Functional Hearing Loss
In functional hearing loss there is no detectable organic damage to the auditory pathways, but some underlying psychological or emotional problem is at fault. Functional hearing loss occurs in clinical practice more frequently than many physicians realize. This is the type of condition in which the patient does not seem to hear or to respond: yet the handicap may not be caused by any organic pathology in the peripheral or the central auditory pathways.
The hearing difficulty may have an entirely emotional or psychological etiology, or it may be superimposed on some mild organic hearing loss, in which case it is called a functional or a psychogenic overlay. Often, the patient really has normal hearing underlying the functional hearing loss. A carefully recorded history usually will reveal some hearing impairment in the patient’s family or some reference to deafness which served as the nucleus for the patient’s functional hearing loss.
The most important challenge in such a case is to classify the condition properly. It may be quite difficult to determine the specific emotional cause, but if the classification is made accurately, the proper therapy can be instituted. Too often, the emotional origin of a functional hearing loss is not recognized, and patients receive useless otologic treatments for prolonged period. In turn, this process may aggravate the emotional element and cause the condition to become more resistant to treatment. Therefore, early and accurate classification is imperative.