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Speech discrim after correction of conductive hearing loss

Ronald Blue rcb5 at classic.msn.com
Thu Oct 2 01:09:05 EST 1997

From: 	daemon at net.bio.net on behalf of Susan M Lopez
Sent: 	Tuesday, September 30, 1997 9:36 PM
To: 	audiolog at net.bio.net
Subject: 	Re: Speech discrim after correction of conductive hearing loss

>If discrim is WNL at a resonable volume, and nothing
>else is going on, this man seems to be in need of some counseling rather
>than a hearing aid.  :
>> I recently saw a 36 year old man who had a maximum conductive >>hearing
>> loss (near as I can tell from what he told me) from early childhood. 
>> Two years ago he had an operation which corrected this, and now his >>air
> >conduction thresholds are within normal limits (15 or better, in fact.) 
> >Hearing has always been excellent at the other ear.  His complaint was
> >that whenever he isolates this ear, he can't hear words, for example
> >when he's on the telephone or when someone whispers in that ear.  His
> >speech testing in the booth is normal (SRT agrees with pure tones, >>word
>> recognition is 92%.)  Does anyone know of any ways of "strengthening"
> >that ear?  I have some ideas, and I was wondering what other
> >audiologists might suggest.   (I thought about having him get a WIDEX
> >SENSO for that ear, but Canada is too far away!)
The keywords are "since early childhood".  Sensory processing is
heavily dependent on learning.  Now the new experience of hearing
is an interaction between the repaired ear and the old ear.  Most
likely the interaction is creating a main gaussian oscillon processing
area that is discrepant from the historical area.  New neuro paths are
being formed and the old ones are dieing off from lack of use.  In this 
case I suppect that the ear that was repaired was the right
ear and the old ear was the left ear.  The two different hemispheres
process information differently.  While I have never read it in the
literature, I would suppect that the left ear would specialize in low
frequency data, and the right in high frequency data.  When the brain 
could specialize, it did so with unpleasant consequence.   The lost
of a previous skill.  The whole process of degradation
may be linked to now forming opponent filters which will ultimately form
a normal hearing system.  But in this case, a superior system relative to
the normal is being destroyed.  

Now to the question.  If the above is true what do you do.
The suggestion was a hearing aid which would increase the relative
neuro firing strength which would increase the relative opponent
firing strenght of the repaired ear.   So I believe this may be a good
choice under the circumstances.

By the way this is not pure speculation and only my opinion.
Ron Blue

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