International Licensing Examination (ILE) Practice Test

What auditory condition is typically indicated by a significant air-bone gap?

1. Sensorineural hearing loss

2. Conductive hearing loss

3. Mixed hearing loss

4. Normal auditory function

The correct answer is: Conductive hearing loss

A significant air-bone gap is a hallmark of conductive hearing loss. Conductive hearing loss occurs when there is a problem with the outer or middle ear that prevents sound from being conducted properly to the inner ear. This can result from a variety of issues, such as fluid accumulation in the middle ear, earwax blockage, or damage to the ossicles. In conductive hearing loss, the air conduction thresholds are poorer than the bone conduction thresholds, leading to the observed gap. This gap signifies that while the inner ear (where sound is converted to nerve impulses) functions normally, the outer or middle ear mechanisms are not effectively transmitting sound. On the other hand, sensorineural hearing loss involves damage to the inner ear or the auditory nerve and does not typically present with an air-bone gap, as both air and bone conduction thresholds are similarly affected. Mixed hearing loss encompasses both conductive and sensorineural components, which would also show an air-bone gap but in conjunction with other findings. Normal auditory function would not show any gaps at all.