Disparity of the results between pure-tone and DPOAE testing in adults with acute sensorineural hearing loss

Abstract

　Combined use of objective testing (such as DPOAEs and ABR) and behavioral testing is recommended for pediatric audiologic assessment, whereas in adults, the results of pure-tone audiometry are usually not verified by objective testing. However, there are some reports of adult cases in which disparities have been demonstrated between the results of subjective and objective auditory testing. In this study, we investigated 38 patients initially diagnosed as having idiopathic sudden sensorineural hearing loss (idiopathic SSNHL) and 18 patients diagnosed as having Ménière's disease by DPOAE for objective hearing assessment. In 4 of the patients (2 of SSNHL and 2 cases of sudden hearing loss because of Ménière's disease), substantial discrepancies were observed between the pure-tone audiogram and DPgram. These 4 cases were finally diagnosed as having psychogenic hearing loss. DPOAEs are easy to perform, and are valuable for early detection of psychogenic hearing loss. The possibility of psychogenic sudden hearing loss should be borne in mind in adult cases. The percentage of cases of psychogenic causes among patients with SSNHL might be underestimated.