Cochlear synaptopathy and hidden hearing loss: a scoping review.
Marina de Figueiredo Colla, Pamela Papile Lunardelo, Fernanda Abalen Martins Dias
PMID 37991055WHAT IT FOUND
Most research on hidden hearing loss uses the term cochlear synaptopathy to describe a specific physical damage to nerve connections.
Hidden hearing loss is a broader label for any difficulty understanding speech with normal test results. Clinicians should avoid using the two terms interchangeably.
Key findings
01The majority of included studies used the term cochlear synaptopathy to refer to the specific phenomenon of losing connections between inner hair cells and auditory nerve fibers.
02Hidden hearing loss is often used as a generic label for various conditions causing speech understanding complaints despite normal peripheral hearing, rather than describing a single specific pathology.
03Tinnitus studies included in this review generally failed to exclude other common causes of the symptom, making it difficult to attribute tinnitus specifically to cochlear synaptopathy.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review focused on terminology and definitions rather than diagnostic accuracy or treatment outcomes. Many included studies did not adequately exclude other conditions that cause similar symptoms, such as central auditory processing disorders. There is no gold standard for diagnosing cochlear synaptopathy in living humans, which complicates the interpretation of the included studies.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume a patient with normal hearing thresholds and speech-in-noise difficulties has cochlear synaptopathy. Hidden hearing loss is a broad descriptive term that can apply to many conditions, and the review found no consensus on a single diagnostic definition.