IN RELATING type of Békésy audiogram to site of lesion within the auditory system, Jerger1 reported that the majority of patients with a sudden onset of hearing loss responded with type III audiograms. A later study by Jerger and colleagues2 of 12 patients with sudden hearing loss revealed two patterns of response: one generally associated with cochlear loss (high small increment sensitivity index [SISI] scores, type II Békésy audiograms, some recruitment, and measurable phonetic balance [PB] discrimination scores), another generally associated with neural loss (low SISI scores, type III Békésy audiograms, minimal recruitment, and nonmeasurable PB discrimination scores).
The test results described here for a patient with sudden onset of hearing loss are presented because the responses to auditory stimuli changed over a period of time from a pattern characteristic of a neural lesion to one characteristic of a cochlear lesion. Of particular interest was the change from
Stephens M, Swisher L, Novotny GM. Change in Response to Auditory Stimuli After Sudden Hearing Loss. Arch Otolaryngol. 1967;86(6):654–657. doi:10.1001/archotol.1967.00760050656010