Speech Discrimination Score (SDS) / Word Recognition Score (WRS) of <50% at maximum comfortable listening level despite appropriate amplification most commonly indicates pathology at which level?

• A Middle ear (conductive level)
• B Cochlear (hair cell) level
• C Central auditory processing level
• D Eighth nerve or retrocochlear level ✓

Explanation

A markedly reduced WRS (<50%), particularly when disproportionately poor relative to pure tone thresholds (rollover phenomenon), is characteristic of retrocochlear pathology (eighth nerve and beyond — acoustic neuroma, auditory neuropathy). Cochlear SNHL typically has WRS that is reduced but proportional to the PTA loss. Conductive loss and central APD typically show better WRS. Rollover (WRS decreasing at higher intensities) is the hallmark of retrocochlear disease.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.