ABCs of Pure Tone Audiometry: A Review Article

Abstract

Pure Tone Audiometry (PTA) remains the cornerstone of clinical audiological evaluation, often referred to as the gold standard for assessing hearing thresholds. This comprehensive review explores the historical evolution, foundational principles, and clinical relevance of PTA in modern audiology. Beginning with its origins in early tuning fork tests, the paper highlights key technological advancements and contributions from pioneering figures such as Harvey Fletcher, C.C. Bunch, and Raymond Carhart. The review details the acoustic, physiological, and technical principles underlying PTA, including concepts of air and bone conduction, transducer properties, calibration standards, and the threshold of hearing. Pre-testing protocols such as biological calibration, case history intake, and otoscopic examination are emphasised as essential to ensuring reliable outcomes. Testing procedures are elaborated step-by-step, incorporating both air and bone conduction techniques, masking principles, and interpretation of audiometric results. The review also underscores PTA’s diagnostic value, utility in monitoring hearing changes, and its pivotal role in hearing aid programming and cochlear implant candidacy assessment. Through historical context and contemporary applications, the review affirms the enduring relevance of pure tone audiometry in audiological science and practice.

Keywords:Pure tone audiometry, Audiometer, Air conduction, Bone conduction, Air-bone gap

DOI: 10.7176/IEL/15-2-01

Publication date:August 31^st 2025