The hearing test that could see what standard exams miss

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: Adult patients (age \> 18 years). Patients affiliated with a social security/health insurance system. Patients consulting the ENT department for hearing difficulties despite normal conventional pure-tone and speech audiometry performed in quiet. Patients whose native language is French. Patients who have received oral and written information about the study and have provided free and informed consent. Normal otoscopic examination: No external auditory canal obstruction. No history of middle ear surgery (except childhood tympanostomy tube placement). Presence of a translucent tympanic membrane in at least one quadrant, with no tympanic membrane perforation. No signs of active otitis infection. No signs of cholesteatoma. Well-ventilated middle ear cavity confirmed by conventional tympanometry at 226 Hz. \- Inclusion criteria for the control group: Adult patients aged between 18 and 25 years. Patients seen during an ENT consultation at Clermont-Ferrand University Hospital, without any hearing complaints. Patients with normal conventional pure-tone audiometry performed in quiet, defined as hearing thresholds between 0 and 20 dB HL across frequencies from 0.25 to 8 kHz, according to BIAP 2017 criteria. No selection bias is expected, as normal hearing is defined as hearing thresholds between 0 and 20 dB HL (BIAP 2017). This age range was selected because it provides the highest likelihood of including individuals with normal auditory function. -Exclusion criteria : Patients under legal guardianship, curatorship, judicial protection, or deprived of liberty. Pregnant or breastfeeding women. History of language disorders. Abnormal pure-tone audiometry in quiet, defined as: Mean pure-tone hearing loss \> 20 dB HL, or At least one frequency threshold \> 20 dB HL. Abnormal speech audiometry, defined as: Speech reception threshold on Lafon disyllabic word lists (male voice) \> 20 dB HL, and/or Maximum speech intelligibility score of 100% obtained at a level \> 40 dB HL. Refusal to participate in the study.