Single-Sided Deafness as Pseudohypacusis

Introduction This case report will show the diagnosis of pseudohypacusis via audiometric measurements in a case of subjective single-sided deafness (SSD). We report the case of a 53 years old male patient with alleged SSD and the potential need for cochlear implantation.

Method Standardized audiometric measurements to evaluate the potential of cochlea implantation were performed. Because of the discrepancy between the self-reported and the objective audiometric measurements, additional testing was performed.

Results All subjective tests (Weber, threshold audiometry, speech audiogram) revealed a normal hearing on the right and deafness on the left side. However, there were repeatable stapedius reflexes ipsilateral on the left side and good directional hearing (localization 93% in the adaptive Oldenburg Sentence Test). Brain stem audiometry showed a threshold of 30 dB on the right and 50 dB on the left ear. Otoacoustic emissions were detectable on both sides, the Stenger test was positive.

Discussion While pseudohypacusis is the most common cause of single-sided deafness in children, it is a rare finding for SSD in adults where cases are often associated with insurance claims. In this case, the patient did not have any financial or social benefits through the diagnosis of SSD. The underlying cause was determined to be of psychiatric nature and the treatment was integrated into already ongoing psychotherapy. The results underline the importance of a systematic and careful audiometric and psychological assessment prior to cochlear implantation.

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Publication History

Article published online:
10 June 2020