Integrated Otologic and Functional Hearing Profiles in an Academic Adult Population: Hidden-Risk Subgroups, Tinnitus, and Speech in Noise Vulnerability

Background: Everyday noise and acoustically demanding study and work environments may induce early auditory dysfunction, tinnitus, and speech‑in‑noise difficulties, long before clinically hearing loss is diagnosed. Academic communities combine high cognitive and communicative demands with long-term noise exposure, yet hearing problems in these settings are often under-recognized or normalized. Objectives: To characterize otologic history, self‑reported hearing, tinnitus, and speech‑in‑noise difficulties in a university population; to derive integrated otologic–hearing risk profiles; and to propose a conception for otologic–acoustic awareness in academic environments. Methods: We conducted a cross‑sectional survey among students and staff at the Wroclaw University of Science and Technology in Poland. The questionnaire covered otologic history, self‑rated hearing, tinnitus, speech‑in‑noise difficulties, and auditory behaviors. We analyzed age‑ and gender‑specific patterns and defined three integrated otologic–hearing groups by combining otologic history and self‑reported hearing status (“concordant impaired,” “concordant healthy,” and “possible hidden‑risk”). Results: One quarter of respondents reported a positive otologic history, with a clear age gradient peaking in the 51–65‑year age group. Despite generally favorable self‑rated hearing (88.8% very good/good), 11.0% reported that they “hear worse,” more than one-third reported at least poor speech understanding in noise, and 35.3% experienced short‑lasting or constant tinnitus. Three integrated groups emerged: 6.6% “concordant impaired,” 64.7% “concordant healthy” (negative otologic history and good hearing), and 28.7% “hidden‑risk” with discordant profiles. Tinnitus burden and speech‑in‑noise difficulties were concentrated in the “possible hidden‑risk” group, while hearing‑aid uptake remained extremely low (1.7% overall; 13.0% among those with worse/very poor hearing). Conclusions: In the academic population, otologic morbidity, tinnitus, and functional listening difficulties are common, and nearly one-third of respondents fall into a “possible hidden-risk” profile despite a predominantly negative otologic history and self‑reported “good” hearing. Integrated otologic–hearing profiles may provide a pragmatic tool to identify vulnerable subgroups and to guide otologic–acoustic awareness initiatives, early screening, and preventive interventions.