Use of Threshold-Equalizing Noise (TEN) Test in Detecting Cochlear Dead Region

Authors : Muhammed Pınar, Özge Kale Peşan, Işılay Öz

Pages : 51-59

Doi:10.51536/tusbad.1782722

View : 126 | Download : 145

Publication Date : 2025-12-28

Article Type : Review Paper

Abstract :Cochlear dead regions (DR) are defined as areas where inner hair cells and/or spiral ganglion neurons are nonfunctional, resulting in the failure of acoustic signals to be transmitted to the central nervous system. Acoustic signals corresponding to the frequencies within these regions, when presented at sufficiently high intensities, may be detected by adjacent healthy regions; however, this phenomenon negatively affects frequency resolution and neural encoding. Clinical indicators such as profound sensorineural hearing loss, steeply sloping audiometric configurations, and difficulties in speech discrimination suggest the presence of cochlear dead regions. In recent years, the Threshold-Equalizing Noise (TEN) test has been increasingly utilized for the detection of cochlear dead regions. In this review, studies published between 2020 and 2025 in the electronic databases PubMed, Web of Science, and Scopus were analyzed using the keyword \\\"threshold-equalizing noise.\\\" Accordingly, our review highlights the role of the TEN test in the assessment of cochlear dead regions. The literature reports that the TEN test threshold is independent of both stimulus intensity and frequency; it may be used to determine the prognosis of sudden sensorineural hearing loss; it should be employed in the identification of cochlear DR in individuals with tinnitus, although it may be insufficient in some cases; TEN test reflects not only inner hair cell dysfunction but also outer hair cell dysfunction; it has limitations in detecting cochlear dead regions during the early stages of severe acute respiratory syndrome coronavirus 2 infection; and that acoustic change complexes should be used to establish normative data in populations where the test has not been applied. It has also been reported that the predictive power of the TEN test can be enhanced by integrating it with artificial intelligence. Due to limited studies on the TEN test for identifying cochlear DR, further research is recommended to expand its clinical use.
Keywords : Koklear, Duyma eşiği, Gürültü

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