two similar cases: one repair of a congenital unilateral conductive loss
with no subjective awareness of improvement; one unilateral conductive
loss from early childhood for which the individual chose to purchase a
tympanette. Both were men in their early thirties. Both denied benefits
but reported that their families noted major improvement.
There are subtle difficulties we cannot measure, and related improvement
we ergo cannot measure. When one ear is normal ... But a conductive loss
means the person's own voice, by bone conduction, has "taught"
transmittors and receptors from the affected ear to do some processing ...
which ought to make it "trainable."
But go to a cafeteria with the person, along with Erber's programme on
a laptop for measuring conversational performance (the one where you press
the space bar while the flow of conversation is interrupted). Do it pre
and post surgery; do it without and with a HA; do it soon after surgery
and again several months later when neural plasticity has enabled the
brain to lear to process newly available acoustic information ; do it
similarly after several months of HA wear. There ought to be some
measurable benefits that word recognition tests would never distinguish.
Maxianne Berger, merely musing