Perceptual Consequences of Cochlear Hearing Loss and their Implications for the Design of Hearing Aids

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Abstract
This paper provides an overview of changes in the perception of sound that result from cochlear damage. It starts with a brief introduction to the physiology of the cochlea, emphasizing the role of the "active mechanism" and describing how cochlear function is altered by cochlear damage. Then the effects of cochlear damage on various aspects of perception are described, including absolute sensitivity, frequency selectivity, loudness perception and intensity discrimination, temporal resolution, temporal integration, pitch perception and frequency discrimination, and sound localization and other aspects of binaural and spatial hearing. The possible role of each of these aspects of auditory perception in the ability to understand speech in quiet and in noise is discussed and evaluated. It is concluded that, for losses up to about 45 dB, audibility is the single most important factor. However, for greater losses, poor discrimination of suprathreshold (audible) stimuli is also of major importance. The final section of the paper describes applications of the findings to hearing aid design. It is concluded that linear amplification can be of only limited benefit in compensating for the effects of cochlear damage. Hearing aids incorporating compression can help to compensate for the effects of reduced dynamic range. Digital signal processing to enhance spectral contrast may be of some help in compensating for the effects of reduced frequency selectivity.

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