Yonsei Med J.  2021 Jul;62(7):615-621. 10.3349/ymj.2021.62.7.615.

Limitation of Conventional Audiometry in Identifying Hidden Hearing Loss in Acute Noise Exposure

  • 1Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea


The concept of hidden hearing loss can explain the discrepancy between a listener’s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms.
Materials and Methods
A total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups.
We found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I–V interpeak interval were compared, and no significant intergroup difference was observed.
The results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.


Auditory brainstem response; hearing loss; noise-induced hearing loss
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