using pure tone audiometry, the cornerstone of audiological testing. Yet the audiogram is limited in ... Article
Article  |   April 01, 2015
The Relation Between Cochlear Neuropathy, Hidden Hearing Loss and Obscure Auditory Dysfunction
Author Affiliations & Notes
  • Garreth Prendergast
    School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
  • Hannah Guest
    School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
  • Christopher J. Plack
    School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
  • Financial Disclosure: Garreth Prendergast is a post-doctoral research assistant at the University of Manchester. Hannah Guest is a postgraduate research student at the University of Manchester. Christopher J. Plack is Ellis Llwyd Jones professor of Audiology at the University of Manchester. This work was supported by the Medical Research Council (MR/L003589/1). Author Hannah Guest is supported by a studentship from Action on Hearing Loss.
    Financial Disclosure: Garreth Prendergast is a post-doctoral research assistant at the University of Manchester. Hannah Guest is a postgraduate research student at the University of Manchester. Christopher J. Plack is Ellis Llwyd Jones professor of Audiology at the University of Manchester. This work was supported by the Medical Research Council (MR/L003589/1). Author Hannah Guest is supported by a studentship from Action on Hearing Loss.×
  • Nonfinancial Disclosure: Garreth Prendergast has previously published in the subject area. Hannah Guest has no nonfinancial interests related to the content of this article. Christopher J. Plack has previously published in the subject area.
    Nonfinancial Disclosure: Garreth Prendergast has previously published in the subject area. Hannah Guest has no nonfinancial interests related to the content of this article. Christopher J. Plack has previously published in the subject area.×
Article Information
Hearing Disorders / Articles
Article   |   April 01, 2015
The Relation Between Cochlear Neuropathy, Hidden Hearing Loss and Obscure Auditory Dysfunction
SIG 6 Perspectives on Hearing and Hearing Disorders: Research and Diagnostics, April 2015, Vol. 19, 32-40. doi:10.1044/hhd19.1.32
History: Received January 31, 2015 , Revised March 9, 2015 , Accepted March 10, 2015
SIG 6 Perspectives on Hearing and Hearing Disorders: Research and Diagnostics, April 2015, Vol. 19, 32-40. doi:10.1044/hhd19.1.32
History: Received January 31, 2015; Revised March 9, 2015; Accepted March 10, 2015

Sensorineural hearing loss is typically defined by threshold elevation, often resulting from dysfunction of cochlear outer hair cells. Damage can occur as a result of ageing and noise exposure, reducing auditory sensitivity, and allowing detection using pure tone audiometry, the cornerstone of audiological testing. Yet the audiogram is limited in its ability to predict perceptual performance, especially for speech perception in noise. The deficits reported in some audiometrically normal listeners provide stark examples of this insensitivity. Recent research in animals has revealed that widespread loss of auditory nerve fibers can take place without hair cell loss or threshold elevation, as a result of either noise exposure or ageing. This pattern of damage may manifest as “hidden hearing loss” in humans, leading to perceptual deficits without affecting the audiogram. A great deal of interest is currently focused on this condition and its putative effects, which are expected to impact listening in complex auditory environments. Much work remains to be done in establishing the existence, causes, effects, and clinical relevance of hidden hearing loss in humans. However, forthcoming research findings are likely to be pivotal and may demand that we reassess our diagnostic methods, management strategies, and fundamental understanding of hearing loss.

Acknowledgments
The authors thank Agnès Léger and three anonymous reviewers for useful comments on earlier versions of the manuscript.
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