Diagnostic Approaches for Hidden Hearing Loss and Cochlear Synaptopathy: A Systematic Review

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Fischer, Alyssa
- Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Speech and Hearing Sciences
Sprouse, Ryan
- Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Speech and Hearing Sciences

Abstract

Cochlear synaptopathy, also known as “hidden hearing loss,” is a recently described auditory disorder that is believed to affect auditory neural processing (Kohrman et al., 2020). Subjects with suspected cochlear synaptopathy most frequently complain of degraded hearing sensitivity in noisy situations, tinnitus, and in some cases, hyperacusis. This type of synaptic damage to the inner ear can be caused by noise trauma, ototoxic drugs, and aging. These physiological changes can occur without affecting peripheral hearing sensitivity. Because pure tone thresholds are not typically affected, hidden hearing loss cannot currently be identified and diagnosed in a standard audiologic hearing evaluation. In fact, most of what is known about cochlear synaptopathy has only been demonstrated in animal models and can only be confirmed in humans through post mortem temporal bone analysis (Brahmall et al., 2019). Several recent studies have sought to establish non invasive assessment methods and diagnostic tools to identify hidden hearing loss. Though a variety of measures have been implemented in studies, a consensus has yet to be reached on establishing a clinical gold standard for assessing cochlear synaptopathy.

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