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On the Etiology of Listening Difficulties in Noise Despite Clinically Normal Audiograms
Journal article   Open access   Peer reviewed

On the Etiology of Listening Difficulties in Noise Despite Clinically Normal Audiograms

Martin Pienkowski
Ear and hearing, v 38(2), pp 135-148
Mar 2017
PMID: 28002080
url
https://europepmc.org/articles/pmc5325255View
Published, Version of Record (VoR)CC BY-NC-ND V4.0 Open
url
https://doi.org/10.1097/AUD.0000000000000388View
Published, Version of Record (VoR) Open

Abstract

Audiology & Speech-Language Pathology Life Sciences & Biomedicine Otorhinolaryngology Science & Technology
Many people with difficulties following conversations in noisy settings have "clinically normal" audiograms, that is, tone thresholds better than 20 dB HL from 0.1 to 8 kHz. This review summarizes the possible causes of such difficulties, and examines established as well as promising new psychoacoustic and electrophysiologic approaches to differentiate between them. Deficits at the level of the auditory periphery are possible even if thresholds remain around 0 dB HL, and become probable when they reach 10 to 20 dB HL. Extending the audiogram beyond 8 kHz can identify early signs of noise-induced trauma to the vulnerable basal turn of the cochlea, and might point to "hidden" losses at lower frequencies that could compromise speech reception in noise. Listening difficulties can also be a consequence of impaired central auditory processing, resulting from lesions affecting the auditory brainstem or cortex, or from abnormal patterns of sound input during developmental sensitive periods and even in adulthood. Such auditory processing disorders should be distinguished from (cognitive) linguistic deficits, and from problems with attention or working memory that may not be specific to the auditory modality. Improved diagnosis of the causes of listening difficulties in noise should lead to better treatment outcomes, by optimizing auditory training procedures to the specific deficits of individual patients, for example.

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Web of Science research areas
Audiology & Speech-language Pathology
Otorhinolaryngology
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