Clinical Implications of Loudness Balancing

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Abstract
THE ABNORMAL growth in loudness of a test tone has come to hold a special and frequently stereotyped significance, applicable only to and diagnostic of certain kinds of end-organ-related hearing losses. Valid as this stereotype may be, most of the time, it is not inviolate and does not always lead the otologist to a proper diagnosis. In fact, considerable valuable diagnostic information is lost by failure to view the Alternate Binaural Loudness Balance (ABLB) test with a broader perspective than it now enjoys. Investigators and clinicians have tried to point this out many times before, including Fowler himself, but their writings seem mainly ignored in everyday application.1-3 In this paper, we join their ranks and explore some test results which we doubt can be ignored. We also offer an operational explanation. Specifically, it will be demonstrated that, it is almost a waste of time to test only for the

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