Abstract
Background Binaural hearing is of utmost importance for communicating in noisy surroundings
and localizing the direction of sound. Unilateral hearing loss (UHL) affects the quality
of life in both childhood and adulthood, speech development, and academic achievements.
Sound amplification using air-conducting hearing aids (HAs) is a common option for
hearing rehabilitation of UHL. The processing time of digital HAs can significantly
delay the acoustic stimulation in 3 to 10 milliseconds, which is far longer than the
maximal natural interaural time difference (ITD) of 750 microseconds. This can further
impair spatial localization in these patients.
Purpose We sought to assess whether HA effects on ITD and interaural level difference (ILD)
impair localization among subjects with unilateral conductive hearing loss (UCHL).
Research Design “Normal”-hearing participants underwent localization testing in different free field
settings.
Study Sample Ten volunteers with “normal”-hearing thresholds participated.
Intervention Repeated assessments were compared between “normal” (binaural) hearing, UCHL induced
by insertion of an inactivated HA to the ear canal (conductive HL), and amplification
with a HA.
Results In UCHL mode, with HA switched-off, localization was significantly impaired compared
to “normal” hearing (NH; η2 = 0.151). Localization error was more pronounced when sound was presented from the
front and from the side of the occluded ear. When switched-on, amplification with
HAs significantly improved localization for all participants compared to UCHL. Better
localization with HAs was seen in high frequencies compared to low frequencies (η2 = 0.08, 0.03). Even with HAs, localization did not reach that of NH (η2 = 0.034).
Conclusion Mild UCHL caused localization to deteriorate. HAs significantly improved sound localization,
albeit the delay caused by the device processing time. Most of the improvements were
seen in high-frequency sounds, representing a beneficial effect of amplification on
ILD. Our results have potential clinical value in situations of mild CHL, for instance,
otitis media with effusion.
Keywords
Unilateral hearing loss - hearing aids - localization - amplification
