Korean J Otorhinolaryngol-Head Neck Surg.  2023 Dec;66(12):798-804. 10.3342/kjorl-hns.2023.00010.

Comparison of Loudness Discomfort Level by the Testing Method in Adults With Normal Hearing and in Patients With Sensorineural Hearing Loss

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea


Background and Objectives
There are several variations in the technique for measuring loudness discomfort levels (LDL). The aim of this study was to evaluate LDL by measuring pure tone and narrow-band noise (NBN) in adults with normal hearing and in patients with sensorineural hearing loss, and to analyze the correlation of LDL at different frequencies.
Subjects and Method
Normal listeners (n=41) with the pure tone average of 12 dB HL and patients with hearing loss (n=42) with the pure tone average of 52 dB HL were studied from 2021 to 2022. Pure tone audiometry and LDL test by pure tone and NBN were performed twice in all participants at 250, 500, 1 k, 2 k, 3 k, 4 k, and 8 kHz.
The LDL test showed some inter-subject variability with the mean being 107.0±9.4 dB, 106.0±11.6 dB by pure tone, and 100.1±6.8 dB, 100.4±6.7 dB by NBN (right and left ear, respectively) in the normal hearing group. There were no significant differences between LDL average by pure tone or NBN between two groups. Two serial tests showed high test-retest reliability. There was no difference in LDL between the two groups at each frequency, except for LDL by pure tone at 8 kHz in the left ear. High correlation of LDL was observed between different frequencies, except between 8 kHz and the other frequencies.
LDL by pure tone and NBN were consistent with or without hearing loss. High correlation of LDL between different frequencies were shown except at 8 kHz. It might be sufficient to measure LDL once by pure tone only, including 8 kHz.


Hearing; Loudness perception; Pure-tone audiometry
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