Difficulties with speech intelligibility in noise in spite of a normal pure-tone audiogram

A group of 15 patients with complaints of having difficulties in understanding speech, especially in noisy surroundings in spite of (nearly) normal pure-tone audiograms, was subjected to a battery of speech-audiometric tests. The results showed that these subjects had a statistically significantly higher speech reception threshold (SRT) for sentences in noise than a reference group of 10 normal-hearing subjects. This difference was most clear for a fluctuating masking noise. In conditions with much reverberation, the patients also proved to be handicapped more than the control group. Binaural hearing gain was equal for both groups. The pathogenesis of the speech-hearing loss is not known, but assessment of the SRT in noise proves to be a valuable asset in objectifying these patients' complaints.