Reverse Slope Loss Treatment Knoxville TN
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At Bridgewater Speech & Hearing, our goal is to help you or your loved one live life to its fullest. We all want to hear the beautiful sounds of nature, to clearly understand converstations, and to be able to communicate perfectly with those around us.Whether you are elderly and losing your hearing over time, or you have an infant who’s hearing ability concerns you, we are dedicated and able to help you to the best possible outcome.Diagnostic Hearing & Balance EvaluationsComprehensive Hear
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Oak Ridge, TN
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Kinds of Hearing Losses
Question: Karen asked: What is a reverse-slope loss? I have something called a cookie bite loss. I have no idea what it is, but that is what my audiologist called it.
Answer: These terms refer to the shape your hearing loss makes on your audiogram. Each of these shapes have been given strange colloquial names such as ski-slope loss, cookie-bite loss, flat loss, reverse cookie-bite loss and reverse-slope (reverse curve) loss. Here is a quick run down on them.
Before you can appreciate what the various hearing losses look like on an audiogram, you first need to know what normal hearing looks like. "Perfect" hearing theoretically would be a straight line at the 0 dB level (Fig. 1). In actual fact, audiologists typically consider “normal” hearing to range anywhere from -10 dB (negative numbers lie above the 0 dB line) to 25 dB. Fig. 2 shows an example of “normal” hearing.
A hearing loss that is approximately the same at all frequencies is more or less a straight horizontal line and is called appropriately enough a “flat loss.” or a “flat curve” (which is a bit of an oxymoron). This kind of loss is more common in people with conductive losses. Fig. 3 gives an example of a flat loss.
Ski-slope losses are by far the most common kind of hearing losses. These losses get their name from the “ski-slope” shape of the hearing loss on the audiogram. With ski-slope hearing losses, there is little or no hearing loss in the low frequencies but considerable loss in the higher frequencies. Often the mid frequency range is severe to profound. The audiogram looks much like a ski slope—the top of the hill is on the left and the slope drops to the right. There is an almost infinite variety of ski-slope curves—some slope down gently (Fig. 4), while others are much steeper. In extreme cases the curve is almost flat in the low frequencies and then, as Fig. 5 illustrates, just about drops straight down (really more like a ski-jump loss)!
A reverse-slope loss is the reverse of the ski-slope loss (hence its name). In reverse-slope losses, the curve is low at the low frequencies and slopes up to the right. Thus, the ski-hill is on the right and drops to the left. A person with a reverse-slope loss hears better in the high frequencies than in the low frequencies. This is a very rare kind of hearing loss. Fig 6. depicts a mild reverse-slope loss, Fig. 7 illustrates an severe reverse-slope loss and Fig. 8 shows an extreme reverse slope loss such as I have. Notice that the high frequency hearing extends to and incredible -30 dB. Also note that this audiogram shows the hearing curve up to 20,000 Hz, whereas the other audiograms all stop at 8,000 Hz, the highest frequency audiologists normally test.
A cookie-bite loss looks like someone took a bite out of the t...
Reverse Slope Hearing Loss
Answers to Your Questions about Hearing Loss Issues
Reverse Slope Hearing Loss
by Neil Bauman, Ph.D.
A concerned mother wrote:
Your audiologist is right. Reverse slope hearing losses (where you hear better in the higher frequencies than in the lower frequencies) are rare–particularly the extreme kind of reverse slope loss that I have. You son has a range of 40 dB between his best hearing frequency and his worst. My wife has a reverse slope loss, but her range is only about 20 dB. In extreme cases such as mine, this range is in the neighborhood of 100 dB.
Just as with the common high frequency hearing loss (typically called a “ski slope loss,” the impact of a 20 dB range versus a 100 dB range is very different.
My concern is that your son was tested in the lower frequencies, probably only up to 8,000 Hz. With a reverse slope loss, you really want to know how good his hearing is in the very high frequencies. Some reverse slope losses can result in incredible hearing in the very high frequencies. For example, my hearing didn’t cross the 0 dB threshold until 10,000 Hz and topped out at about -30 dB close to 20,000 Hz. This is incredible hearing! (-30 dB is 30 dB above the 0 dB line. 0 dB is considered the softest sound a perfect normal human ear can hear. This means that my hearing in the very high frequencies was far more acute than people with perfect hearing.)
In practical terms, having this extreme reverse slope hearing loss meant that I could hear people whispering from across a big school classroom because of my incredible high-frequency hearing, yet couldn’t hear the teacher talking just 4 feet in front of my face because my worst loss whas right at 1,000 Hz where a lot of speech occurs.
As far as reverse slope losses being progressive, I don’t think they are any more progressive than many other kinds of losses, but yes, reverse slope losses can indeed be progressive. For example, reverse slope hearing losses run in my family. For those affected family members, our hearing dropped rapidly from birth to about 5 years of age. After that, our hearing remains constant until we lose hearing from old age or from other causes.
In my family, reverse slope hearing loss is a dominant genetic condition. As such, each child has a 50% of being born with this loss. As a result, more or less half of us in each generation have this hearing loss. Also, reverse slope losses tend to be non-syndromic. This just means that there ar...
The Bizarre World of Extreme Reverse-Slope Hearing Losses
Imagine a person with a hearing loss so severe he can’t hear thunder rumbling overhead, yet, at the same time, has hearing so acute he can hear a pin drop; or imagine a person that can’t hear you talking just 4 feet away, yet clearly hears a whisper from across a large room; or imagine a person that can’t hear a car motor running right beside him, yet can hear a single dry leaf skittering along in the gutter 50 feet away.
“Impossible,” you say, “a person could never have such good and bad hearing at the same time!”
Surprise! It’s true. Welcome to my world—the bizarre world of people with extreme reverse-slope hearing losses.
What Is a Reverse-Slope (or Low Frequency) Hearing Loss?
Hearing losses are sometimes classified according to the shape they form on an audiogram. They commonly go by strange names such as ski-slope loss, cookie-bite loss, flat loss, reverse cookie-bite loss and reverse-slope (or reverse curve) hearing loss. (My article Kinds of Hearing Losses explains these different hearing losses and illustrates the various shapes they form on audiograms.)
By far the most common kind of hearing loss is the typical ski-slope loss where the line on the audiogram slopes down to the right. In contrast, a reverse-slope loss (as its name implies) does the reverse and slopes up to the right.
As a result this kind of hearing loss is sometimes referred to as an up-sloping loss, a rising loss, or even a low fr...
What Is A Reverse-Slope Hearing Loss?
by Neil Bauman, Ph.D.
A lady asked:
Sure thing. Hearing losses go by some strange names such as cookie-bite loss, ski-slope loss, reverse-slope loss, etc. These names come from the shape of the hearing loss when it is plotted on an audiogram.
The most common is the ski-slope hearing loss. The ski-slope loss is where you have reasonably good hearing in the low frequencies (shown on the left side of the audiogram), but you don’t hear much at all in the high frequencies (shown on the right side of the audiogram). The audiogram thus looks much like a ski hill sloping down to the right.
A reverse slope loss, as its name implies, is just the opposite. Hearing loss is mostly in the low frequencies, with little or no loss in the high frequencies. Thus a reverse-slope loss slopes up to the right. Reverse-slope losses–especially the extreme version I have, are very rare.
If you want to learn more about the strange names associated with the various kinds of hearing losses, and see the shapes they form on audiograms, read my short, illustrated article “ Kinds of Hearing Losses .”
If you want to learn more about the rare reverse-slope hearing loss and just how weird hearing is with this kind of loss, read my articles (long or abridged) entitled “ The Bizarre World of Extreme Reverse-Slope Hearing Loss that is now posted to the HearingLossHelp website...