Lecture 8 - Clinical Masking

Question 1

What is effective masking?

Answer 1

of dB that a masker shifts threshold of a test signal (in same ear), relative to quiet

Question 2

What is actual masking?

Answer 2

How much a certain amount of masking has shifted a person’s threshold

Question 3

What is the purpose of clinical masking?

Answer 3

Put in masking in non-test ear to shift threshold in that ear so that it doesn’t perceive signal that crossed over

Question 4

In what situations can you mask?

Answer 4

1. Pure tone air conduction assessment
2. Pure tone bone conduction assessment
3. Speech recognition threshold assessment
4. Suprathreshold speech recognition testing

Question 5

What is interaural attenuation?

Answer 5

The loss of signal intensity as the sound travels to the non-test cochlea

Question 6

What is the interaural attenuation for pure tone air conduction?

Answer 6

Supra-aural earphones: 40-50 dB

• Due to through-the-head transmission (bc)
• Partially because of around-the-head transmission (ac)

Insert earphones, deep insertion: 75 dB

• Smaller amount of leakage
• Less through the head transmission

Question 7

What is the interaural attenuation for bone conduction?

Answer 7

0-10 dB

• Vibration of the skull
• The most sensitive cochlea responds to BC testing

Question 8

When do I mask? (supra-aural earphones)

Answer 8

When the AC threshold in the test ear (TE) is 40 dB less than or equal to the bone conduction threshold in the non-test ear (NTE)

Question 9

How can you use the Hood Plateau Technique for calculating the initial masking level?

Answer 9

1. Start out with 10 dB + the AC threshold in the non-test ear
2. Re-assess masked threshold in test ear
3. Increase effective masking level by 5 dB in non-test ear
4. Reassess threshold in test ear
5. Continue until you reach a masked threshold in test ear that remains stable over 15-20 dB of increments in EML in NTE
6. The masked threshold = true threshold in test ear

Question 10

How can you determine the minimum and maximum masking level for pure tone AC thresholds?

Answer 10

Minimum Masking Level
Min EML = AC threshold (TE) - 35 dB + air-bone gap (NTE)

Maximum Masking Level
Max EML = BC threshold (TE) + IA (by AC)

Question 11

When should you mask during bone conduction testing?

Answer 11

• You always have to mask when testing BC

Exception: AC thresholds are = bilaterally and = unmasked BC thresholds

Question 12

How can you determine how the minimum amount of masking is needed in the non-test ear for BC testing?

Answer 12

Min EML = AC threshold (NTE) + 10 dB + occlusion

Question 13

How much is the occlusion effect (OE) with insert earphones?

Answer 13

• OE is greater with shallow insertion

- OE is smaller with deep insertion

Question 14

What is undermasking?

Answer 14

The tone that is presented to the test ear is picked up by the better cochlea

Question 15

What is effective masking?

Answer 15

Masks the non-test ear from picking up the signal

Question 16

What is overmasking?

Answer 16

There is so much masking noise that’s going to the non-test ear, which means that the test ear is picking up that masking noise.

Question 17

What is the Audiometric Weber?

Answer 17

• Place the bone oscillator on the patient’s forehead
• If the patient has a conductive hearing loss in one ear, and a sensorineural hearing loss in the other ear, they will hear the tone in the ear with the conductive hearing loss
• If the patient has a bilateral conductive hearing loss, the patient will hear the tone in the center of the head (will not lateralize)