Table of ContentsView AllTable of ContentsTypesThe Auditory SystemSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Types
The Auditory System
Symptoms
Causes
Diagnosis
Treatment
Low-frequency hearing loss is a relatively rare condition in which a person has a decreased ability or inability to hear deeper or low-pitched sounds. These occur in the frequency of 2,000 hertz (Hz) or lower, like an airplane passing overhead or a running appliance.
There are many different causes of low-frequency hearing loss, including Meniere’s disease and genetic syndromes. Treatment often involves hearing aids or addressing the root cause, or both of these approaches.
Types of Low-Frequency Hearing Loss
The Hearing (Auditory) System
Your hearing (auditory) system is divided into three main parts—the outer ear, middle ear, and inner ear.
How you hear is a complex, precise phenomenon. Basically, your outer ear “catches” sound waves, which are funneled through your ear canal. The sound waves then vibrate your tympanic membrane, which causes the ossicles to move, stimulating very small hair cells located within your cochlea. These hair cells then turn the sound vibrations into nerve signals that are sent to your brain via your auditory nerve.
Low-Frequency Hearing Loss Symptoms
People with low-frequency hearing loss have a hard time hearing low-pitch, deeper sounds, like a man’s voice (which is typically deeper than that of a woman or child).
Other sounds that a person with low-frequency hearing loss may be unable to hear or have more difficulty hearing include:
It’s important to note that people with low-frequency hearing loss can understand speech normally (although they usually prefer face-to-face conversations).
There is a range of low-frequency hearing loss. Some people have only a mild loss, which may go undetected for years until a person undergoes diagnostic testing. Others have a more severe or profound hearing loss of low-frequency sounds.
Sensorineural Low-Frequency Hearing Loss
Low-frequency sensorineural hearing loss is associated with Meniere’s disease. Other potential causes include various genetic syndromes, low cerebrospinal fluid pressure, and possibly aging or viral infections.
Meniere’s Disease
With Meniere’s disease, a person will typically experience sudden episodes of vertigo,tinnitus, and hearing loss (which is usually low frequency). These episodes may last several minutes to a few hours.
Over several years, the hearing loss may become permanent and include the loss of high frequencies as well.
Verywell / JR Bee
Genetic Mutations
In addition to low-frequency sensorineural hearing loss, this condition causes diabetes mellitus,diabetes insipidus, and optic atrophy (when the nerve that connects your eye to your brain is damaged).
Besides Wolfram syndrome, a congenital malformation of the cochlea called Mondini dysplasia has been associated with low-frequency sensorineural hearing loss, as have other very rare genetic mutations.
Low Cerebrospinal Fluid Pressure
Situations in which a person develops a lowcerebrospinal fluidpressure in the brain, like after undergoingspinal anesthesia, may cause low-frequency sensorineural hearing loss.
With low cerebrospinal fluid pressure, the low-frequency hearing loss and other potential symptoms (e.g., headache, nausea, vertigo, tinnitus) become worse with standing or sitting up.
Aging
There are rare reports of low-frequency hearing loss occurring in old age. Hearing loss that occurs with age is usually high frequency.
Ramsay Hunt Syndrome
Viral infections typically cause a sensorineural hearing loss associated with the loss of high-frequency sounds.That’s not the case withRamsay Hunt syndrome.
Ramsay Hunt occurs when the shingles virus (herpes zoster) infects the facial nerve. This affects both high- and low-frequency sensorineural hearing loss. Facial paralysis may also occur.
Sudden Hearing Loss
Some types ofsudden sensorineural hearing lossmay affect low-pitch sounds. A person with sudden sensorineural hearing loss may experience other symptoms like ear fullness, vertigo, or tinnitus.
People with low-frequency sudden sensorineural hearing loss have a better chance of hearing recovery than those with high-frequency sudden sensorineural hearing loss.
Conductive Low-Frequency Hearing Loss
Low-frequency hearing loss may also stem from a middle ear problem, such as secretory otitis media orotosclerosis.
Secretory Otitis Media
Secretory (also called serous) otitis mediaoccurs when fluid accumulates within the middle ear as a result of an unresolved infection or from a eustachian tube blockage (e.g., from allergies).
Otosclerosis
Otosclerosisoccurs when there is an overgrowth of bone around the foot plate of the stapes bone in the middle ear, causing hearing loss in the lower frequencies.
This condition is more common in women and usually develops between the ages of 15 and 40. Possible causes include autoimmune processes and viral infections, as well as genetic, metabolic, and hormonal factors.
The audiogram will reveal a “reverse-slope” pattern, where the line on the graph starts at the lower left and slopes upward steeply, indicating the loss of low-pitched sounds.This is opposite the result seen on an audiogram for high-frequency hearing loss, where the line on the graph starts in the upper left and slopes downward steeply.
If your healthcare provider suspects that your low-frequency hearing loss is associated with other conditions, like Meniere’s disease or otosclerosis, other diagnostic tests may be ordered, such as imaging tests or vestibular testing.
Tests for Hearing Loss
The treatment of low-frequency hearing loss depends on the underlying cause.
Some causes are reversible—for example, low-frequency hearing loss that occurs as a result of low cerebrospinal pressure from spinal anesthesia can be reversed with ablood patch procedure.
Likewise, low-frequency hearing loss from secretory otitis media generally improves on its own. If persistent or severe, anear tubecan be placed. Low-frequency hearing loss is then usually restored.
Low-frequency conductive hearing loss from otosclerosis can generally be reversed through the surgical repair of the stapes bone in the middle ear. This surgery is called a stapedectomy (or stapedotomy) and involves using a laser to make a hole in the stapes footplate and then placing a prosthetic device or implant.
Hearing Aids, Therapies, and Modifications
For irreversible causes of low-frequency hearing loss,hearing aids, which are programmed to amplify lower-pitch sounds, are the mainstay of treatment.
Hearing aids are now available over the counter for adults 18 years and older with mild to moderate hearing loss.
It’s important to find an audiologist who has experience fitting hearing aids for people with low-frequency hearing loss. It may be a bit of a trial-and-error process to get the settings just right.
Meniere’s disease can be particularly tricky to treat, as the disease tends to occur in stages. Hearing loss may come and go earlier on in the disease, and then usually progressively worsens.
Besides hearing aids, in order to improve other symptoms of Meniere’s disease (such as vertigo and tinnitus), various lifestyle habits and therapies may be useful, including:
A Word From Verywell
If you are concerned about your (or your child’s) reduced ability to hear low-pitch sounds, ask your healthcare provider for an audiology referral. The good news is that this condition, albeit rare, can be diagnosed easily and objectively with an audiogram. Treatment is important—not only to make everyday life easier and more enjoyable, but also for your safety (so you are able to hear a car or truck approaching, for example).
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kresge Hearing Research Institute at University of Michigan Medicine.Low-frequency hearing loss.Wong ACY, Ryan AF.Mechanisms of sensorineural cell damage, death and survival in the cochlea.Front Aging Neurosci.2015;7:58. doi:10.3389/fnagi.2015.00058National Institute on Deafness and Other Communication Disorders.How do we hear?American Academy of Otolaryngology-Head and Neck Surgery.ENT health: Otosclerosis.National Institute on Deafness and Other Communication Disorders.Ménière’s disease.Rigoli L, Bramanti P, Di Bella C, De Luca F.Genetic and clinical aspects of Wolfram syndrome 1, a severe neurodegenerative disease.Pediatr Res. 2018;83(5):921–9. doi:10.1038/pr.2018.17Yoshida T, Sone M, Naganawa S, Nakashima T.Patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss and endolymphatic hydrops.J Laryngol Otol. 2015;129(1):95–7. doi:10.1017/S0022215114003399Botica I, Vrca A, Špero M, et al.A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome.Med Glas (Zenica). 2016;13(1):31–5. doi:10.17392/830-16Bowl MR, Dawson SJ.Age-related hearing loss.Cold Spring Harb Perspect Med. 2019;9(8):a033217. doi:10.1101/cshperspect.a033217Cohen BE, Durstenfeld A, Roehm PC.Viral causes of hearing loss: A review for hearing health professionals.Trends Hear.2014;18:2331216514541361. doi:10.1177/2331216514541361Kim CH, Choi H, Shin JE.Characteristics of hearing loss in patients with herpes zoster oticus.Medicine (Baltimore). 2016;95(46):e5438. doi:10.1097/MD.0000000000005438National Institute on Deafness and Other Communication Disorders.Sudden deafness.American Academy of Otolaryngology-Head and Neck Surgery.Conductive hearing loss.Children’s Hospital of Philadelphia.Otitis media with effusion (OME).Quesnel AM, Ishai R, McKenna MJ.Otosclerosis: Temporal bone pathology.Otolaryngol Clin North Am. 2018;51(2):291-303. doi:10.1016/j.otc.2017.11.001Salmon MK, Brant J, Hohman MH, et al.Audiogram interpretation. In:StatPearls. StatPearls Publishing; 2022.National Institute on Deafness and Other Communication Disorders.Hearing aids.U.S. Food & Drug Administration.OTC hearing aids: What you should know.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kresge Hearing Research Institute at University of Michigan Medicine.Low-frequency hearing loss.Wong ACY, Ryan AF.Mechanisms of sensorineural cell damage, death and survival in the cochlea.Front Aging Neurosci.2015;7:58. doi:10.3389/fnagi.2015.00058National Institute on Deafness and Other Communication Disorders.How do we hear?American Academy of Otolaryngology-Head and Neck Surgery.ENT health: Otosclerosis.National Institute on Deafness and Other Communication Disorders.Ménière’s disease.Rigoli L, Bramanti P, Di Bella C, De Luca F.Genetic and clinical aspects of Wolfram syndrome 1, a severe neurodegenerative disease.Pediatr Res. 2018;83(5):921–9. doi:10.1038/pr.2018.17Yoshida T, Sone M, Naganawa S, Nakashima T.Patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss and endolymphatic hydrops.J Laryngol Otol. 2015;129(1):95–7. doi:10.1017/S0022215114003399Botica I, Vrca A, Špero M, et al.A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome.Med Glas (Zenica). 2016;13(1):31–5. doi:10.17392/830-16Bowl MR, Dawson SJ.Age-related hearing loss.Cold Spring Harb Perspect Med. 2019;9(8):a033217. doi:10.1101/cshperspect.a033217Cohen BE, Durstenfeld A, Roehm PC.Viral causes of hearing loss: A review for hearing health professionals.Trends Hear.2014;18:2331216514541361. doi:10.1177/2331216514541361Kim CH, Choi H, Shin JE.Characteristics of hearing loss in patients with herpes zoster oticus.Medicine (Baltimore). 2016;95(46):e5438. doi:10.1097/MD.0000000000005438National Institute on Deafness and Other Communication Disorders.Sudden deafness.American Academy of Otolaryngology-Head and Neck Surgery.Conductive hearing loss.Children’s Hospital of Philadelphia.Otitis media with effusion (OME).Quesnel AM, Ishai R, McKenna MJ.Otosclerosis: Temporal bone pathology.Otolaryngol Clin North Am. 2018;51(2):291-303. doi:10.1016/j.otc.2017.11.001Salmon MK, Brant J, Hohman MH, et al.Audiogram interpretation. In:StatPearls. StatPearls Publishing; 2022.National Institute on Deafness and Other Communication Disorders.Hearing aids.U.S. Food & Drug Administration.OTC hearing aids: What you should know.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kresge Hearing Research Institute at University of Michigan Medicine.Low-frequency hearing loss.Wong ACY, Ryan AF.Mechanisms of sensorineural cell damage, death and survival in the cochlea.Front Aging Neurosci.2015;7:58. doi:10.3389/fnagi.2015.00058National Institute on Deafness and Other Communication Disorders.How do we hear?American Academy of Otolaryngology-Head and Neck Surgery.ENT health: Otosclerosis.National Institute on Deafness and Other Communication Disorders.Ménière’s disease.Rigoli L, Bramanti P, Di Bella C, De Luca F.Genetic and clinical aspects of Wolfram syndrome 1, a severe neurodegenerative disease.Pediatr Res. 2018;83(5):921–9. doi:10.1038/pr.2018.17Yoshida T, Sone M, Naganawa S, Nakashima T.Patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss and endolymphatic hydrops.J Laryngol Otol. 2015;129(1):95–7. doi:10.1017/S0022215114003399Botica I, Vrca A, Špero M, et al.A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome.Med Glas (Zenica). 2016;13(1):31–5. doi:10.17392/830-16Bowl MR, Dawson SJ.Age-related hearing loss.Cold Spring Harb Perspect Med. 2019;9(8):a033217. doi:10.1101/cshperspect.a033217Cohen BE, Durstenfeld A, Roehm PC.Viral causes of hearing loss: A review for hearing health professionals.Trends Hear.2014;18:2331216514541361. doi:10.1177/2331216514541361Kim CH, Choi H, Shin JE.Characteristics of hearing loss in patients with herpes zoster oticus.Medicine (Baltimore). 2016;95(46):e5438. doi:10.1097/MD.0000000000005438National Institute on Deafness and Other Communication Disorders.Sudden deafness.American Academy of Otolaryngology-Head and Neck Surgery.Conductive hearing loss.Children’s Hospital of Philadelphia.Otitis media with effusion (OME).Quesnel AM, Ishai R, McKenna MJ.Otosclerosis: Temporal bone pathology.Otolaryngol Clin North Am. 2018;51(2):291-303. doi:10.1016/j.otc.2017.11.001Salmon MK, Brant J, Hohman MH, et al.Audiogram interpretation. In:StatPearls. StatPearls Publishing; 2022.National Institute on Deafness and Other Communication Disorders.Hearing aids.U.S. Food & Drug Administration.OTC hearing aids: What you should know.
Kresge Hearing Research Institute at University of Michigan Medicine.Low-frequency hearing loss.
Wong ACY, Ryan AF.Mechanisms of sensorineural cell damage, death and survival in the cochlea.Front Aging Neurosci.2015;7:58. doi:10.3389/fnagi.2015.00058
National Institute on Deafness and Other Communication Disorders.How do we hear?
American Academy of Otolaryngology-Head and Neck Surgery.ENT health: Otosclerosis.
National Institute on Deafness and Other Communication Disorders.Ménière’s disease.
Rigoli L, Bramanti P, Di Bella C, De Luca F.Genetic and clinical aspects of Wolfram syndrome 1, a severe neurodegenerative disease.Pediatr Res. 2018;83(5):921–9. doi:10.1038/pr.2018.17
Yoshida T, Sone M, Naganawa S, Nakashima T.Patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss and endolymphatic hydrops.J Laryngol Otol. 2015;129(1):95–7. doi:10.1017/S0022215114003399
Botica I, Vrca A, Špero M, et al.A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome.Med Glas (Zenica). 2016;13(1):31–5. doi:10.17392/830-16
Bowl MR, Dawson SJ.Age-related hearing loss.Cold Spring Harb Perspect Med. 2019;9(8):a033217. doi:10.1101/cshperspect.a033217
Cohen BE, Durstenfeld A, Roehm PC.Viral causes of hearing loss: A review for hearing health professionals.Trends Hear.2014;18:2331216514541361. doi:10.1177/2331216514541361
Kim CH, Choi H, Shin JE.Characteristics of hearing loss in patients with herpes zoster oticus.Medicine (Baltimore). 2016;95(46):e5438. doi:10.1097/MD.0000000000005438
National Institute on Deafness and Other Communication Disorders.Sudden deafness.
American Academy of Otolaryngology-Head and Neck Surgery.Conductive hearing loss.
Children’s Hospital of Philadelphia.Otitis media with effusion (OME).
Quesnel AM, Ishai R, McKenna MJ.Otosclerosis: Temporal bone pathology.Otolaryngol Clin North Am. 2018;51(2):291-303. doi:10.1016/j.otc.2017.11.001
Salmon MK, Brant J, Hohman MH, et al.Audiogram interpretation. In:StatPearls. StatPearls Publishing; 2022.
National Institute on Deafness and Other Communication Disorders.Hearing aids.
U.S. Food & Drug Administration.OTC hearing aids: What you should know.
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