Effectiveness of Auditory Measures for Detecting Hidden Hearing Loss and/or Cochlear Synaptopathy: A Systematic Review.
Level 3 - non-randomized controlled study
Systematic review of observational human diagnostic studies and animal experiments
PubMed 29915454 · doi:10.1055/s-0038-1641743
What was done
A systematic review was conducted across MEDLINE, Embase, and Web of Science to identify peer-reviewed studies assessing the sensitivity of audiologic tests for detecting hidden hearing loss (HHL) and cochlear synaptopathy (CS). Study selection and quality assessment were executed using a consensus approach with standardized score sheets.
What was found
Fifteen articles were included (7 human, 7 animal, and 1 combined). Evaluated measures included ultra-high-frequency audiometry (up to 20 kHz), otoacoustic emissions, electrocochleography, auditory brainstem response (ABR), electrophysiological tests, speech recognition in noise (with/without temporal distortion), interviews, and questionnaires. Ultra-high-frequency audiometry identified sensory hair cell loss invisible on standard audiograms, while ABR wave I amplitude, summating potential-to-action potential ratio, and speech-in-noise testing were identified as promising for CS. No diagnostic accuracy numbers or effect estimates were reported in the abstract.
Why it matters
Patients with normal standard audiograms can still suffer from neural or high-frequency hair cell deficits that cause difficulty hearing in noise or tinnitus. This review catalogs candidates for a targeted clinical test battery to diagnose these hidden auditory deficits.
Limits
More than half of the included evidence base consists of animal studies (8 of 15). The abstract reports no quantitative performance metrics (such as sensitivity, specificity, or predictive values), and human investigations were observational.
Cited by
- supports Individuals with hidden hearing loss show normal thresholds on standard audiograms but report difficulty hearing in noisy environments or new-onset tinnitus.