Ability to hear better in the midst of noisy surroundings is a conspicuous symptom of some patients with defective hearing. It is usually limited to hearing of the spoken voice, and is observed apparently only when deafness is the result of obstruction in the conduction mechanism. It is, of course, necessary that both ears be involved and that the defect in hearing be fairly well developed before this symptom may be recognized. The paracusis becomes increasingly conspicuous as the deafness progresses; it persists in those cases in which, in addition to the defect from obstruction, the secondary degeneration of the eighth nerve, which sooner or later complicates many advanced cases of obstructive deafness, all but wipes out the hearing for the voice.
That some deafened persons actually hear the voice better in noisy than in quiet surroundings, better even than does a person with normal hearing, is readily
SHAMBAUGH GE. EXPLANATION FOR THE SYMPTOM OF PARACUSIS WILLISI: A DEMONSTRATION. Arch Otolaryngol. 1927;6(3):228–236. doi:10.1001/archotol.1927.00610010244004
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