Békésy is an automatic method of measuring audiometric thresholds. It can be used for audiometric screening or in differentiation between the cause of the hearing loss e.g. non-organic hearing loss (Gelfand, 2009) or the origin of the damage in the ear (conductive, cochlear or retro cochlear) (James Jerger, 1962).
The patient being tested needs to hold down the response button when the tone is heard and release when the tone is no longer heard. When the response button is pressed, the intensity level of the frequency tested will automatically be reduced. When the response button is released, the intensity level will automatically increase. The patient’s response will be recorded as a trace on the Test Screen.
When using the Békesy for clinical purposes, one threshold is obtained with a continuous tone and one with a pulsed tone. The results are interpreted based on the display of the continuous and pulsed tone.
Békésy Type 1: Continuous and pulsed tone overlapped (Cochlear disorder)
Békésy Type 2: Continuous tracing slightly worse than pulsed tone tracing (Cochlear disorder) Békésy Type 3: Continuous drops off the graph as a result of adaptation to the tone (Retro cochlear disorder)
Békésy Type 4: Continuous tracing is 20 dB lower that pulsed tone tracing (Retro cochlear disorder)
Békésy Type 5: Pulsed tone tracing below continuous tracing (feigning hearing loss)
Setup│Auto settings allows for changing the allowed deviation and number of reversals needed for a response to be stored.
Gelfand, S.A. (2009) Essentials of Audiology, Theime.
Jerger, J. (1962) Bekesy Audiometry, Hearing Tests in Otologic Diagnostics, ASHA May.