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5%) of imaged patients. In 8/44 (18.2%), imaging findings caused a change in treatment. In 99/107 (92.5%) of the cohort, imaging was either not performed or did not change management. CONCLUSION In select cases, imaging may help guide patient management. Sufficient evidence does not yet exist to support routine imaging for patients with nail unit SCC.OBJECTIVES Speech-in-noise (SIN) perception is essential for everyday communication. In most communication situations, the listener requires the ability to process simultaneous com