Abstract
Hearing loss is associated with decreased speech perception as well as with changes in the auditory pathway. The effects of those changes on binaural speech perception with hearing aids are not yet fully understood. To provide further evidence on the functional changes of the auditory pathway, several speech perception tests (unilateral and bilateral, aided and unaided, in quiet, and in noise) were conducted in a population of 370 bilateral hearing aid users covering the entire range of the World Health Organization’s most recent classification of hearing loss. To characterize the effects of asymmetric hearing thresholds, a generalized linear model was used for regression analysis. The model revealed a detrimental effect of the poorer ears’ thresholds on both the unaided and the aided unilateral word recognition scores that were attained by the better ear. Moreover, aided binaural word recognition (in quiet and in noise) was affected to a degree that cannot be explained on the sole basis of bilateral summation. Thus, this study provides evidence that there is reorganization and altered functioning of the afferent and efferent auditory pathways due to asymmetric hearing loss. Consequently, more attention should be paid to provision with a hearing aid as early as possible, and separately for each ear.
Highlights
Hearing loss is associated with a number of negative effects (Chia et al, 2007) and represents the fifth largest burden of disability (Vos et al, 2015)
We measured the unaided speech perception threshold in quiet and word recognition scores in noise, and we investigated the relationship between these routine clinical measures and the grade of asymmetry of hearing loss
In cases where there was a significant effect of asymmetric hearing loss on unilateral or bilateral scores, the results of the regression model are shown as examples for (i) symmetric hearing, (ii) for asymmetry of 15 dB, and (iii) for asymmetry of 30 dB
Summary
Hearing loss is associated with a number of negative effects (Chia et al, 2007) and represents the fifth largest burden of disability (Vos et al, 2015). There was Speech Perception in Hearing Aid Users With Asymmetric Hearing Loss no recommendation for treatment of the worse ear. The comment is made that “unilateral hearing loss can pose a significant challenge for an individual at any level of asymmetry. It requires suitable attention and intervention based on the difficulty experienced by the person” (WHO, 2021). For several reasons (Lin and Reed, 2021), the most commonly used reference for hearing loss is the PTA. This measure certainly fails to reflect the full impact of hearing loss (e.g., Plomp, 1978). Standardized speech perception tests should complement puretone audiometry as an indispensable measure for individuals with hearing loss
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