Hearing Loss Perceptions in Patients With Subjective Asymmetry: Analysis and Implications

Area of Science:

• Audiology
• Otolaryngology
• Hearing Science

Background:

• Asymmetric hearing loss (AHL) affects many adults.
• Accurate self-assessment of hearing loss severity and asymmetry is challenging.
• Objective audiometric evaluation is the gold standard for diagnosing AHL.

Purpose of the Study:

• To assess the accuracy of self-reported hearing asymmetry in predicting objectively defined AHL.
• To identify patient factors influencing the over- or underestimation of hearing loss severity in individual ears.

Main Methods:

• Cross-sectional survey analysis of 50 adult patients with self-reported hearing asymmetry.
• Subjective hearing loss severity was quantified via survey before audiometric evaluation.
• Accuracy of self-reported AHL (≥ 15 dB interaural difference) and individual ear severity estimation was determined.

Main Results:

• 70% of patients inaccurately identified AHL based on audiometric results.
• Misclassification rates did not vary significantly by age, sex, or race.
• Patients with better binaural hearing (lower pure-tone averages) were more likely to misclassify AHL.
• The worse hearing ear was overestimated by 94% of misclassifying patients.
• The better hearing ear was underestimated by 58% of misclassifying patients.

Conclusions:

• Patient self-estimation of AHL (≥ 15 dB interaural difference) is unreliable.
• Better binaural hearing and less interaural asymmetry correlate with poorer estimation of the worse ear.
• Audiometric confirmation is essential, particularly for patients with preserved hearing.