A term coined in 2009 explaining the difficulty understanding in background noise without any difficulty in quiet and hearing within normal limits on a standard audiogram.

“Hidden” hearing loss is the everyday name for auditory synaptopathy which results from acoustic trauma to the inner ear resulting in damage to the synapses between the inner hair cell and the auditory neuron. This is a permanent disruption with the cochlear neurons typically resulting in normal or near normal audiograms (hearing charts) but difficulty understanding speech in noise. While results on some diagnostic measurements may be just outside of normal, the vast majority of individuals with hidden hearing loss are diagnosed by their symptoms. The individuals affected are often young, even in their teens and early 20’s with a history of excessive “noise” exposure (i.e. music, concerts, power tools, machine shops, etc). The accumulation of this damage over time may be a factor in age-related hearing loss (presbycusis) as the cochlear damage becomes more significant and widespread.


Protecting your ears from excessively loud sounds is key to healthy hearing. Even repeated damage of short bursts of loud sounds can cause irreversible damage to your inner ear. Wearing quality earplugs (consider custom) that allow you to lower the volume of your music or podcasts is helpful. Wearing hearing protection to concerts (high fidelity earplugs) and noise plugs around machines, lawn mowers, etc. is critical.


Even though traditional hearing loss is not diagnosed, providing the brain with additional information in those difficult situations and wearing hearing protection when appropriate has shown to be very beneficial to individuals with hidden hearing loss. Patients report significant increase in ease of listening and overall communication with the help of technology. Through the use of properly fitted hearing aids (overall volume not affected), patients have been very successful. Research is still investigating other diagnostic methods and treatment options.