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A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram

Jafari, Zahra; Baguley, David; Kolb, Bryan E.; Mohajerani, Majid H.

A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram Thumbnail


Zahra Jafari

David Baguley

Bryan E. Kolb

Majid H. Mohajerani


OBJECTIVES: Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers. DESIGN: A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss." RESULTS: From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses. CONCLUSIONS: Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.

Journal Article Type Article
Acceptance Date Mar 25, 2022
Online Publication Date May 13, 2022
Publication Date Nov 1, 2022
Deposit Date Apr 25, 2022
Publicly Available Date May 14, 2023
Journal Ear and hearing
Print ISSN 0196-0202
Electronic ISSN 1538-4667
Publisher Ovid Technologies (Wolters Kluwer Health)
Peer Reviewed Peer Reviewed
Volume 43
Issue 6
Pages 1643-1652
Keywords Speech and Hearing; Otorhinolaryngology
Public URL
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