Functional hearing loss.

Functional hearing loss is a rather common entity, although it probably is overlooked more often than not. In most instances, the services of an experienced audiologist are necessary if one is to detect these cases. First, one must consider carefully the patient's behavior before and during the otologic and audiologic examination, and note the referral source, if any, since patients with certain backgrounds are more apt to exhibit functional hearing loss than others. Second, careful attention is given to certain aspects of the initial basic audiometric examination. Discrepancies here often stand out and point clearly toward functional loss. A so-called "modified approach" to conventional audiometry has enabled us to detect almost all cases of functional hearing loss without resort to the special audiometric tests designed for that purpose.