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Problems in assessing the audiogram in patients with severe hearing impairment

Published online by Cambridge University Press:  29 June 2007

M. Giles*
Affiliation:
Department of Otolaryngology, Waikato Base Hospital, Hamilton, New Zealand
G. G. Browning
Affiliation:
MRC Institute of Hearing Research, Scottish Section, Glasgow Royal Infirmary, Glasgow, Scotland, UK
S. G. Gatehouse
Affiliation:
MRC Institute of Hearing Research, Scottish Section, Glasgow Royal Infirmary, Glasgow, Scotland, UK
*
Address for correspondence: Dr M. Giles Department of Otolaryngology, Waikato Base Hospital, Hamilton, New Zealand.

Abstract

Severe hearing impairment (SHI) is an impairment of hearing in which the air conduction mean over 0.5–4 kHz in the better hearing ear lies between 70 and 90 dB. Masking of bone and air conduction thresholds is seldom possible with SHI, leading to difficulties in assessing the pure tone audiogram whenever there is a potential air bone gap in either ear.

An audiological survey of 83 patients with severe hearing impairment was conducted. In 16 per cent of patients there was no possibility of a material air bone gap in either ear and no difficulty in interpreting the audiogram. In 23 (28 per cent), the audiogram was consistent with, but did not prove the presence of, an air bone gap in the poorer hearing ear. In 25 patients (30 per cent of 108) the better hearing ear could not be determined, and in 22 (27 per cent) a profound sensorineural impairment in the poorer hearing ear could not be excluded. The implications of this for the otologist are discussed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1996

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References

British Society of Audiology. Technical Note (1986) Recommendations for masking in pure-tone threshold audiometry. British Journal of Audiology 20: 307314.CrossRefGoogle Scholar
British Society of Audiology. Technical Note (1985) Recommended procedure for pure-tone bone-conduction audiometry without masking using a manually operated instrument. British Journal of Audiology 19: 281282.CrossRefGoogle Scholar
Browning, G. G. (1986) Clinical Otology and Audiology. 1st Edition. Chap. 1. Butterworths, London, p 5.Google Scholar
Davis, A. C. (1989) The prevalence of hearing impairment and reported hearing disability among adults in Great Britain. International Journal of Epidemiology 18: 911917.CrossRefGoogle ScholarPubMed
Frattali, M. A., Sataloff, R. T. (1993) Far-advanced otosclerosis. Annals of Otology, Rhinology and Laryngology 102: 433437.CrossRefGoogle ScholarPubMed
Iurato, S., Ettore, E. G., Onofri, M., Davidson, C. (1992) Very far-advanced otosclerosis. American Journal of Otology 13: 482487.Google ScholarPubMed
Keith, R. W., Kereiakes, T. J., Wiliging, J. P., Devine, J. (1992) Evaluation of cochlear function in a patient with ‘far advanced’ otosclerosis. American Journal of Otology 13:Google Scholar
Lippy, W. J., Battista, R. A., Schuring, A. G., Rizer, F. M. (1994) Far-advanced otosclerosis. American Journal of Otology 15: 225228.Google ScholarPubMed
McClymont, L. G. (1990) A clinical characterization of severely and profoundly hearing impaired adults attending an audiology clinic. MD Thesis, University of Glasgow.CrossRefGoogle Scholar
McClymont, L. G., Browning, G. G. (1991) Characterization of severely and profoundly hearing impaired adults attending an audiology clinic. Journal of Larvngology and Otoloy 105: 534538.CrossRefGoogle ScholarPubMed
Morrison, A. W. (1969) Management of severe deafness in adults. Proceedings of the Royal Society of Medicine 62: 959967.CrossRefGoogle ScholarPubMed
Nauton, R. F. (1960) A masking dilemma in bilateral conduction deafness.Archives of Otolaryngology 72: 753757.CrossRefGoogle Scholar
Sheehey, J. L. (1964) Far advanced otosclerosis. Archives of Otolaryngology 80: 244248.Google Scholar