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Updated: Jan 18, 2026

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Subtle Peripheral Auditory Dysfunction in Patients With Listening Difficulties.

Teppei Noda1, Kazuki Nishida2,3, Basile Chretien2

  • 1Department of Otolaryngology, Head and Neck Surgery, Kyushu University, Fukuoka, Japan.

Ear and Hearing
|September 8, 2025
PubMed
Summary
This summary is machine-generated.

Subtle peripheral auditory dysfunction may cause listening difficulties (LiD) in some individuals. Advanced tests like the threshold-equalizing noise (TEN) test and distortion-product otoacoustic emissions (DPOAE) can help identify these issues.

Keywords:
Distortion-product otoacoustic emissionsListening difficultiesMainly adultsThreshold equalizing noise test

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Area of Science:

  • Audiology
  • Neuroscience
  • Otolaryngology

Background:

  • Listening difficulties (LiD) can significantly impact quality of life.
  • Standard audiometry may not detect subtle peripheral auditory dysfunction contributing to LiD.

Purpose of the Study:

  • To investigate the role of subtle peripheral auditory dysfunction in LiD.
  • To evaluate the efficacy of the threshold-equalizing noise (TEN) test and distortion-product otoacoustic emissions (DPOAE) in identifying these dysfunctions.

Main Methods:

  • A case-control study involving 61 patients with LiD and 22 controls with normal hearing thresholds.
  • Utilized pure-tone audiometry, speech-recognition tests, DPOAE, and the TEN test.
  • Calculated signal-to-TEN ratio (STR) for the TEN test.

Main Results:

  • The LiD group exhibited significantly higher STR values and lower DPOAE levels, particularly at 6 kHz.
  • The TEN test and DPOAE identified dysfunction in a substantial proportion of LiD patients (80.0% and 71.4%, respectively).
  • A combination of TEN test, DPOAE, and developmental disorder status showed potential for simplified LiD diagnosis.

Conclusions:

  • Subtle peripheral auditory dysfunction, missed by standard tests, likely contributes to LiD in some patients.
  • The TEN test and DPOAE offer a more sensitive approach to diagnosing LiD.
  • Further multicenter studies are needed to validate and refine this diagnostic approach.