Functional hearing loss may be defined as a decrease in measured auditory acuity without a known organic basis. Usually a diagnosis of functional hearing loss is made when there are significant intratest or intertest disagreements among audiometric assessments of a person's hearing acuity, and medical examination reveals that the discrepancies cannot be attributed to organic pathology, such as otitis media. Thus a diagnosis of functional hearing loss is based on a consideration of audiometric, otological, and other medical findings. Functional hearing loss is usually superimposed upon an organic auditory deficit, in which case it is referred to as a functional overlay. Functional hearing loss without an organic component appears to occur rarely.
One of the most commonly accepted indications of functional hearing loss is puretone threshold variability greater than ±5 db. in the absence of a known organic condition to account for such variability.3-5 There are, however, a number
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