Hidden Hearing Loss in Young Adults with Normal Audiograms: A Review

Author(s)	Mr. Lalit Kumar Maurya, Mr. Anshuman Yadav, Mr. Himanshu Singh
Country	India
Abstract	Hidden hearing loss (HHL) refers to auditory dysfunction that occurs despite normal pure-tone audiometric thresholds. Young adults with normal audiograms frequently report difficulty understanding speech in noisy environments, listening fatigue, and reduced sound clarity—symptoms not explained by conventional hearing assessments. Increasing evidence suggests that cochlear synaptopathy, characterized by damage to synapses between inner hair cells and auditory nerve fibers, may underlie these perceptual deficits. This review synthesizes current literature on the mechanisms, clinical manifestations, diagnostic challenges, and controversies surrounding hidden hearing loss in young adults. Behavioral, electrophysiological, and extended audiometric findings are examined, with emphasis on speech-in-noise perception and auditory brainstem response measures. Although animal studies provide strong support for cochlear synaptopathy, evidence in human populations remains mixed. The review highlights the need for standardized diagnostic protocols and longitudinal research to better understand the prevalence and clinical implications of hidden hearing loss in young adults with normal audiograms.
Keywords	hidden hearing loss, cochlear synaptopathy, speech-in-noise, young adults, normal audiogram
Field	Medical / Pharmacy
Published In	Volume 8, Issue 1, January-February 2026
Published On	2026-02-17

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