Hearing loss determination and assessment of the reduction in earning capacity taking speech discrimination tests in noise into account

摘要

BACKGROUND: In Germany the guideline for the hearing loss quantification and the resulting assessment of the reduction in earning capacity is the Konigsteiner Merkblatt (KM). The quantification depends on the results of the tone and speech audiogram in silence. However, speech discrimination tests in noise may provide additional information about the impairment of the ENT patients. Especially, the impairment of persons with a slight hearing loss, characterized by high-frequency hearing loss, in noisy environment can not be indicated by the measurement in silence, which is proposed in the KM. METHODS UND PATIENTS: The Gottingen sentence test in noise was applied as a supplement to the routine ENT procedures of the medical estimate in 135 test persons. Based on these measurement results a table for the percentage hearing loss in noise is defined. Furthermore, an integration of the hearing loss in noise in the assessment of the reduction in earning capacity is proposed in addition to the hearing loss in silence. RESULTS: Using the newly introduced hearing loss for speech in noise, a suitable assessment for persons with a slight hearing loss is achieved. By integrating it into the assessment procedure additionally to the hearing loss in silence, the hearing impairment of all patients can be rated depending on their speech test results in silence and in noise. In comparison to the results obtained by the KM, the new procedure does not lead to higher values for the proposed reduction in earning capacity in general, but instead seems to be equally suitable for all groups of patients.