The classical method for the measurement of sensorineural hearing loss, bone-conduction audiometry, presents serious problems both at the clinical and theoretical levels. First, available methods for the calibration of the bone-conduction system have never satisfied the conscientious clinician. Second, the many variables affecting the bone-conduction threshold in mild hearing losses have often led clinicians to question the validity of bone responses. The problems involved in testing unilateral losses, for example, are well known. At the theoretical level, unanswered questions regarding when to mask the nontest ear and how much masking to use on it are highlighted by the widely varying opinions presently existing in the field.1-8
Rainville9 has attempted to circumvent many of these problems by approaching the measurement of sensorineural loss with an entirely new procedure. His technique can be briefly described as follows: First, the air conduction threshold is determined on the ear under test. Second,
JERGER J, TILLMAN T. A New Method for the Clinical Determination of Sensorineural Acuity Level (SAL). AMA Arch Otolaryngol. 1960;71(6):948–955. doi:https://doi.org/10.1001/archotol.1960.03770060060008
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