What Is Low-Frequency Hearing Loss?

Low-frequency hearing loss is a relatively rare condition and means that a person has a decreased ability to hear deeper or low-pitched sounds—ones that occur in the frequency of 2,000 Hertz (Hz) or lower.

There are many different causes of low-frequency hearing loss, including Meniere's disease, genetic syndromes, and otosclerosis. Symptoms include a reduced ability to hear male voices (which are lower-pitched than female voices) and bass music. Treatment often involves hearing aids and/or addressing the root cause of the hearing loss.

The Hearing (Auditory) System

Your hearing (or auditory) system is divided into three main parts—the outer ear, middle ear, and inner ear.

  • Outer ear: Contains the pinna (the fleshy, visible part of your ear, also called the auricle) and the ear canal.
  • Middle ear: Contains the tympanic membrane (also called your eardrum) and three tiny bones called ossicles (malleus, incus, and stapes).
  • Inner Ear: Contains a snail-shaped structure called the cochlea, semicircular canals, and the auditory nerve.

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.

Types of Low-Frequency Hearing Loss

There are two main types of low-frequency hearing loss:

  • Sensorineural Low-Frequency Hearing Loss is caused by damage to the hair cells, your cochlea, or your auditory nerve.
  • Conductive Low-Frequency Hearing Loss is caused by a problem within your middle ear.

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, as compared to a woman's or a child's voice.

Other sounds that a person with low-frequency hearing loss may be unable to hear or have more difficulty hearing include:

  • Thunder in a rainstorm
  • The "humming" of a refrigerator
  • The "rumbling" sound of a car, truck, or airplane motor
  • Bass sounds (like a tuba) in a musical concert
  • Vowel sounds (which are spoken at a lower pitch than consonants)
  • Phone conversations (which delivers sounds at lower and middle frequencies)

It's important to note that people with low-frequency hearing loss can understand speech normally (although, they prefer face-to-face conversations). They also tend to have excellent speech skills because they can hear and are actually more sensitive or perceptive to high-frequency sounds.

Keep in Mind

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. 

Causes

Low-frequency hearing loss may be caused by either an inner ear problem (sensorineural hearing loss) or a middle ear problem (conductive hearing loss).

Sensorineural Low- Frequency Hearing Loss

Low-frequency sensorineural hearing loss is mainly 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

Meniere's disease develops as a result of fluid buildup within the inner ear (the exact mechanism remains unknown).

With Meniere's disease, a person will typically experience sudden episodes of vertigo, tinnitus, and hearing loss (which is almost always 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 (in addition to low).

causes of low-frequency hearing loss
Verywell / JR Bee

Genetic Mutations

Wolfram syndrome is a rare autosomal recessive genetic disease caused by a mutation (a change in the genetic sequence) of the WFS1 gene.

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), as well as other very rare genetic mutations, have been associated with low-frequency sensorineural hearing loss.

Low Cerebrospinal Fluid Pressure

Situations in which a person develops a low cerebrospinal fluid pressure in the brain, like after undergoing spinal anesthesia, may develop 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.

Ramsay Hunt Syndrome

Viral infections typically cause a sensorineural hearing loss associated with the loss of high-frequency sounds. However, in a syndrome called Ramsay Hunt Syndrome (where the herpes zoster virus infects the facial nerve), both high and low-frequency sensorineural hearing loss, along with facial paralysis, may occur.

Sudden Hearing Loss

Some types of sudden sensorineural hearing loss may affect low-pitch sounds. A person with sudden sensorineural hearing loss may experience other symptoms like ear fullness, vertigo, or tinnitus.

Conductive Low-Frequency Hearing Loss

Low-frequency hearing loss may also stem from a middle ear problem, such as secretory otitis media or otosclerosis.

Secretory Otitis Media

Secretory (also called serous) otitis media occurs when fluid accumulates within the middle ear as a result of an unresolved infection or from a eustachian tube blockage (e.g. from allergies).

With this fluid accumulation, your eardrum cannot vibrate properly to transmit sounds. Low-frequency sounds are reduced first followed by high-frequency sounds. 

Otosclerosis

Otosclerosis occurs when there is an overgrowth of the stapes bone in the middle ear, causing hearing loss in the lower frequencies.

This condition is more common in women and develops usually between the ages of 15 and 40. Possible causes include autoimmune processes and viral infections, as well as genetic, metabolic, and hormonal factors.

Diagnosis

Low-frequency hearing loss can be diagnosed by an audiologist with a hearing test. The hearing level results are displayed on a chart called an audiogram.

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 the opposite shape 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 doctor suspects that your low-frequency hearing loss is associated with other conditions, like Meniere's disease or otosclerosis, other diagnostic tests may be ordered, like imaging tests or vestibular testing.

Treatment

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 a blood patch procedure.

Likewise, low-frequency hearing loss from secretory otitis media generally improves on its own. If persistent or severe, an ear tube can 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 removing and replacing part or all of the stapes bone with a prosthetic device or implant. 

For irreversible causes of low-frequency hearing loss, hearing aids, which are programmed to amplify lower-pitch sounds, are the mainstay of treatment. 

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 (vertigo and tinnitus), various lifestyle habits and therapies may be useful, such as:

A Word From Verywell

If you are concerned about your reduced ability to hear low-pitch sounds, ask your doctor 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 for your pleasure, but also for your safety (so you are able to hear a car or truck approaching, for example).

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Article Sources
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