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Hearing Loss Perceptions in Patients With Subjective Asymmetry: Analysis and Implications
Aaron Tucker1, Andrew Belilos1, Pavan S Krishnan2
1Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond.
American Journal of Audiology
|July 17, 2026
Summary
Patients often misjudge hearing asymmetry, especially those with better hearing. Audiometric confirmation is crucial for accurate assessment of hearing loss severity.
Area of Science:
- Audiology
- Otolaryngology
- Hearing Health
Background:
- Asymmetric hearing loss (AHL) affects many adults.
- Accurate self-assessment of hearing loss severity is challenging.
- Objective audiometric evaluation is the gold standard for diagnosing hearing loss.
Purpose of the Study:
- To evaluate the accuracy of self-reported hearing asymmetry in predicting objectively defined asymmetric hearing loss (AHL).
- To identify patient factors associated with over- or underestimation of individual ear hearing loss severity.
Main Methods:
- Cross-sectional survey analysis of 50 adult patients reporting hearing asymmetry.
- Subjective hearing loss severity was quantified via survey before audiometric evaluation.
- Accuracy of self-reported AHL (≥ 15 dB interaural difference) was determined.
Main Results:
- 70% of patients incorrectly identified AHL based on audiometric testing.
- Patients with better binaural hearing were more likely to misclassify AHL.
- Worse hearing ears were significantly overestimated (94% of misclassifications), while better ears were underestimated (58% of misclassifications).
Conclusions:
- Patients do not reliably estimate AHL, particularly those with better hearing and less asymmetry.
- Audiometric confirmation is essential for accurate diagnosis and management of hearing loss.
- Overestimation of worse-hearing ears is a common bias.
