How Concussions Affect Hearing

A concussion or mild traumatic brain injury (mTBI) doesn’t just affect memory and balance—it can also disrupt the auditory system, making it harder for the brain to process sound efficiently. This can result in tinnitus (ringing in the ears) and difficulty hearing despite having a normal hearing test, as concussions often impair how the brain interprets and organizes sound.

At our audiology clinic, we specialize in diagnosing and managing post-concussion hearing, tinnitus and auditory processing issues, ensuring you receive the right care for long-term recovery.

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The Brain, Hearing, & Concussions

The Central Auditory Pathway is very vulnerable to Injury

 The central auditory pathway, which connects the ears to the brain, is particularly vulnerable to injury after a concussion. This damage can lead to:
✔ Diffuse axonal injury – Damages the connections between the cochlea and the brain
✔ Deafferentation & neuronal loss – Reduces the brain’s ability to process sound precisely
✔ Reduced neural synchrony – Disrupts the timing and coordination of auditory signals

 Cognitive Changes & Auditory Processing

Since cognition and hearing are closely linked, concussions often cause top-down disruptions in the brain’s ability to process sound, leading to:
🔹 Reduced speech processing speed
🔹 Deficits in attention & focus
🔹 Challenges in executive function & memory
🔹 Language processing difficulties

Common Hearing & Auditory Symptoms After a Concussion

1. Hearing Difficulties

🔹 80-100% of concussion patients report difficulty hearing, especially in noisy environments (Hoover et al., 2014; Oleksaid et al., 2012).

💬 “I can’t follow conversations in a crowded room.”
💬 “Fast speech sounds jumbled or different than before my injury.”

Why does this happen?

• The brain struggles to process speech in complex environments.

• Traditional hearing tests may show "normal hearing", but the auditory system is compromised.

2. Tinnitus (Ringing in the Ears)

🔹 Post-concussion tinnitus is often more severe than non-injury-related tinnitus

🔹 Tinnitus can interfere with sleep, concentration, and emotional well-being.

💬 “The ringing in my ears won’t stop, and it’s making it hard to focus.”

3. Hyperacusis (Sound Sensitivity)

🔹 Concussions can cause poor sound tolerance, making everyday sound feel uncomfortably loud.

💬 “Sudden noises make me anxious, and everything sounds too sharp or harsh.”

Comprehensive Concussion Hearing Evaluations

A standard hearing test may not detect post-concussion hearing issues. That’s why we offer advanced audiological testing to assess how well the brain processes sound.

Testing may Include:

✔ Comprehensive Hearing Evaluation – Checking overall hearing ability
✔ Speech-in-Noise Testing – Evaluating how well you hear in real-world situations

✔ Auditory Processing Test Battery – Assessing how both ears work together, how the brain fills in missing sounds, and how it processes timing
✔ Tinnitus & Hyperacusis Assessments – Measuring how tinnitus and sound sensitivity affect daily life

✔Electrophysiological Testing: Objective Measures of Auditory Processing

We use cutting-edge electrophysiology to measure how well the brain encodes sound: Frequency Following Response (FFR).

FFR: A Breakthrough in Concussion Diagnosis & Recovery Tracking

The Frequency Following Response (FFR) is a highly reliable, sensitive, and objective measure of concussion-related auditory processing deficits.

🔹 FFR shows

✔ Concussed patients show a smaller response to fundamental sound frequencies.
✔ Speech processing accuracy is reduced, affecting how pitch and timing are perceived.
✔ Neural timing is delayed compared to individuals without a concussion.

📌 How does FFR help track recovery?
🔹 Long-term studies show that fundamental frequency processing improves as concussion symptoms fade.
🔹 FFR can confirm when the auditory system has healed and is functioning normally again.