Abstract
<title>Abstract</title> <p> <bold>Aim and Objectives</bold> This study investigates the impact of Acceptable Noise Level (ANL) on speech perception and evaluates how varying degrees of sensorineural hearing loss (SNHL) influence a user’s subjective tolerance for background noise. The primary objective was to determine the relationship between ANL thresholds and clinical success in both normal-hearing and hearing-impaired populations. <bold>Material and Methods</bold> A total of 72 subjects were recruited and divided into two cohorts: Group 1 (n = 24, normal hearing) and Group 2 (n = 48, varying degrees of SNHL ranging from mild to moderately severe). Following comprehensive audiometric and impedance evaluations, behavioral ANL was measured using standardized Hindi and English speech passages. This approach allowed for a comparative analysis of how the severity of hearing loss dictates the psychoacoustic willingness to accept background noise while maintaining focus on a primary speech signal. <bold>Results</bold> The data revealed a clear progression: as the severity of hearing loss increased, the capacity to tolerate background noise significantly decreased. The mean ANL for the normal-hearing group was 11.12 ± 2.29 dB. Within the hearing-impaired cohort, mean ANL values rose progressively with the degree of loss: 12.15 ± 1.28 dB (mild), 16.20 ± 2.7 dB (moderate), and 18.60 ± 2.61 dB (moderately severe). These findings indicate that higher degrees of SNHL are associated with a diminished ability to manage noise interference, regardless of absolute word recognition scores. <bold>Conclusion</bold> The results underscore ANL as a critical prognostic indicator for hearing aid outcomes. While individuals with low ANLs ( <bold>< 7</bold> dB) demonstrate high tolerance and a strong probability of device success, those with high ANLs ( <bold>></bold> 13 dB) face significant challenges in noise acceptance. Incorporating ANL testing into the standard audiological battery enables clinicians to provide more accurate counseling, set realistic expectations, and personalize rehabilitative strategies for hearing aid users. </p>