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.
