Modification of Speech Discrimination in Patients with Binaural Asymmetrical Hearing Loss

Abstract

Ten patients with bilateral asymmetrical hearing losses were tested for differences in speech discrimination scores under the following listening conditions: poorer ear under earphone; better ear under earphone; sound field, ears unoccluded; and sound field, poorer ear occluded. A patient manifesting a bilateral asymmetrical hearing loss may not be able to either separate or integrate two speech signals; however, occlusion of the poorer ear may be an advantageous means of obtaining maximum speech discrimination. Examination of the speech discrimination scores indicates the existence of detrimental interaction between ears exhibiting bilateral asymmetrical hearing loss. These findings also indicate that when the difference between ears is greater, speech discrimination is better than when asymmetry approximates symmetry. Apparently, the greater the impairment in the better ear, the greater the results to be gained by occluding the poorer ear. These findings were interpreted as being relevant in determining candidacy for binaural amplification. Such candidacy should be determined on the basis of speech discrimination scores obtained from each ear independently, and the combined effect of both aids.