Impaired Tone-in-Noise Detection in Individuals Who Report Temporary Hearing Symptoms After Noise Exposure.

The study population consisted entirely of US Service Members, who may have different noise exposure profiles and susceptibility factors than the general civilian population. The design is observational and cross-sectional, so it cannot prove that temporary symptoms cause the detection deficits; it only shows an association. Hearing status was defined by pure-tone thresholds, which do not account for hidden hearing loss or other cochlear pathologies that might influence results. The self-reported history of temporary symptoms relies on participant recall, which can be inaccurate.

The research was supported by grants from the Defense Health Program and the National Institute on Deafness and Other Communication Disorders. The funders had no role in the design, conduct, analysis, or writing of the study. The authors declared no conflicts of interest.

Do not assume that a normal standard hearing threshold means the patient has no auditory deficit. The study shows that patients with normal audiograms can still have significantly impaired tone-in-noise detection if they have a history of temporary hearing symptoms after noise exposure. Furthermore, do not rely on the traditional MLD score (the difference between in-phase and out-of-phase conditions) to identify this problem, as the study found this metric was less sensitive to the deficit than the absolute detection threshold.