The Carhart notch is a depression in the bone-conduction audiogram of
patients with clinical otosclerosis. The middle frequencies from 0.5 t
o 2 kHz, which correspond to the resonance frequency of the middle ear
, can be substantially improved following successful stapes surgery. T
wenty-nine consecutive patients with clinical otosclerosis were tested
2 weeks before and 7 months after stapes surgery with conventional ai
r-conduction (AC) and bone-conduction (BC) audiometry and electric bon
e-conduction (EBC) audiometry using an Audimax 500 audiometer. The BC
thresholds improved at 0.5-2.0 kHz corresponding to the Carhart notch.
On average, the EBC thresholds remained more stable, showing no Carha
rt phenomenon, which supports the concept that EBC stimulation is not
entirely equivalent to conventional BC audiometry, but has a different
mode of action on the inner ear.