Subcategories of patients with King-Kopetzky syndrome.

King-Kopetzky syndrome (Obscure Auditory Dysfunction, OAD) has been recognized as a clinically distinct condition in audiological and ENT clinics. It is characterized by normal hearing thresholds on pure tone audiometry (PTA) but complaints of difficulties in understanding speech in the presence of background noise. In a study on 110 consecutive patients with King-Kopezky syndrome referred to the Welsh Hearing Institute, subjects were subdivided into seven subcategories based on sensitized measures of auditory dysfunction and on psychological assessment. These were: (1) middle ear dysfunction; (2) mild cochlear pathology; (3) central/medial olivocochlear efferent system (MOCS) auditory dysfunction; (4) purely psychological problems; (5) multiple auditory pathologies; (6) combined auditory dysfunction and psychological problems and (7) unknown. Different subgroups may represent different pathogenic and aetiological factors. Thus, subcategorization provides further understanding of the basis of King-Kopetzky syndrome, and hence may guide the rehabilitative management of these patients.