Binaural loudness summation in the hearing impaired.

Binaural loudness summation was measured using three different paradigms with 10 normally hearing and 20 bilaterally symmetrical high-frequency sensorineural hearing loss subjects. An adaptive paradigm and a loudness matching procedure measured summation at the lower and upper level of comfortable loudness and the loudness discomfort level (LDL). Monaural and binaural LDLs also were obtained with a clinical procedure designed to select maximum output of hearing aids. Stimuli for all three tasks consisted of 500- and 4000-Hz pure tones and a speech spectrum noise. Binaural summation increased with presentation level using the loudness matching procedure, with values in the 6-10 dB range. Summation decreased with level using the adaptive paradigm, and no summation was present with the clinical LDL task. The hearing-impaired subjects demonstrated binaural summation that was not significantly different from the normally hearing subjects. The results suggest that a bilaterally symmetrical sensorineural hearing loss does not affect binaural loudness summation. The monaural and binaural dynamic range widths were similar, and the LDL results suggest that binaural loudness summation may not be an important factor in selecting maximum output of hearing aids.