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What is Your Opinion on Bone-Air Gaps?

L. Maureen Valente, PhD

September 22, 2014

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Question

What is your opinion when you see a bone conduction threshold that is worse than the air conduction threshold at the same frequency on an audiogram? 

Answer

Certainly we do see that at times.  There could be small bone-air gaps of 5-10 dB.  Remember that threshold can be variable by 5 dB from moment to moment.  If you find bone-air gaps, I would look at your calibration, reinstruct the patient, and repeat testing at those frequencies.  If you still find the bone-air gaps, I would record that you have noted it and report it as such.  However, if the bone-air gaps are more than 10 dB, then something may be wrong.  After you have checked your calibration, reinstructed the patient, and repeated your testing, also consider whether there may be a functional hearing loss. 

Editor’s note: This Ask the Expert was taken from the recorded course, Pure Tone Testing and Audiogram Interpretation presented by Dr. L. Maureen Valente.  To view the course in its entirety, please register here.


l maureen valente

L. Maureen Valente, PhD

Dr. Valente has been honored to serve as the Director of Audiology Studies and Associate Professor within Washington University in St. Louis School of Medicine’s Program in Audiology and Communication Sciences. She earned her Doctor of Philosophy degree in Speech and Hearing Sciences from Washington University in St. Louis. She was employed as a clinical/rehabilitative audiologist in a variety of medical settings, prior to serving as a full-time faculty member at Saint Louis University for 18 years. She has served in her current position for eight years, considering working with students and AuD Education among her greatest professional passions.  She has co-authored numerous peer-reviewed journal articles and textbook chapters, notably having published a textbook entitled “Pure-tone Audiometry and Masking” in 2009 (Plural Publishing). Clinical and research interests have included Diagnostic Audiology, Vestibular Assessment Across the Lifespan, and Auditory Processing Disorders.  She is thrilled to have been invited to coordinate and moderate this “Back to Basics Series” and to also serve as one of the presenters.   


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