A great variety of threshold curves are found on audiometric examination of patients with lesions of the conduction apparatus. The old teaching that loss of hearing acuity for low frequencies means a conduction lesion and loss for high frequencies a nerve lesion is found to be incorrect from experience with the audiometer, tuning fork tests and loudness balance studies. Present refinements in testing auditory thresholds through most of the acoustic spectrum for both air-conducted and bone-conducted sounds have increased more rapidly than knowledge of the function of the normal and the diseased sound-conducting mechanism itself in response to the various frequencies of the acoustic spectrum. One is confronted with the fact that one cannot predict the audiogram by objective examination of the ear because it is not known what the various components of the conducting apparatus contribute to the hearing curve and how this is altered by disease. Conversely, one
PERLMAN HB. LESIONS OF THE CONDUCTION APPARATUS. Arch Otolaryngol. 1943;37(5):680–690. doi:10.1001/archotol.1943.00670030694007
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