REMs for patients with Otosclerosis

[SHowe]

As discussed on another thread, we fit patients with conductive losses using REIG if they appear to have normal ear canal acoustics and REAG if they do not. We also add on extra gain according to the air-bone gap by using BC values with the NAL-NL1 prescription formula.

There are some concerns in our department however that we may not be optimally aiding our patients who have otosclerosis, as there is a 'false' BC threshold at 2 kHz. Therefore when NOAH uses BC values, it adds extra gain at all frequencies except 2 kHz. Given that this BC value does not represent a sensorineural hearing loss at this frequency, should we be prescribing more gain around 2 kHz than NOAH would suggest?

Do any other departments/individuals have any different protocols for fitting patients with otosclerosis, or should we be sticking to the same rationale for all conductive patients?

[Madge]

I have been wondering a similar thing but in a slightly diffirent context. At the moment I'm thinking that: whatever the physical/acoustical effects of otosclerosis that give this 'false' BC threshold at 2kHz will be the same whether the person is listening to a puretone signal during testing or to speech/other sounds during normal listening therefore no additional amplificaton would need applied at 2kHz to compensate for a greater ABG than is suggested by the audio results. Maybe?
We don't have any specific protocols for fitting people with otoscelorisis in our department.