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Cookie bite hearing loss: causes, symptoms, and treatment

This unique type of hearing loss is the result of a dramatic loss in mid-frequency hearing levels.

Medically reviewed by

Dr. Jessica Hinson

Writtenm by

Dr. Jessica Hinson


May 3, 2024

The 3 key takeaways

  • Cookie bite describes mid-frequency hearing loss — This type of sensorineural hearing loss occurs when the tiny hair cells in the inner ear are damaged.
  • This type of hearing loss is quite rare — Few people with hearing loss have cookie bite hearing loss, and in most cases, it’s hereditary.
  • Tools for adaptation and support are available— Early intervention with the help of an audiologist will set the patient up for success.

Cookie bite hearing loss, or mid-frequency sensorineural hearing loss (MFSNHL), gets its unique name from the U-shaped audiogram graph correlated to this type of hearing loss. People with cookie bite hearing loss have trouble in the mid-frequency range of around 500 to 2,000 Hz, while their low and high-frequency hearing remains intact. Most speech communication and music fall into this middle-frequency range of sound, making it a debilitating loss for those affected.

Signs and symptoms of cookie bite hearing loss

Cookie bite hearing loss is quite uncommon, with a reported prevalence of just 0.7%. However, a few clues that you may be affected by MFSNHL is if you’re having trouble hearing everyday conversation or constantly turning the TV volume up. As with other forms of hearing loss, your friends and family may be the first to notice something is wrong.

What causes cookie bite hearing loss?

Don’t fall prey to common hearing loss myths. Genetic or environmental factors can cause this unique form of hearing loss, but it is usually hereditary. In genetic cases, symptoms either appear at birth (congenital) or appear gradually over time. In very rare instances, acoustic neuromas, or benign tumors in the inner ear, can cause cookie bite hearing loss.

Diagnosis of cookie bite hearing loss

Audiologists diagnose patients with cookie bite hearing loss by administering a hearing test that produces an audiogram graph. This graph prints a visual representation of each patient’s specific type of hearing loss. The graph uses a frequency axis to represent the degree of frequency or pitch of sound and an intensity axis to convey the intensity or sound. In cookie bite hearing loss, there is a visible dip in the graph at the mid-frequency level, causing the graph to look like a cookie bite.

Impact of cookie bite hearing loss on daily life

Because most speech and music sounds register at the mid-frequency level, those with cookie bite hearing loss must adjust their everyday lives. Some people find it helpful to make home modifications for hearing loss, such as installing active listening systems and different types of alarms.

Making small adaptations in public spaces can be very beneficial for those with this type of hearing loss. For instance, sitting close to the person speaking in a crowded social setting and watching their face can help overcome some communication barriers. Choosing a seat near the amplification device may be most helpful in a public speaking or classroom environment.

Cookie bite hearing loss treatment and management

People suffering from hearing loss often turn to hearing aids for treatment and management. Hearing aids that amplify sounds in the mid-frequency range are the best option for those with cookie bite hearing loss. Many models and styles of hearing aids can fit the bill, so long as they have a customizable frequency response that your audiologist can program. Unfortunately, over-the-counter hearing aids are usually not a good fit for those with cookie-bite hearing loss, as they cannot accommodate mid-frequency hearing loss.

Bluetooth connectivity and feedback management are a few other features to consider when shopping for a hearing aid with this type of hearing loss. Phone conversations and watching television are difficult for people with cookie bite hearing loss, since these are often mid-frequency sounds. A Bluetooth connection that allows for phone call streaming is a helpful tool. Feedback management works to cancel any feedback or whistling sounds in the ear canal the microphone or receiver in the canal may cause.

Living a full life with cookie bite hearing loss

Cookie bite hearing loss is a life-changing diagnosis and patients may have to reevaluate many areas of their lives. The progression of hearing loss over time can vary dramatically from person to person. Those with mid-range hearing loss often struggle to understand speech, particularly in noisy environments, and this can be among the first signs that something is wrong. Early intervention is key to receiving the best support and tools necessary, so do not hesitate to schedule an appointment with an audiologist.

After diagnosis, support from family and friends is crucial. Those closest to you can help with the big decisions to follow, such as hearing aid selection and in-home modifications. Patients with cookie bite hearing loss must not allow this diagnosis to rule their lives but need the right treatment and tools to support their hearing loss journey.

Frequently asked questions

How is cookie bite hearing loss diagnosed?

Audiologists and hearing health professionals can diagnose this form of hearing loss with the help of an audiogram graph.

Is cookie bite hearing loss a disability?

Legally speaking, yes, this form of hearing loss is considered a disability. According to the Americans with Disabilities Act (ADA): “the term “disability” refers to a physical or mental condition that limits one or more major life activities.” The limitation in this case is hearing.

Can cookie bite hearing loss be prevented?

Because this type of hearing loss is often genetic and passed down from family members, it is often not preventable. Additionally, sensorineural hearing loss cannot be reversed but treated and managed to prevent less damage going forward.

Can mid-range hearing loss be reversed?

Mid-range or mid-frequency hearing loss cannot be reversed or cured. This is why early intervention for treatment options is so important.

Does cookie bite hearing loss always get worse?

There is no way to predict how each individual’s hearing loss may progress. Some people experience a sudden decline in hearing, while others decline slowly over time. Your audiologist can provide more in-depth knowledge as to your hearing health.