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Loudness Discomfort Levels

What is The Test, how is it useful and Who Should Do It?

If you’re bothered by sounds that other people are barely aware of, please know that sound intolerance (or auditory hypersensitivity) is more common than you think!

The Loudness Discomfort Levels (LDL) is a simple and easy exam. It is usually performed as a complement to the tonal and vocal audiometry, when the otorhinolaryngologist requests the audiologist to do it. The test shows different frequencies of sound to the patients, one at a time, and the sound intensity is slowly and progressively increased until reaching the first intensity that causes discomfort at each frequency.

It is useful to evaluate the 3 types of hypersensitivity to sounds and patients who wear hearing aids or sound generators

– When the annoyance is with the VOLUME of the sounds (TV, music, voices, restaurants etc), these people can perfectly cope with such sounds as long as the volume is lower. These are the pure cases of hyperacusis. The LDL usually results altered.

– Iwhen the nuisance is with the REPEATITION of LOW sounds (chewing, breathing, swallowing, throttling, pen click, slipper dragging etc), these people cannot stand such sounds while they are present, as they provoke a strong and uncontrollable reaction of anger and irritability. These are the pure cases of Misophonia or Syndrome of Selective Sensitivity to Sounds (4S). The LDL results can be normal or not.

– When the reaction is FEAR to be exposed to sounds because they can damage the ear or the general health, this means phonophobia, which is usually associated with the two previous ones. The LDL usually results very altered.

– Indication for use of hearing aid for hearing loss or sound generator for tinnitus and/or sound intolerance control. Measuring LDL can optimize the regulation of the volume of sounds emitted by the devices so as not to cause discomfort in patients.