What is Reverse-Slope Hearing Loss?

Reverse-slope hearing loss makes it difficult to hear sounds that fall into lower frequencies. Read this article to learn more about this type of hearing loss.

What is Reverse-Slope Hearing Loss?

Reverse-slope hearing loss (RSHL) can also be referred to as sloping hearing loss or low-frequency hearing loss. It’s not a common type of hearing loss, and it is sometimes not easy to recognize.

Reverse-slope hearing loss makes it difficult to hear sounds that fall into lower frequencies, like rumbling thunder or a deep man’s voice. Today we’re taking a closer look at the causes and symptoms of reverse-slope hearing loss, as well as what your treatment options are.

What is Reverse-Slope Hearing Loss?

Reverse-slope hearing loss got its name from the shape of an audiogram chart. If you’ve never seen an audiogram, they look a little bit like a ski slope (Check one out here).

Just like with other types of hearing loss, RSHL can cause varying degrees of hearing loss. A more common form of hearing loss, high-frequency hearing loss, is easier to recognize than RSHL. This is down to how RSHL impairs your hearing.

What are the Symptoms of Reverse-Slope Hearing Loss?

With reverse-slope hearing loss, you can often hear most sounds without a problem. It’s generally only lower frequency sounds that you struggle to hear. Symptoms include:

  • You can understand women and children easier than male voices
  • You find in-person conversations easier to hear when compared to conversations on the phone
  • You don’t often hear the rumbling of a jet engine
  • Music can sound tinny
  • You may be able to hear high-pitched sounds more so than other people

It’s estimated that in the U.S. and Canada, RSHL is only diagnosed in 1 out of every 12,000 diagnoses of hearing loss. While not very common, this form of hearing loss can pose issues with safety. Common low frequency sounds you may be exposed to in your day to day life include:

  • Cars
  • Machinery
  • Industrial equipment

Not being able to hear these sounds can increase your risk of an accident. Therefore, it’s important to ensure you speak to a hearing healthcare professional if you suspect you have reverse slope hearing loss.

What Causes Reverse-Slope Hearing Loss?

Common causes of reverse-slope hearing loss include:

  • Inherited through a genetic trait
  • Wolfram syndrome or Mondini dysplasia
  • Childhood illness
  • Ménière’s disease
  • Anything that changes the pressure in your endolympth (fluid in your inner ear). This could be the result of a general or spinal anesthesia, perilymphatic fistula or intracranial hypertension.

How is Reverse-Slope Hearing Loss Diagnosed?

Reverse-slope hearing loss can be diagnosed with a hearing assessment. Your hearing healthcare professional will be looking for:

  • Unusually good speech
  • Poor speech perception without visual cues
  • High speech-detection thresholds
  • A sensitivity to environmental sounds that are high-frequency.
  • An inability to adjust to the standard ski-slope hearing settings.

How is Reverse-Slope Hearing Loss Treated?

RSHL can be treated with hearing aids. However, unlike more common forms of hearing loss (such as high-frequency hearing loss), reverse-slope hearing loss will require more bespoke settings.

We’re Here to Help!

Still have questions? Want to have your hearing checked? At Hearing Balance & Speech Center, we are committed to all of your hearing healthcare needs. Contact us at Hearing, Balance, & Speech Center to speak with one of our hearing professionals.


  1. https://www.bootshearingcare.com/hearing-test/audiogram/
  2. https://www.healthyhearing.com/report/53038-What-is-low-frequency-reverse-slope-hearing-loss
  3. https://medicine.uiowa.edu/iowaprotocols/how-read-audiogram
  4. https://www.audiologyhears.com/reverse-slope-hearing-loss/