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Impaired speech perception in noise in patients with a normal audiogram
L Ferman1, J Verschuure, B Van Zanten
1Department of Otorhinolaryngology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Summary
Many individuals with normal hearing struggle to understand speech in noisy environments. This study found that most patients with this complaint had abnormal speech reception thresholds in noise, indicating a common auditory processing issue.
Area of Science:
- Audiology
- Neuroscience
- Speech and Hearing Science
Background:
- Many individuals report difficulty understanding speech in noisy environments despite having normal hearing acuity.
- This subjective complaint, often termed the 'cocktail party problem,' can significantly impact quality of life.
Purpose of the Study:
- To investigate the audiological correlates of impaired speech perception in noise in patients with normal hearing.
- To evaluate the utility of objective audiological tests in corroborating subjective complaints of speech-in-noise difficulties.
Main Methods:
- A cohort of patients with normal hearing but subjective speech-in-noise difficulties underwent a comprehensive audiological evaluation.
- Key assessments included the speech reception threshold in noise (SRT-N) and various central auditory tests.
- Auditory brainstem-evoked potentials (ABEPs) were also measured in a subset of participants.
Main Results:
- The patients' complaint of impaired speech perception in noise was objectively confirmed in 95% of cases via an abnormal SRT-N.
- Central auditory tests revealed abnormalities in 65% of the patients evaluated.
- ABEPs were normal in nearly all tested patients, suggesting the issue is not typically related to the brainstem auditory pathway.
Conclusions:
- An abnormal SRT-N is a common objective finding in patients complaining of poor speech understanding in noise, even with normal hearing.
- Central auditory processing deficits are frequently observed in this patient group.
- The findings suggest that difficulties in speech-in-noise perception often stem from central auditory system dysfunction rather than peripheral hearing loss or brainstem pathway abnormalities.