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Masking

The document discusses the concept of masking in audiometry, which is necessary to isolate the test ear from the nontest ear to accurately determine hearing thresholds. It outlines the minimum and maximum masking levels, including formulas for calculating these levels during air and bone conduction testing, as well as the advantages and disadvantages of each. Proper masking is essential to prevent crossover of sound and ensure accurate audiometric results.

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ASMAA NOORUDHEEN
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4 views

Masking

The document discusses the concept of masking in audiometry, which is necessary to isolate the test ear from the nontest ear to accurately determine hearing thresholds. It outlines the minimum and maximum masking levels, including formulas for calculating these levels during air and bone conduction testing, as well as the advantages and disadvantages of each. Proper masking is essential to prevent crossover of sound and ensure accurate audiometric results.

Uploaded by

ASMAA NOORUDHEEN
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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MASKING

Air-conduction and bone-conduction pure-tone audiometry are often confounded


by crossover or contralateralization of the signal. A signal that is presented to one
ear, if it is of sufficient magnitude, can be perceived by the other ear. This is
known as crossover of the signal. Suppose, for example, that a patient has normal
hearing in the right ear and a profound hearing loss in the left ear. When tones
presented to the left ear reach a certain level, they will cross over the head and be
heard by the right ear. As a result, although you may be trying to test the left ear,
you will actually be testing the right ear because the signal is crossing the head.

When crossover has occurred, you need to isolate the ear that you are trying to test
by masking the other (nontest) ear. Masking is a procedure wherein noise is placed
in one ear to keep it occupied while the other ear is being tested.With appropriate
masking noise in the right ear, the left ear can be isolated for determination of
thresholds.

MINIMUM MASKING LEVEL:


Minimum masking level is the minimum level of noise needed to eliminate the
contribution of the nontest ear to establish the true or correct threshold in the test
ear.

The initial masking level (in dB EM) is equal to 5 dB EM (i.e., ACNontest Ear).
Martin (1974) recommends that approximately 10 dB should be added to the initial
masking level to account for intersubject variability. dB EM refers to the HL (dB
HL) to which threshold is shifted by a given level of noise. The minimum
masking level for normals is the same as 0 dB EM (Martin, 1967). If masked
thresholds are normally distributed around the average effective level and if the
standard deviation of the distribution is about 5 dB, then a safety factor of not less
than 10 dB should be added to the calculated minimum masking level. Given this
recommendation, Martin’s simplified equation for initial masking level (in dB EM)
during air-conduction threshold audiometry can be stated as follows:

Initial Masking Level =AC NontestEar+10 dB


Lidén et al. (1959) and Studebaker (1964) offered formulas for minimum masking
level during bone conduction testing that are derived from the same theoretical
constructs used during air-conduction testing. Again, the formula approach during
bone-conduction threshold audiometry is not clinically practical. The use of
Martin’s simplified approach is recommended. Specifically, initial masking level
during bone-conduction audiometry is equal to the air- conduction threshold of the
nontest ear. However, we will need to add the OE to the initial masking level to
compensate for covering (i.e., occluding) the nontest ear with an earphone (Martin,
1967, 1974; Studebaker, 1964). Martin’s simplified equation for initial masking
level (in dB EM) during bone-conduction threshold testing can be stated as
follows:

Initial masking level=AC non test ear+OE+10dB

ADVANTAGE:

 Calculating minimum masking level is necessary during administration of


suprathreshold auditory tests

DISADVANTAGE:

 It can be time consuming


 The clinician may not have all required information to accurately calculate
minimum masking level at that point in time.

MAXIMUM MASKING LEVEL:


The maximum masking level (MML) is the highest masking noise level that can be
used without causing overmasking to occur.Two factors influence maximum
masking level during puretone audiometry:

 The bone-conduction threshold of the test ear (BCTest Ear)


 IA of the air-conducted masking stimulus

Mmax=BCtest ear+IA-5dB

If BCTest Ear + IA is just sufficient to produce overmasking, then clinically, we


want to use a masking level that is somewhat less than the calculated value.
Consequently, 5 dB is subtracted from the level that theoretically produces
overmasking. Because we are concerned about an undesired masking effect in the
test ear, bone-conduction sensitivity in that ear must be considered

ADVANTAGE:

 Consideration of the maximum level of noise that can be used in the nontest
ear can alert the audiologist to the possibility of overmasking, particularly in
cases of conductive hearing loss when bone-conduction hearing sensitivity is
very good.

DISADVANTAGE:

 It is neither time efficient nor necessary to calculate maximum masking level


during puretone threshold audiometry, particularly when using
psychoacoustic or threshold shift masking procedures .
 The estimated maximum masking level is typically very conservative and
not an accurate indication of the true maximum.
References:

 Handbook Of Clinical Audiology(Jack Katz)


 Introduction to audiology.( Frederick N.Martin,John Greer Clark.)
 Essentials of Audiology(Stanley A Gelfand)

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