Skip to main content
Department of Health Sciences

What If My Hearing Is Normal?

Hidden Hearing Loss

For most people, a diagnosis of normal hearing provides nothing but relief, but for a subset of our patients they continue to perceive their hearing as anything but “normal.” Often these patients report difficulty hearing in noise and yet their hearing evaluations suggest “normal hearing.” How can this be? Is the testing wrong? Is the patient? Let’s explore this topic further.

Understanding “Hidden Hearing Loss”

  1. A standard hearing evaluation only evaluates a patient’s ability to hear in quiet. One’s ability to detect soft sounds may not offer full insight into their ability to understand or process sound in non-quiet environments.
  2. Speech in noise testing is crucial to further assess a patient’s real-world abilities. We include speech in noise testing in all of our Functional Communication Assessment appointments.
  3. These patient may have a history of noise exposure. Research suggests that past noise exposure (even from childhood) can cause damage to the sensory cells of hearing, which first shows up as difficulty hearing in noise.
  4. Counseling and aural rehabilitation is key! Communication strategies to improve hearing in complex environments can be a significant impact on a patient’s quality of life. One does not have to wear hearing aids to receive personalized Audiology services.
  5. Some patients with hidden hearing loss may benefit from the careful use of OTC hearing devices, low gain prescription hearing aids, or personal sound amplifiers (PSAPS). These non-programmable devices can provide a situational boost in sound to improve attention and distance listening. OTC devices should still be fit in the context of a treatment plan and can be evaluated for safety by your Audiologist.

You are NOT without Options!

Unfortunately, patients with normal audiograms, but self-identified hearing difficulties are often turned away. The provider may say, “Come back when your hearing is worse.” Nothing can be more invalidating or discouraging. While our diagnostic testing has not yet developed to detect sub-neural hearing loss or sub-clinical hearing loss, we know this condition exists and that it can have meaningful impact on our patients’ lives. The UNC Hearing and Communication Center is committed to treating our patient’s COMMUNICATION difficulties, not just their hearing loss. Make an appointment today to see how your personal listening needs can be addressed.