[Speech audiometry in expert assessment of hearing impairment].

In the assessment process of hearing impairment the medical expert has to verify its causality and to quantify its severity as hearing loss in percentage. Based on the determined hearing loss in percentage, the degree of impairment/disability or, in the case of work-related noise-induced hearing loss, the reduction in earning capacity is estimated. In Germany the guideline for the expert assessment of work-related noise-induced hearing loss is the Königstein Guideline. Currently, the 5th edition from 2012 is used. Here, the hearing loss quantification depends mainly on the results of speech audiometry. Based on the Freiburg speech test, the hearing loss in percentage is determined using approved tables. For patients with a mild hearing loss, typically characterized by a high-frequency hearing loss, tone audiometry results are consulted additionally. Speech-in-noise tests are available and are frequently used to measure the benefit of hearing systems. They allow for the detection of these patients' hearing impairment, which generally occurs in noisy environments. The first suggestions for a table to determine hearing loss in noise in percent are available. In experimental studies it was shown that tests in quiet, other than the Freiburg speech test, can be used and the same tables can be applied. In this article the current use of speech audiometry for expert assessment is presented, and options of using further developed speech test material are discussed.