If you’ve ever been in a situation where you’re in an environment with lots of background noise—such as a party with loud music in the background or a crowded restaurant—and noticed that you’re having a lot of trouble following a conversation, that could be hidden hearing loss.

What Is Hidden Hearing Loss?
Hidden hearing loss, or HHL for short, is a relatively new term; it describes hearing loss in which a person has difficulty hearing in noisy environments but has normal results on a hearing test. The key difference between traditional hearing loss and HHL is which part of the auditory system is breaking down.
In traditional hearing loss, the ear or the cochlea—an organ in the inner ear responsible for transmitting sound to the brain—struggles with collecting sound information. With HHL, the ear and cochlea can gather sound information just fine, but the peripheral auditory system struggles to sort and comprehend the sound information it receives.
Why Is Hidden Hearing Loss More Noticeable in Crowded Places?
As you dine out at your favorite restaurant or attend holiday parties this holiday season, you’ll notice that HHL is especially pronounced. This is because the higher levels of background noise flood the auditory processing center in the brain with extra sound information; in addition to listening to your friend talking, you’re also processing the sound of the music over the speakers, the silverware clanking against plates, conversations at nearby tables and sounds escaping from the kitchen.
This overwhelming amount of sound information puts an extra strain on your already-stressed auditory processing center, causing you to struggle to follow along with the conversation.
How Hearing Tests Work and How to Detect Hidden Hearing Loss
There are many types of hearing tests, and they all measure different aspects of your hearing health. The most common type of hearing test is the pure tone test.
The Pure Tone Test
A pure tone test takes place in a soundproof room. You are given a pair of headphones, which will play a series of beeps at different volumes and pitches. They may also send these beeps to one ear at a time or both simultaneously. You indicate, either by raising your hand or pressing a button, when you hear a beep. This test establishes your baseline auditory threshold: what sounds your ears are capable of detecting.
Speech-In-Noise Test
A speech-in-noise test is a more specialized test, although at first glance it resembles a pure tone test. Still in a soundproof room and still wearing headphones, you will hear a series of audio recordings of speech. These recordings will play over various background noises at various levels. Your task is to repeat what was said in the recording. This test mimics real-life listening scenarios and tests your listening comprehension, particularly when there is competing background noise.
Detecting HHL
A pure tone test may not pick up on HHL—after all, your auditory threshold is not the issue with HHL—but a speech-in-noise test can. By simulating the environments in which HHL is most prominent, HHL can be caught and diagnosed.
If you think you have HHL or want to find out more information about HHL, call us at The House Institute. Our skilled audiologists want to help you on your hearing journey.