Diplacusis Binauralis – Causes & Treatments

What is Diplacusis?

Diplacusis (pronounced dip-lah-KOO-sis), also known as diplacusis binauralis, “binauralis disharmonica“ or interaural pitch difference (IPD). It comes from the Greek words “diplous” and “akousis” meaning double hearing. This is the most common type. It will occur when a person hears the same sound as two separate sounds differently in each ear that may differ in pitch, tone or timing. Not exclusively, but it may be experienced as a secondary symptom of sensorineural hearing loss (SHL). Although not all patients having sensorineural hearing loss will experience diplacusis or tinnitus.

At any particular time, our ears hear a multitude of noises and based on all that incoming information, our brain is making a lot of decisions. Patients with sensorineural hearing loss may experience diplacusis or tinnitus. While  hearing different pitches in each ear are common, which come in many forms.

Different types of diplacusis

According to a research, in diplacusis people experience hearing of one sound as two sounds. It is of three types such as –

Diplacusis dysharmonica-  You hear the correct pitch in one ear, while another ear hears at a different pitch i.e. incorrectly. Incorrect sound can be higher or lower pitch than correct one.

Diplacusis Binauralis- It is same as dysharmonica. In this people hear the same sound at a different pitch in each ear. But the only difference is binaural refers to differences in timing. Means’ ear doesn’t hear the sounds from each ear at the same time. It is more frequent, and more pronounced, in people with hearing difficulty, especially, people with asymmetric hearing loss compared to people with normal hearing.

Diplacusis Echoica-  It is an unusual form, the person will hear the same sound repeated like an echo in the same ear. You hear an echo sound of the original sound, which gives rise to the term double hearing.

Diplacusis monauralis  The ear hears the same sound as two sounds in the same ear. They may be different pitches or tones and variations in sound.


Diplacusis is a symptom of sudden or bilateral hearing loss. It results when people experience some hearing loss in one ear, or experience uneven hearing loss in both of your ears. It is sudden and caused by excess noise, an ear infection, clogged sinuses, tumor, excess earwax, or head trauma. People who develop diplacusis may also experience tinnitus, a ringing or buzzing noise in the affected ear. It is typically the result of a sensorineural hearing loss, but that is not always the case.

The diplacusis is caused when the ear is unable to transmit the message to the brain. It is so because of the blocked passageway. If your ear will not function properly, you may experience more than one sound at a different pitch in your ear. Hearing loss is extremely common amongst musicians.

This type hearing loss can be either temporary or permanent in nature. Whereas some other potential causes of hearing loss include

  • ear infection
  • wax build up
  • head trauma
  • damage to the inner ear
  • noise-induced-hearing-loss (NIHL)
  • a number of other health conditions which impact upon hearing.

In case of temporary hearing loss, the Diplacusis is most likely to correct itself as soon as the hearing returns.

Who is at Risk?

Since Diplacusis is a type of hearing impairment, which is very common amongst musicians. There is nothing to be surprised that musicians are at higher risk for Diplacusis as compared to normal population. Though unfortunate, they tend to notice pitch and tone differences more readily. This is what an average person does not notice. Therefore, they are more aware of potential pitch and tone differences. Due to this, they even posses higher risk when it comes to developing Diplacusis.

In comparison to 1.5% of the general population, roughly 5% of musicians admitted experiencing a form of Diplacusis. The most effective way to lessen the risk of developing Diplacusis is by preventing noise-induced hearing loss (NIHL). This involves careful management of noise exposure for prolonged periods of time, meanwhile taking precautions such as using earplugs when requires.

Tests for Diplacusis

Most of the musicians don’t recognize while playing the note B flat that while their right ear is detecting the B flat but their left ear instead of B flat, it is recognizes it closer to B natural. Therefore, a semitone deference is detected between the two ears in case of diplacusis. According to health professionals, difference in intensity or volume of pitch over a long period of time can cause hearing difficulty in future.

According to a research published in NCBI, a randomized maximum sequential procedure was developed, to test the relationship between the pitch sensation between the two ears  as a matched frequency range. This improved pitch- matching test is used to judge the characteristics of diplacusis in people with hearing loss as well as in people with normal hearing.

Most of the musician test their hearing using pitch detection testers, that is used to identify the fundamental frequency (f0), known as pitch. You can check also test your hearing using Tone tester.


Tone tester


Tone tester use simple sliders with which you can adjust the pitches played until the right and left ears hear the similar sound. The tester tells you the difference in pitches in terms difference in semitone. It also helps in improving your hearing by recommending the different pitches. In some cases, tone test also suggests to consult an audiologist to find the exact cause of hearing loss.


Treatment for double hearing varies from case to case. The best way to cure would be treating the underlying hearing loss. If your diplacusis caused by an obstruction, it can be resolved once you remove the earwax or clean your ear infection. While this hearing loss may be permanent and can possibly be treated with hearing aids or cochlear implants. This will be helpful in reducing the negative symptoms of diplacusis.

There may be some cases with no cure. Then the sufferer needs to develop an understanding regarding the condition. After this, seek for therapy to help overcome the ongoing suffering.

It’s very important to diagnose the type of diplacusis so that the appropriate treatment can be applied. So if you notice any symptom of double hearing, consult with your doctor or hearing healthcare professional for an appointment. They can do a painless hearing test or go for a toner test. Depending the result of your test consult a hearing specialist who will provide a right course of action.

Diplacusis Binauralis – Causes & Treatments
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