Functional components and resolved thresholds in patients with unilateral nonorganic hearing loss

This study expanded upon previous work (Gelfand & Silman, 1985) on the relationship between functional components (the difference between the nonorganic and resolved thresholds) and the underlying organic hearing levels. The nature of nonorganic hearing loss (NOHL) was studied with respect to hearing sensitivity after resolution of the nonorganic components in 25 patients with unilateral NOHLs. Most of the subjects had an organic hearing loss underlying the functional components. The configuration of the functional components as a function of frequency was related to that of the resolved hearing levels in a manner similar to that reported for bilateral NOHLs. The strategy employed to exaggerate the loss in the ear with the nonorganic overlay appeared to be unrelated to the nature of the loss in the opposite ear, but the perception of an interaural difference might in some way bias the patient to 'choose' a unilateral NOHL as opposed to a bilateral one. The findings confirm and expand upon the prior ones, suggesting the use of an internalized loudness-based anchor by patients with NOHLs. Thus, the pure tone configuration of NOHL is consistently accounted for on the basis of known and explainable auditory factors regardless of whether the hearing levels are exaggerated in one or both ears.