King Kopetzky syndrome

From Otolaryngology Online


King Kopetzky syndrome is a condition in which an individual complaints of difficulty in hearing, especially in the presence of back ground noise. Ironically these patients have a normal pure tone audiogram.

Hinchcliffe described this disorder as "Auditory stress disorder". He also coined the term King Koptezky syndrome to describe this disorder to honor Koptetzky who described this disorder in 1948 and King who discussed the etiological factors behind this syndrome in 1954.


Auditory stress disorder, KK syndrome, Obscure auditory dysfunction, Auditory disability with normal hearing.


KKS is relatively a common condition. It is seen in 5% of patients who attend audiological clinic with problems in hearing.

This syndrome is fairly common in elderly, with a mean age of occurrence of 76.


This condition could be caused by minor cochlear defect associated with psycological causes. These patients also have a high family prevalence of deafness.

Certain authors consider this disorder to be a late manifestation of a dominantly inherited genetic disorder.

Noise exposure has also been postulated as one of the etiological factors of KK syndrome.

Poor central auditory function

Auditory stressful work

Awareness of previous ear disease



Clinical features:

1. These patients have difficulty in hearing in noisy environment

2. Significant percent of these patients have difficulty in handling group conversations

3. A small percentage 5% of these patients have difficulty in comprehending TV / Radio programmes

Types of KK syndrome:

Etiologically King Kopetzky syndrome has been classified into four types:

1. Middle ear kk syndrome

2. Cochlear kk syndrome

3. Central kk syndrome

4. Psychological kk syndrome


Puretone audiometry: shows a notch in midfrequency range.

Speech audiometry shows low values.

Patients have low speech scores under noisy environments


1. Stress management

2. Allaying the patient's anxiety

3. Use of hearing aids

4. Counseling