Hidden Hearing Loss: Learn the Signs. Take Action.
November 15, 2021

Hidden Hearing Loss: Learn the Signs. Take Action.

Do you feel like you hear fine, but you struggle to understand speech when there is a competing of background noise, like at a large family gathering? You could have hidden hearing loss.

"With a hidden hearing loss, the brain is still able to process simple sounds resulting in the appearance of 'normal hearing,' but more difficult sounds like conversational speech can be harder for the brain to process."
-- Ali Carmichael, Au.D.

“A person’s sense of hearing connects them to the world around them and helps them stay

engaged with the people, places and events in their lives,” said Dr. Megan Johnson,

audiologist and owner of Johnson Audiology. “Yet many people discount their hearing,

ignoring the signs that something is amiss with their inner ear and waiting years to address

it. I see it every day in my practice; people who tell me they have been struggling in different

listening environments for 10 years or more. It disturbs me that people put off seeking

helping because of embarrassment, or fear or misunderstanding, especially now in an era

when help for hearing issues is so advanced and accessible.” Dr. Johnson continued, “Part

of Johnson Audiology’s mission is to bring education about hearing and hearing loss to the

forefront, teach people how important your sense of hearing is and smash the stigma that

some feel in regards to their hearing issues. Hearing loss is widespread; yet treatment is

right around the corner at your nearest audiologist. People don’t have to live with untreated

hearing loss anymore!”


How widespread is hearing loss?

Dr. Ali Carmichael, one of the 12 audiologists that makes up the team of hearing

professionals at Johnson Audiology, said, “More than 20% of the United States population

is affected by various types and degrees of hearing loss. That’s more than 65.5 million

people! Additionally, tinnitus, which is a constant or intermittent ringing, buzzing, or hissing

in the ears, affects more 30 million Americans.” Recent research has come out that states

that up to 13 million Americans without any degree of hearing loss also experience some

form of tinnitus. Through medical conditions, noise exposure, genetic conditions, or the

processes of aging, hearing loss can occur gradually or suddenly at any stage of life. The

inner ear, or cochlea, is composed of thousands of small hair-like fibers responsible for

sending hearing signals to the brain. One of the leading causes of hearing loss in people

under the age of 40 is due to noise exposure, which can cause major damage to the inner

ear leading to hearing loss and tinnitus.


What is hidden hearing loss?

Dr. Johnson said, “For most people with hearing issues, a basic hearing test, also called an

audiogram, reveals, in a very obvious way, the type and severity of a person’s hearing loss.”

Sometimes damage done to the inner ear, either by noise exposure or auto-immune

disorders, is not so transparent though. Dr. Johnson mentioned that in some cases

“damage can create a ‘hidden hearing loss’ where the hearing test shows normal hearing,

but tinnitus or difficulty hearing in a noisy environment is still a concern.” This damage

causes an incomplete signal being sent to the brain, which can lead to a familiar hearing

complaint where a person knows that something is being said but cannot understand the

actual words. The repeated noise exposure causes a breakdown of the hearing system in a

way that is not detectable by a standard hearing test; however, the damage can cause

enough inner hair fibers to be destroyed, which leads to the sensation of tinnitus but with a

lack of detectable hearing loss. Dr. Carmichael said, “With a hidden hearing loss, the brain

is still able to process simple sounds resulting in the appearance of ‘normal hearing,’ but

more difficult sounds like conversational speech can be harder for the brain to process. As a

result, communication often fails.” Long-term exposure to noise, even in small amounts, has

been shown to be one of the leading causes of hidden hearing loss and tinnitus.


Why is hidden hearing loss something to be concerned about?

The frustration a person feels when dealing with hidden hearing loss and tinnitus can lead

to social isolation and a decrease in social interactions. Also, because hidden hearing loss

is more difficult to diagnose, it may be overlooked, a person’s complaints and struggles

minimized, and their frustration grows. A university-trained audiologist is the professional

most equipped and skilled to recognize when a person might be struggling with hidden

hearing loss and to initiate the expanded testing that is necessary for diagnosis. A standard

hearing test with additional noise testing can help to identify the degree of difficulty a person

is having in noisy situations. Speech in noise testing, which includes repeating sentences as

the volume of background noise increases, can be done to help determine the amount of

difficulty someone is experiencing when processing sound with background noise present.

Dr. Johnson urged, “When visiting your audiologist, it is important to relay all symptoms

related to your hearing and balance. This will help your audiologist pick the correct tests and

formulate an appropriate treatment plan.” Important symptoms to relay if hidden hearing

loss may be a concern include:


·often hearing speech incorrectly

·feeling like you are struggling when listening in environments when background noise is

loud but you understand people well in quiet situations

·constant tinnitus, or

·feeling distracted, or even anxious, in difficult listening environments.


Advancements in technology make the difference

Dr. Carmichael said, “Treatment for hidden hearing loss continues to develop, and research

has shown that around 60% of patients with tinnitus say they experience some relief from

their symptoms while wearing hearing aids.” It also has been proven that the improvements

in directional microphones of hearing aids have helped to overcome communication

breakdowns in noisy situations. The advances in noise reduction in hearing aids have

developed to help overcome the volume of noise and help to focus attention towards the

important conversations with loved ones.

Dr. Johnson said, “Over the course of my 19-year

career as an audiologist, I have seen such advancements in technology. It’s these

advancements that have made the detection and treatment of hidden hearing loss possible.

It can be a real game changer for people.”

Knowledge about the structure and workings of the inner ear continues to progress, and a

better understanding of how damage to the inner ear creates different types and degrees of

hearing loss continues to develop. Additionally, hearing technology and treatment for

hearing loss is advancing by leaps and bounds. “At no other time in history have we been

more informed and more equipped to help people with all types of hearing loss,” said Dr.

Carmichael. “Take control of your hearing loss. Take action today.”

Untreated hearing loss is changing your brain

By Jan Hollingsworth • May 16, 2024
Research reveals that hearing loss actually rewires your neural pathways Your Amazing Brain Your brain is an amazing organ! This wrinkly, reddish-pink mass weighs about the same as your two-slice toaster, tipping the scales at about three pounds. Acting as a master control center, your brain enables every thought, breath, eye blink, heartbeat, movement—everything—that happens in your body. Rivaling the world’s most powerful supercomputer, your brain can download, process, and react in milliseconds to the tidal wave of information coming from your eyes, skin, nose, tongue, and ears. Neuroplasticity and Your Sense of Hearing Researchers have discovered that the human nervous system—made up of the brain, spinal cord, and a complex network of nerves—has incredible capacity to modify itself, both in function and physical structure. This is called neural plasticity . Dr. Megan Johnson, audiologist and owner of Johnson Audiology explains, “Neural plasticity is going gangbusters in a child’s brain as the child develops and matures into adulthood. Based on years of brain research, we also know that the adult brain is far from being fixed. It, too, changes and adapts when you learn new information or skills or as a response to stress, hormonal fluctuations, drug interactions, injury, and much more.” Dr. Johnson also relates that “your brain displays neuroplasticity when you experience hearing loss.” By measuring brain waves using an electroencephalograph, or EEG, scientists have studied how the brain of a person with hearing loss functions compared to a person with normal hearing. The results are both fascinating and sobering as studies reveal that, in those with hearing loss, the portion of the brain devoted to hearing becomes reorganized. This can be true even with early-stage, mild hearing loss, and the process happens quickly, often in months rather than years. The Hearing Center of Your Brain and Beyond What is actually happening when this takes place? Your brain has a right and a left hemisphere and six major lobes. Think of your frontal lobe as your brain’s boss, where executive functions like decision making, emotion and impulse control, and planning occur. Your temporal lobe, which contains the auditory cortex, is doing the heavy lifting when it comes to interpreting sounds and assigning those sounds meaning. The temporal lobe processes speech and language, and it is where initial learning of new information takes place, which is the first step for logging that information into memory. Dr. Johnson goes on to relate, “When the delicate infrastructure of your ear has become damaged through noise exposure, infection, etc. leading to hearing loss, your auditory cortex cries out to your frontal lobe, saying ‘Help! Help! I’m not receiving any sound to process, so I feel lost.’ The frontal lobe ‘boss’ jumps to attention, and your occipital lobe, responsible for processing vision and touch, takes over the areas in which hearing is normally processed. In other words, your other senses seek to compensate for the deficit due to the loss of your sense of hearing.” Amazing, right? So, where’s the rub? Picture a car assembly line; each worker has an assigned task. One day, the worker who installs the windshields is absent, and the worker who attaches the rearview mirrors is assigned double duty, and a duty that was not part of job training. It is easy to see how the worker left juggling both jobs is compromised, and a car might slip through minus a rear view mirror. Similarly, the areas of your brain that are being taxed to make up for a lack of hearing are overloaded and less able to do their assigned responsibilities. “This explains why so many of my patients with hearing loss relate feeling exhausted and frustrated after a big family gathering—where multiple talkers and sounds must be interpreted—rather than happy and invigorated by the experience. We call this listening fatigue ,” states Dr. Johnson. Additionally, when left untreated long enough, researchers point to the brain’s reorganization due to hearing loss as a significant correlation with dementia. Hearing Technology and Your Brain “But here's the great news!” Dr. Johnson says. When a person is fit with hearing aids or a cochlear implant and sound is restored, the brain has the ability to adjust back—partially or completely—to proper function. How swiftly that happens often depends on how long the hearing loss went untreated and is why she encourages patients to treat hearing loss sooner rather than later. “Here is what I tell patients who are downplaying the importance of hearing: If you won’t treat your hearing loss for the sake of your ears, do it for your brain!”

Move from the Gunbarrel Road office to a new and larger office will allow Johnson Audiology to help even more people in the Chattanooga region

By Jan Hollingsworth • January 9, 2024
Johnson Audiology is pleased to announce that the practice will be moving one of its Chattanooga area offices from its current location on Gunbarrel Road to a new location at 6830 Lee Highway. The move will take place January 15. “We are extremely excited to be re-locating to a much larger space later this month,” Dr. Megan Johnson, founder and owner of the award-winning practice, says. “About a year ago, we realized that we needed more room to meet the needs of our growing patient base so we could help even more people with hearing loss. We sought a place that would allow us to stay in the East Brainerd/Hamilton Place area so that the office would still be conveniently located for patients. Our Hixson office will remain at 5617 Highway 153, Suite 203 and is also being upgraded with a second sound booth and beautiful new decor. These two strategically located offices mean that we can continue to serve patients who live east and west of the Tennessee River.” Dr. Johnson says that when she identified the building on Lee Highway, she knew it was an ideal site for this next growth leap. “Our company culture is anchored on the premise of always offering an exceptional patient experience,” she says. “Thanks to our wonderful family of Johnson Audiology patients, we have outgrown our current office and have found the perfect location for offering the best care to even more of our Chattanooga neighbors.” The new location offers many positive features that will benefit patients: The office is conveniently located off Lee Highway in the area between Shallowford Road and Hickory Valley Road, directly behind Dr. Keith B. Dressler’s orthodontic practice. It is a stand-alone office that is not shared with any other businesses. The building is more than 4,000 square feet, which is double the space of the current office on Gunbarrel Road. The added square footage will accommodate a spacious patient welcome and reception area, three sound booths for hearing testing, and a private area for patient check-out. The building has exam rooms for four full time audiologists and an audiology assistant, a large front desk area, and a sizeable lab for hearing aid maintenance and repair. The office has ample space for the practice’s growing Cochlear Implant (CI) Program with a dedicated sound booth and exam area just for CI patients. The building design allows for easy circular patient flow throughout the office. The building has a dedicated, 20-space parking lot just for Johnson Audiology patients and additional parking for Johnson Audiology staff. Dr. Johnson mentions that the building was a non-medical office previously, so updates were needed to bring it up to par for a bustling hearing health care clinic. It currently is being remodeled, and the parking lot resurfaced. “We have plans to transition to the new building by January 15 with some final touches to the office’s aesthetics continuing through the spring,” she says.  Dr. Johnson wishes to assure folks that measures are in place to alleviate disruption to the service patients receive during this time and thanks patients in advance for their continued support and understanding during the transition. “The new office is going to be incredible!” she says. Initial correspondence has been delivered to patients about the move. Dr. Johnson says, “Patients who have appointments scheduled in early January or those who need walk-in service for hearing aid maintenance and supplies from now until January 15 should continue visiting the Gunbarrel Road location.” Dr. Johnson says, “In February, we will invite our friends and neighbors in the Chattanooga community to an open house celebration, where we will do an official reveal of the new space!” Johnson Audiology has been faithfully serving the citizens of Chattanooga since the practice opened its doors on October 1, 2009. “As we prepare to celebrate our 15th anniversary this year, the new office location on Lee Highway and the upgrades to the Hixson office are evidence of our commitment to patients.” Dr. Johnson goes on to say, “Chattanoogans have named Johnson Audiology Best of the Best in the category of Favorite Audiologist and Hearing Aid Clinic for 11 years straight. And they consistently name Johnson Audiology in the top three in the category of Best Customer Service among all Chattanooga businesses. We seek to live up to those accolades daily!” Dr. Johnson concludes, “One of our patients, Mr. Van Tenpenny, recently had this to say about us: ‘My visit to Johnson Audiology has been life changing! After decades of hearing loss, I am able to hear normal conversations in any environment.’ It is our highest ideal to be here for Mr. Tenpenny and the thousands of other patients like him who prioritize their hearing for the best quality of life.” Do you want to get on the road to healthy hearing? Johnson Audiology is currently accepting new patients at all locations. Call today to schedule an appointment or book online at www.johnsonaudiology.com/schedule.
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