Effect of sensorineural hearing loss on loudness discomfort level and most comfortable loudness judgments

A simple up-down adaptive procedure was used to estimate the 50% point on the psychometric function for loudness discomfort level (LDL) and the two functions describing the range of most comfortable loudness (MCL) for listeners with sensorineural hearing impairment. For pure tone and speech stimuli, median LDL and MCL levels were observed at relatively constant SPLs for subjects with hearing loss less than or equal to dB HL and at progressively higher SPLs with further increase in hearing loss. Correlation analysis verified a statistically significant relationship between LDL and magnitude of hearing loss. The nonlinear relationship between LDL and hearing loss together with the large intersubject variability in the data suggest that prediction of LDL from hearing threshold would often be highly inaccurate. These results also demonstrate that averaging LDL data across a group of subjects with a wide range of hearing loss may lead to inaccurate conclusions regarding the effects of sensorineural hearing loss on LDL.