One of the major problems in audiometry is that of determining thresholds in monaural and asymetrical binaural hearing losses. The clinician confronted with a patient whose two ears differ in acuity may have serious difficulty in obtaining accurate measures of hearing for the poorer ear. Under such circumstances, the clinician may arrive at estimates of hearing for the poorer ear that are better than the actual thresholds in that ear. Such erroneous results may even lead to attempted middle ear surgery on an ear having a profound sensorineural hearing loss.When the two ears differ sufficiently in acuity, the intensity of the tone presented to the poorer ear may be raised to such a level that it is heard in the better ear, either across the head by air conduction or through the head by bone conduction. A number of investigators10,12-14,22 have shown that pure tones may
SANDERS JW, RINTELMANN WF. Masking in Audiometry: A Clinical Evaluation of Three Methods. Arch Otolaryngol. 1964;80(5):541–556. doi:10.1001/archotol.1964.00750040555008
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