Reverse Slope Hearing Loss
Reverse slope hearing loss is an audiogram configuration in which hearing thresholds are poorer at low frequencies and relatively better at high frequencies. This is the opposite pattern of the high-frequency sloping hearing loss commonly seen in age-related and noise-induced hearing loss. When plotted on an audiogram, the line connecting the thresholds slopes downward from left (low frequencies) to right (high frequencies) rather than upward, creating what appears as a reversed or descending slope.
Reverse slope hearing loss is also called low-frequency hearing loss. It is uncommon compared to high-frequency patterns and is most often associated with genetic or hereditary causes, Meniere's disease, superior semicircular canal dehiscence, and some cases of sudden sensorineural hearing loss. People with reverse slope hearing loss tend to have most difficulty hearing low-pitched sounds (bass tones, the rumble of voices in a group) and may find voices sound thin or high-pitched.
Hearing aid fitting for reverse slope hearing loss differs from the standard approach because amplification is required at lower frequencies rather than high ones. This can feel unusual to first-time wearers who may notice the bass quality of their own voice or environmental sounds increasing. Real ear measurement is particularly important in these fittings to verify that low-frequency gain targets are being met. See also the glossary entry for Low-Frequency Hearing Loss.
