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What is Diplacusis? Known as double hearing, learn about the symptoms, causes, and treatments available

Kimberley Bradshaw - Head of Online Medical Content for Hearing Aid UK
Written By:
Kimberley Bradshaw

Head of Online Medical Content

What is Diplacusis?

What is Diplacusis?

Understanding why some hear different pitches or echoes

 

Overview    |    The different types    |    The causes    |    The treatments    |    Conclusion

 

What is double hearing?

When we think about how we hear, most ears work in sync, giving us sound as a unit to our brains.  This is similar to our brain needing to merge what is seen by two eyes for a single image.  Even if our ears pick up slightly different pitches, our brains are still able to understand the sound's source. 

When this doesn't happen, it's called diplacusis, or "double hearing", resulting in a two-sound experience.  In this article, we briefly go through the key symptoms, causes, treatment available, and what your next steps should be if you think you might be suffering from double hearing.

 

Main points

  1. Diplacusis is also known as "double hearing", considered rare, which means you can hear a single sound as two different pitches.
  2. Diplacusis usually affects those with hearing loss, especially asymmetrical hearing loss or ear complications.
  3. Treatments generally, at minimum, reduce symptoms or are known to stop them entirely.
  4. Musicians are at a higher risk of developing diplacusis due to being exposed to loud noises.  This means their ears are more sensitive to both pitch and tone.
  5. With this lesser-known condition, the pitch, volume, or timing of a sound can be impacted.

 

Diplacusis

 

Are there different types of diplacusis?

Those with diplacusis hear one single sound as two separate pitches, which can either be in addition to tinnitus (ringing of the ears) or experienced on its own.  A concerning condition for those affected, double hearing is usually caused by certain conditions, but the reality is that it can affect anyone.

You can experience diplacusis in one ear or both. If it is present in both, it is known as diplacusis binauralis or duplacusis monauralis when referring to just one ear.  There are also different subtypes of diplacusis.  These are:

  • Diplacusis dysharmonica:  Seen as the most common type of double hearing, and is when you don't struggle with timing, but you have problems with different pitches.
  • Diplacusis echoica:  This is when your ears hear sound at different speeds, often sounding like an echo.

 

Causes of diplacusis

Double hearing can be caused by taking medications that are known to damage the ear; these are called ototoxic drugs, along with the following:

One ear is affected by hearing loss:  There are two types of hearing loss that are strongly linked to diplacusis.  One being asymmetrical hearing loss, when one ear is worse than the other.  The second is unilateral hearing loss (single-sided deafness), when you can hear normally in just one ear.

Sensorineural hearing loss:  This is recognised as the most common form of hearing loss, often due to exposure to loud noise or ageing, and it affects both ears the same.

Blockages in the ear:  If there are obstructions in the ear, it can alter how you interpret sound and ultimately impact your hearing.  In most cases, if a blockage is removed, normal hearing can resume.  Examples of blockages could be an ear infection, excessive earwax, eustachian tube dysfunction, and acoustic neuroma.

Trauma to the head or ears:  Such injuries can affect the inner ear structures, like the cochlea and auditory nerve, which can impact how the brain processes sound.

Related reading:  Sensorineural hearing loss

 

Diplacusis treatments

The treatment needed will depend on the cause, and in some cases, it might be simple to address. For example, if your diplacusis is due to an obstruction, such as a buildup of earwax or fluid from an infection, your hearing usually returns to normal once the blockage is cleared or the infection resolves.

If your double hearing is connected to hearing loss, hearing aids could improve your ability to hear more clearly and balance the sound input between both ears. Customised settings can be tailored to your specific hearing loss needs, helping to compensate for any imbalance in hearing between your ears. 

In cases of severe or profound hearing loss, cochlear implants may be recommended as a solution.

Other approaches might involve auditory rehabilitation or training, which can assist your brain in adjusting to changes in sound perception. Sound therapy may also help to desensitise you to various pitches, while cognitive behavioural therapy (CBT) could be used to manage the stress and anxiety that often accompany double hearing.

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How to seek help for diplacusis

If you experience double hearing, it’s important to see an audiologist or an ENT doctor as soon as possible.

They will assess your symptoms and typically perform a hearing test to identify any underlying issues.

Additional tests, such as an auditory brainstem response (ABR) test, may also be done.

This is to check for potential problems with the inner ear or auditory nerve that could be contributing to the distortion.

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