Hidden Hearing Loss: Why is it Hidden?

ArSHA Webinar | One Hour (60 Minutes) Recorded Presentation

Dates Offered: August 15-26 2022

Presenter: Zarin Mehta, PhD, CCC-A, FAAA


Hidden hearing loss (HHL) is a relatively recently reported auditory neuropathy. To perceive auditory signals, it is necessary that both the peripheral cochlear sensory cells and the cochlear neurons are functioning normally. In animal and human studies, HHL presents with normal/near normal auditory thresholds but impaired cochlear neurotransmission. In humans, the impaired cochlear neurotransmission manifests as difficulty understanding speech, especially in noise. It has been a long-held belief that poor speech understanding in the presence of normal peripheral auditory thresholds is the result of deficits in central auditory processing. Emerging evidence indicates that poor speech processing can occur because of defects in inner hair cell synapses within the cochlea (auditory synaptopathy). These changes are seen as a result of noise exposure, ageing and with some neurodegenerative diseases. Defective myelination due to Schwann cell damage may also result in HHL. This presentation will explore the different etiologies of HHL reported in the literature and discuss its diagnosis and management exemplified through case studies.

Biography of the Speaker:

Zarin Mehta, PhD, is an associate professor, and chair, Entry-Level AuD Admissions Committee, at A.T. Still University (ATSU), in Mesa, Arizona. She teaches in the areas of auditory and vestibular disorders, central auditory processing disorders, pediatrics, genetics and pharmacology. She also supervises students at ATSU’s AFA Balance & Hearing Institute.

Learner Outcomes: At the end of this presentation, participants will be able to:

    • Explain the etiology of hidden hearing loss.
    • Identify the clinical presentation of hidden hearing loss.
    • Determine appropriate management of hidden hearing loss.

Level of Learning: Intermediate

Time Ordered Agenda

    1. What is Hidden Hearing Loss (HHL)? – 5 minutes
    2. Cochlear Ribbon Synapses – 5 minutes
    3. Noise and HHL (with two case studies) – 15 minutes
    4. Ageing and HHL – 5 minutes
    5. Neurodegenerative Conditions & HHL (with two case studies) – 10 minutes
    6. Cognition and HHL (with one case study) – 15 minutes
    7. Management of HHL and Take-Home Message – 5 minutes


Convention attendees 2022 – free
ARSHA members – $25
Non-members – $50

The Arizona Speech-Language-Hearing Association is approved by the American Academy of Audiology to offer Academy CEUs for this activity. The program is worth a maximum of  0.10  CEUs. Academy approval of this continuing education activity is based on course content only and does not imply endorsement of course content, specific products, or clinical procedure, or adherence of the event to the Academy’s Code of Ethics. Any views that are presented are those of the presenter/CE Provider and not necessarily of the American Academy of Audiology.


Relevant Financial Disclosures: Presenter received an honorarium from ArSHA for her presentation.

Relevant Non-Financial Disclosures: Presenter has no relevant financial relationships to disclose.