Automatic versus standard audiometry.

Abstract

The trend of replacing standard (manual) audiometry by means of automatic (self-recording) may be a source of error: Békésy's technique is to be considered an essential complement to manual audiometry and this combination may represent and outstanding diagnostical tool for the otologist.Two pathological conditions were observed which strengthened the above-mentioned assumption. Cases of acute viral haemorragic otitis, which displayed – with manual audiometry – the commonly encountered picture of a slight conductive hearing loss, revealed, after automatic testing, a cochlear damage, presumably restricted to a quite small region of the endorgan (type I-II audiogram).Patients subjected to stapedectomy (House's procedure), exhibited, at standard tests, a high tone hearing loss. A type I Békésy's audiogram indicated this loss to be due to an impairment of the transmission power of the middle ear, caused, perhaps, by a mass overloading of the gelfoam sheet on the oval window niche. This hypothesis was confirmed by complete recovery, after some days, of the patients high frequency threshold to the same level as that for low and middle tones.