There are many methods for malingering test of hearing, so author have studied threshold gap between ascending and descending method in fixed frequency tracing and conventional tracing with
Békésy audiometer for the purpose of evaluation of the most reliable malingering test and its normal range. The subjects were 50 cases with normal hearing. Author measured normal hearing threshold by ascending and descending methods with interrupted and conventional tone in fixed frequency tracing at 500 Hz, 1,000 Hz, 2,000 Hz and 4,000 Hz. And we measured arbitrary hearing threshold by ascending and descending methods with interrupted and continuous tones in fixed frequency tracing at 500 Hz, 1,000 Hz, 2,000 Hz and 4,000 Hz and arbitrary hearing threshold by ascending and descending methods with conventional tracing. The results were obtained as follows : 1) The averge threshold gap between descending and ascending method with interrupted tone in fixed frequency tracing at 500 Hz, 1,000 Hz, 2,000 Hz and 4,000 Hz were -0.1±1.9 dB, 0.3±1.5 dB, 0.4±1.5 dB and with continuous tone at each frequency were 0.6±1.9 dB, 0.8±1.8 dB, 1.2±1.9 dB and 0.3±1.5 dB and there was no significant difference. 2) The average arbitrary threshold gap between descending and ascending method with interrupted tone in fixed frequency tracing at 500 Hz, 1,000 Hz, 2,000 Hz and 4,000 Hz were 9.2±5.1dB, 9.0±5.1 dB, 8.0±5.5 dB and 7.3±6.8 dB and with continuous tone at each frequency were 6.5±6.3 dB, 8.4±4.2 dB, 9.4±5.1 dB and 8.8±5.7 dB and there was significant difference. The average arbitrary threshold gap between descending and ascending methods with interrupted tone in conventional tracing at 125 Hz, 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz and 8,000 Hz were 11.5±7.6 dB, 7.8±8.2 dB, 7.7±9.2 dB, 6.2±8.6 dB, 6.7±8.7 dB, 4.5±10.1 dB and 4.1±9.6 dB and there was significant difference. 3) In the arbitrary threshold gap between each methods, the largest gap at 500 Hz and 1,000 Hz were 9.2±5.2 dB and 9.0±5.1 dB with interrupted tones, and threshold gap at 2,000 Hz and 4,000 Hz were 9.4±5.1 dB and 8.8±5.7 dB with continuous tones. 4) Authors concluded that the most reliable test for malingering with
Békésy audiometer is comparision between descending and ascending methods with interrupted and continuous tone and above 5 dB of threshold gap suggest strongly as malingering.
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