DISEASE PAGE

Pseudohypacusis (Non-organic Hearing Loss)

A present, normal OAE that objectively contradicts a claimed hearing loss.

The OAE signature

  • Emissions are present, robust, and normal in an ear whose behavioural thresholds are reported as significantly impaired — an internal contradiction.[14]
  • Because the OAE needs almost no cooperation from the patient, a normal emission objectively refutes a claimed loss greater than roughly 30 dB in the tested region.[16]
0 ms20 ms
— Normal ear— Pseudohypacusis (Non-organic Hearing Loss)
Simulated TEOAE comparison. Educational signal model — not recorded patient data.

Audiogram companion

The pure-tone audiogram below accompanies the OAE signature. Reading the two together — what the threshold shows and what the emission shows — is the core diagnostic skill.

0204060801002505001k2k4k8kFrequency (Hz)
○ Right — PTA 52 dB (Moderate)✕ Left — PTA 18 dB (Normal)
Pure-tone audiogram companion. dB HL increases downward, following clinical convention. Illustrative thresholds — not recorded patient data.

Why the emission looks this way

  • Non-organic hearing loss — whether psychogenic or deliberate — is a loss greater than auditory pathology can explain. The cochlea and outer hair cells are intact, so the emission is entirely normal; only the behavioural response is discrepant.[14]

TEACHING POINT

This is the mirror image of auditory neuropathy: there a present OAE accompanies real severe loss, here a present OAE exposes loss that is not organic. The OAE is a fast, objective cross-check when behavioural thresholds are inconsistent.[14]

Sources for this page are listed on the References page. Browse all condition patterns from the atlas home.