Auditory and Nonauditory Bone-Conduction Responses

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Abstract
MOST OTOLARYNGOLOGISTS and audiologists are quite aware of the differences between auditory and nonauditory bone conduction responses and are familiar with the techniques required to evaluate these differences. Residents, however, frequently are confused by the severely hardof-hearing patient whose sole response to pure tone air-conduction testing reveals only a low frequency residual hearing island, yet who responds consistently to bone-conduction testing, as will be discussed in this report. Part of this confusion exists since there is no otologic evidence of an air-bone gap. Thus, the dilemma: Are the bone-conduction responses auditory or nonauditory? The purpose of this paper is to demonstrate a clinical technique for differentiating auditory from nonauditory bone-conduction responses and to suggest a method for reporting the findings clearly and concisely. Bekesy,1 Dean,2 Link and Zwislocki,3 Pohlman and Kranz,4 Studebaker,5 and Dirks,6 to name only a few, have examined the effects of

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