Clinical Implications of Loudness Balancing

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.^1-3In 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,<i>it is almost a waste of time to test only for the</i>