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Related Concept Videos

The Cochlea01:13

The Cochlea

The cochlea is a coiled structure in the inner ear that contains hair cells—the sensory receptors of the auditory system. Sound waves are transmitted to the cochlea by small bones attached to the eardrum called the ossicles, which vibrate the oval window that leads to the inner ear. This causes fluid in the chambers of the cochlea to move, vibrating the basilar membrane.

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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
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Tone-in-notched-noise testing for screening high-frequency sensorineural hearing loss.

Xinyang Wang1, Wan Nur Asyiqin Rasidi1, See Ziau Hoe1

  • 1Department of Physiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia.

The Journal of the Acoustical Society of America
|May 22, 2026
PubMed
Summary

Notched noise (TNN) testing shows high reliability and accuracy for screening high-frequency sensorineural hearing loss (HF-SNHL). This method is effective for early detection and complements traditional hearing assessments.

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Area of Science:

  • Audiology
  • Hearing Science
  • Medical Diagnostics

Background:

  • High-frequency sensorineural hearing loss (HF-SNHL) is permanent and progressive, necessitating early detection.
  • Current screening methods may require improvement for accuracy and reliability.

Purpose of the Study:

  • To evaluate masked tone thresholds in narrowband noise (TNB), notched noise (TNN), and their derived difference (TFS) for HF-SNHL screening.
  • To assess the reliability and diagnostic accuracy of TNN for detecting HF-SNHL at 4 and 8 kHz.

Main Methods:

  • Eighty-eight participants (18-79 years) with normal hearing or HF-SNHL underwent testing using a self-administered Frequency Selectivity Screener app.
  • Evaluated within-session test-retest reliability, Bland-Altman limits of agreement, and associations with pure-tone audiometry.
  • Assessed diagnostic accuracy using receiver operating characteristic curves.

Main Results:

  • Notched noise (TNN) demonstrated superior or equivalent test-retest reliability compared to TNB and TFS.
  • TNN showed strong correlations with pure-tone audiometric thresholds (Spearman's ρ = 0.84-0.87).
  • TNN exhibited excellent diagnostic accuracy (AUC > 0.90), outperforming TNB and matching TFS performance.

Conclusions:

  • Notched noise (TNN) testing is a reliable, frequency-specific screening tool for high-frequency sensorineural hearing loss (HF-SNHL).
  • TNN testing can effectively complement conventional audiological assessments for early detection.
  • Further research is needed to validate TNN across diverse populations and for longitudinal monitoring.