In the context of audiological evaluations, what is the main risk of not using masking when necessary?

The main risk of not using masking when necessary during audiological evaluations is under-diagnosing hearing loss. Masking is a technique used to ensure that the non-test ear does not contribute to the test results, which can happen when the test signal presented to one ear is loud enough to be heard by the other ear. If masking is not employed properly, the audiologist may not accurately assess the hearing thresholds of the test ear, leading to a potential underestimation of the severity or presence of hearing loss.

This is particularly critical in cases of unilateral or asymmetric hearing loss, where one ear may have normal hearing while the other is impaired. Without appropriate masking, the audiologist might conclude that both ears have similar hearing abilities when, in reality, one ear has a significant hearing loss. This misdiagnosis can prevent patients from receiving necessary treatments or interventions that could improve their quality of life. Therefore, the accurate diagnosis of hearing loss is contingent upon the correct use of masking when indicated.