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Dissociative deafness — Clinical Guidelines

Overview

Dissociative deafness encompasses conditions where auditory perception is impaired due to central nervous system dysfunction rather than peripheral auditory damage. This includes scenarios like word deafness and central deafness resulting from midbrain lesions, distinct from peripheral hearing loss.

Diagnosis

Clinical Presentation: Difficulty understanding spoken words despite intact peripheral hearing 8 16.

Neurological Assessment: Evaluation for central nervous system involvement, including imaging studies (e.g., MRI) to identify lesions 9 16.

Auditory Processing Tests: Use of speech pattern audiometers and electropalatography to assess speech production and perception deficits 11 12.

Speech Therapy Evaluation: Assessment by speech and language therapists for phoneme discrimination and speech rehabilitation needs 2 8.

Management

Speech and Language Therapy: Focused rehabilitation programs targeting phoneme discrimination and speech production skills 2 8.

Assistive Devices: Utilization of contralateral routing of sound (CROS) aids and bone conduction devices (BCDs) for single-sided deafness 4.

Educational Support: Tailored educational strategies and accommodations for pediatric patients 2.

Communication Strategies: Development of alternative communication methods, especially for special populations like deaf surgical trainees 1.

Special Populations

Pediatrics: Emphasis on early intervention with speech therapy and assistive listening devices 2 4.

Pregnancy: Special considerations for communication with deaf pregnant patients, utilizing written communication when necessary 10.

Elderly: Limited specific data; focus on comprehensive neurological and auditory assessments 17.

Key Recommendations

Implement comprehensive speech and language therapy for patients with word deafness and central auditory processing disorders to improve communication skills (Evidence: Moderate 8).

Utilize assistive listening devices such as CROS aids and BCDs for managing single-sided deafness to enhance auditory perception (Evidence: Moderate 4).

Ensure adequate training and support for healthcare providers in communication strategies for deaf patients, particularly in specialized fields like otolaryngology (Evidence: Expert opinion 1).

References

1 Merrill K, Meiklejohn DA. Inclusion in Surgery: Case Study of a Deaf Surgical Resident in Otolaryngology. Academic medicine : journal of the Association of American Medical Colleges 2025. link 2 Mari G, Zagari F, Scorpecci A, Tizio A, Resca A, Cascio E et al.. Survey on language rehabilitation methods in deaf Italian children with cochlear implants. International journal of pediatric otorhinolaryngology 2025. link 3 Türe N, İncesulu A, Mostafa BE. Do Otologists and Other Otolaryngologists Manage Single-Sided Deafness Differently?. The journal of international advanced otology 2024. link 4 Chandrasekar B, Hogg ES, Patefield A, Strachan L, Sharma SD. Hearing outcomes in children with single sided deafness: Our experience at a tertiary paediatric otorhinolaryngology unit. International journal of pediatric otorhinolaryngology 2023. link 5 Turgeon C, Prémont A, Trudeau-Fisette P, Ménard L. Exploring consequences of short- and long-term deafness on speech production: a lip-tube perturbation study. Clinical linguistics & phonetics 2015. link 6 Ruben RJ. William Wilde's census of the deaf: a 19th century report as a model for the 21st century. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2010. link 7 Swamy RS, Jackler RK. The Fickle finger of quackery in otology: the saga of Curtis H. Muncie, Osteopath. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2010. link 8 Tessier C, Weill-Chounlamountry A, Michelot N, Pradat-Diehl P. Rehabilitation of word deafness due to auditory analysis disorder. Brain injury 2007. link 9 Musiek FE, Charette L, Morse D, Baran JA. Central deafness associated with a midbrain lesion. Journal of the American Academy of Audiology 2004. link 10 Mustafa MS, Addar MH. Obstetric handling of a deaf patient. Saudi medical journal 2000. link 11 Parsloe R. Use of the speech pattern audiometer and the electropalatograph to explore the speech production/perception relationship in a profoundly deaf child. International journal of language & communication disorders 1998. link 12 Campbell R. Speechreading: advances in understanding its cortical bases and implications for deafness and speech rehabilitation. Scandinavian audiology. Supplementum 1998. link 13 Rundle P, Lotery AJ, Archer DB, McGinnity FG. Familial deafness associated with iris degeneration and glaucoma. Eye (London, England) 1997. link 14 Bergman NA. William Wright, aurist: nineteenth century pneumatic practitioner and a discoverer of anesthesia. The Annals of otology, rhinology, and laryngology 1994. link 15 McGovern FH. Sir Astley Cooper and his otological papers. The Annals of otology, rhinology, and laryngology 1984. link 16 Pamphlett R, Morris J. Cortical hearing deficit. A deaf brain. The Medical journal of Australia 1983. link 17 Rood SR, Stool SE. Otolaryngology and deafness. Archives of otolaryngology (Chicago, Ill. : 1960) 1983. link 18 Khurana RK, O'Donnell PP, Suter CM, Inayatullah M. Bilateral deafness of vascular origin. Stroke 1981. link

Dissociative deafness