A Large-Scale Study of the Relationship Between Degree and Type of Hearing Loss and Recognition of Speech in Quiet and Noise.
Michael L Smith, Matthew B Winn, Matthew B Fitzgerald
PMID 38389129WHAT IT FOUND
Patients with conductive hearing loss understood speech in noise as well as those with normal hearing when sound was loud enough.
Those with sensorineural or mixed loss struggled in noise even with mild hearing loss. Word recognition in quiet missed these difficulties.
Key findings
01Conductive hearing loss did not significantly impair speech-in-noise performance compared to normal hearing when audibility was compensated.
02Speech recognition in noise was sensitive to mild sensorineural and mixed hearing losses, whereas word recognition in quiet remained near ceiling levels for these patients.
03Hearing loss type and degree were only partially predictive of individual speech-in-noise performance, leaving considerable unexplained variance.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Retrospective design with no control over testing conditions or patient selection. Hearing loss duration was not recorded, so chronic versus recent conductive losses were not distinguished. Four-frequency pure-tone average was used, potentially missing high-frequency hearing loss that affects speech perception. Language proficiency was not fully controlled, as some patients were non-native English speakers. Presentation levels were adjusted to maximize audibility, which may have reduced the sensitivity of quiet word recognition tests.
Declared interests
This work was supported by Stanford University. No other conflicts of interest were reported.
The easy way to misread this
Do not assume that normal word recognition in quiet scores indicate normal speech-in-noise ability. This study showed that many patients with mild sensorineural hearing loss had excellent quiet scores but significant difficulty understanding speech in noise.