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Carhart notch and electric bone-conduction audiometry

K Laitakari1, H Löppönen

  • 1Department of Otolaryngology, University of Oulu, Finland.

Scandinavian Audiology
|January 1, 1994
PubMed
Summary

The Carhart notch in otosclerosis patients improved after stapes surgery. Electric bone-conduction audiometry showed stable thresholds, unlike conventional bone-conduction, indicating a different inner ear stimulation mechanism.

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Area of Science:

  • Otolaryngology
  • Audiology
  • Neurosurgery

Background:

  • Otosclerosis is a condition affecting the middle ear, often characterized by a Carhart notch on bone-conduction audiograms.
  • The Carhart notch represents a specific hearing loss pattern in the middle frequencies (0.5-2 kHz).
  • Stapes surgery is a common treatment for otosclerosis, aiming to improve hearing by addressing the stapes bone fixation.

Purpose of the Study:

  • To compare conventional bone-conduction (BC) audiometry with electric bone-conduction (EBC) audiometry in otosclerosis patients.
  • To evaluate the effect of stapes surgery on the Carhart notch using both audiometric methods.
  • To investigate the underlying mechanisms of EBC stimulation compared to conventional BC.

Main Methods:

  • Twenty-nine patients with clinical otosclerosis underwent conventional air-conduction (AC) and BC audiometry, along with EBC audiometry.
  • Audiological assessments were performed 2 weeks before and 7 months after stapes surgery.
  • An Audimax 500 audiometer was used for all measurements.

Main Results:

  • Conventional BC thresholds showed significant improvement at 0.5-2.0 kHz, consistent with the resolution of the Carhart notch post-surgery.
  • EBC thresholds remained relatively stable, demonstrating no Carhart phenomenon.
  • The findings suggest EBC audiometry has a different mode of action on the inner ear compared to conventional BC.

Conclusions:

  • Stapes surgery effectively improves hearing thresholds in the frequency range of the Carhart notch.
  • Electric bone-conduction audiometry offers a distinct measure of hearing, unaffected by the Carhart phenomenon observed in conventional BC.
  • EBC audiometry may provide complementary diagnostic information in cases of otosclerosis and other conductive hearing losses.

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