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Relating Sound Externalization, Own-Voice Perception, and Occlusion in Adults With Hearing Aids
1Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA.
Ear and Hearing
|July 21, 2026
Summary
Hearing aids can negatively impact sound externalization and voice perception, especially with closed-fit domes. Objective occlusion measures did not strongly correlate with these subjective ratings at the individual level.
Area of Science:
- Audiology
- Psychoacoustics
- Hearing Aid Technology
Background:
- Hearing aid domes can alter sound perception, making external sounds seem closer or internalized.
- The occlusion effect influences ear canal acoustics and perceived voice quality during speech.
Purpose of the Study:
- To investigate the relationship between hearing aid dome occlusion and sound externalization.
- To determine if the occlusion effect impacts the perception of externally presented speech.
- To assess the effect of hearing aids on own-voice naturalness.
Main Methods:
- Young adults with normal hearing and hearing loss participated.
- Participants were fitted with open- and closed-fit hearing aids, and used their own devices.
- Subjective ratings of sound externalization and voice naturalness were collected, alongside objective occlusion measurements.
Main Results:
- Hearing aids reduced sound externalization and own-voice naturalness compared to unaided listening.
- Closed-fit domes resulted in greater negative effects than open-fit domes.
- Objective occlusion measures did not significantly predict individual ratings of externalization or voice quality.
Conclusions:
- Hearing aids, particularly with closed fittings, negatively impact sound externalization and voice perception.
- Individual measures of occlusion and sound externalization showed a weak relationship.
- Regularly worn hearing aids may improve voice perception but disrupt externalization.
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