A 62-year-old woman with moderate sensorineural hearing loss and clear evidence of loudness recruitment is being fitted with hearing aids. She finds that ordinary sounds quickly become uncomfortably loud while soft speech remains inaudible with a conventional linear aid. Which amplification strategy addresses her problem directly?
- A Linear amplification with a fixed gain set at half the hearing loss
- B Peak clipping with increased maximum output
- C Wide dynamic range compression, which compresses input across levels into the narrowed dynamic range ✓
- D Frequency transposition to shift high frequencies downward
Correct answer: C. Wide dynamic range compression, which compresses input across levels into the narrowed dynamic range
Explanation
In recruitment the dynamic range between threshold and discomfort is compressed, so a single linear gain cannot serve soft and loud inputs simultaneously. Wide dynamic range compression provides progressively more gain for softer sounds and less for louder ones, fitting the whole speech spectrum into the narrowed range. Peak clipping distorts loud inputs without aiding soft ones, and frequency transposition addresses dead regions rather than recruitment.
Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.