Hearing aids and cochlear damage: The case against fitting the pure tone audiogram

Herein we propose a different approach to hearing aids, an approach that flows logically from the pathophysiology of cochlear disorders. This approach challenges some central tenets of the industry by 1) suggesting that many, if not most, cases would be better served by flat, undistorted gain across all frequencies rather than by “fitting” gain to the audiogram; and 2) suggesting that most of the improvements in hearing aid technology are targeted at reducing patient complaints as opposed to increasing measurable word recognition performance. We recommend that it is better to accommodate the damaged cochlea in these cases than to attempt to reverse-engineer the audiometric test results.