Effects of Extended High-Frequency Hearing Loss on Speech-in-Noise Perception in Earphone Usage

Purpose: This study aimed to investigate the effects of earphone usage on extended high-frequency (EHF) hearing thresholds and speech-in-noise perception in young adults with normal hearing. Methods: Forty-seven participants aged 19~26 years with normal hearing were divided into three groups based on daily earphone usage: low (<1 hour/day), medium (1~3 hours/day), and high (>3 hours/day). Participants completed questionnaire on earphone use, conventional audiometry, EHF audiometry (9~20 kHz), and speech perception in noise tests at 5, 0, and -5 dB signal to noise ratio (SNR). Results: The high-use group showed significantly elevated hearing thresholds at 12.5, 14, and 16 kHz in the right ear and at 10 kHz in the left ear compared with the medium-use group (<i>p</i> < 0.05). Furthermore, the high-use group demonstrated poorer sentence recognition accuracy under -5 dB SNR compared with the low-use group (<i>p</i> < 0.05). Correlation analyses revealed that elevated thresholds at 16, 18, and 20 kHz in the right ear and 10 kHz and 14 kHz in the left ear were negatively associated with speech-in-noise accuracy (<i>p</i> < 0.05). Conclusion: Prolonged earphone use is associated with EHF hearing loss and reduced speech-in-noise perception, highlighting the need for auditory health education and preventive strategies. It means that the extended high frequency hearing loss may be a clinical index for predicting hearing change after earphone use.