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Hi,

Would really appreciate if anyone especially an audiologist or ENT can help explain this situation we’re in.

Our baby boy born Oct 12 this year, failed two hearing screening tests and was referred to an audiologist. The audiologist did the first test on Nov 27 and found he had profound conductive hearing loss at 95db on frequency 500 to 4000hz on the right ear but she seemed uncertain about the results and said she was going to get a second opinion. She concluded it was conductive because the bone conduction test was good. After doing research, I found conductive hearing loss can only be maximum at moderate level. I asked the audiologist and she agreed too that it was strange that it was in profound range and suspected maybe the earphone was loose during the test so she asked us to go in for a retest. So on dec 12, we went in for the retest. This time she concluded that it was profound sensorineural hearing loss. We were confused and asked why in the first test, the bone conductivity test was good and now it’s sensorineural loss. She said it could be because the assistant that helped held the equipment piece on baby’s head behind the ear placed it on the wrong spot so that the signals she got were actually muscle movements. (The second time the audiologist was the one who held the equipment piece on baby’s head.) we thought this was strange. Wouldn’t the assistant be experienced in this? How could they make a mistake like this? And how come audiologist seem so certain in first test that the bone conductivy result was good? Also, in the retest, baby hearing was 75db at 500hz, 85db at 1000hz, 95db at 2000hz, 105db at 4000hz. We are confused why the first test, it was 95db for all frequency and the second test was showing a gradual increase in loss the higher the frequency. Could someone please help explain these different findings? Thanks!

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Hello @Cookie28 and welcome.

This must be very confusing indeed.  Is there a cochlear implant center near you where you can have your son’s hearing tested?  They are very experienced in determining the type and degree of hearing loss.

I wish your son the very best!  Please keep us posted.

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Okay, let's start with the initial finding - a profound conductive hearing loss does not exist.

Why? Because skull bones behave as sort of conduction system from outside to the inner ear. The conductive hearing loss is purely mechanical, unlike the sensorineural hearing loss. I am pretty much puzzled, how on Earth the audiologist did not remind this simple but so logical argument during a discussion regarding your boy's hearing.

Just an episode, last week occurred an incident with the audiometer in the hospital where I work - it started to act strangely giving me quite puzzled results, for instance - older people with the mixed hearing loss which is impossible having in mind their hearing loss history. 

Back to your sons' story, the excuse that the other person didn't put the testing part in the correct spot just do not buy the story - from space, it is visible that it was put in a wrong way and retest should be done. Having in mind this, the second result is pretty much accurate - the way you described his hearing loss threshold is a typical way how hearing cells start to malfunction: at first and with the greatest extent higher frequencies. The lower frequencies are last and come after the middle frequencies. It's due to so-called tonotopicity of a cochlea. 

https://blog.medel.com/how-the-cochlear-understands-so-many-different-sounds/

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