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September 1972

Tone Decay Test in Neuro-Otological Diagnosis

Author Affiliations

From the Medical Research Council Hearing and Balance Unit, Institute of Neurology, National Hospital, Queen Square, London.

Arch Otolaryngol. 1972;96(3):231-247. doi:10.1001/archotol.1972.00770090353006

The tone decay test was carried out upon normal subjects and patients with a variety of pathological conditions. With normal hearing and conductive deafness, tone decay termed type I was minimal and never exceeded 15-dB. In endorgan deafness type I predominated but a few exhibited slightly greater decay termed type II. Type IV, in which the threshold elevation was severe and rapid, was a characteristic finding in 15 subjects with nerve fiber lesions, including 12 with cerebellopontile angle tumors.

Of 52 patients with brain stem lesions a well marked, but slow rate, tone decay type III, was found in a significant proportion including a number with normal hearing. In the latter, good correlation was established between lateralization of the lesion effected by the caloric and the tone decay tests.