In Reply.—Harless suggests that the preoperative discrimination score of the patient described in our article was "contaminated by the possibility of crossover." While his point regarding the possible need for masking in any suprathreshold audiometric procedure is well taken, it is irrelevant in this case.
The interaural attenuation for speech has been indicated by Liden1 to be 50 dB. In this case, the difference between the presentation level for speech in the right ear (hearing threshold level, 90 dB) and the puretone average for bone conduction in the left ear (40 dB) was just 50 dB. In essence, it could be argued that speech was reaching the untested ear at a 0-dB sensation level. It is unlikely that a score of 70% could have been obtained at that level, if the discrimination score represented a response from the left ear.
In our view, this is supported by the audiogram in
SHEA JJ. Clinical Masking in Word Discrimination Testing-Reply. Arch Otolaryngol. 1983;109(4):275. doi:10.1001/archotol.1983.00800180073017
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