Short Increment Sensitivity Index (SISI)
The SISI test is still widely used to determine whether the patient is having cochlear pathology. This test is based on a phenomenon known as recruitment (abnormal loudness growth).
Short Increment Sensitivity Index (SISI)
What is the SISI test?
The SISI test, also called the short increment sensitivity test, checks how well a person can detect very small increases in loudness. A continuous tone is presented, and tiny 1 dB increments are added at regular intervals. At Muskan Speech & Hearing Centre, audiometry SISI is carried out by audiologists as a supporting test alongside other hearing assessments.
How is the SISI test performed?
- The person wears headphones in a quiet, sound-treated room.
- A steady carrier tone is played at 20 dB above the person's hearing threshold.
- Brief increases in loudness are added every five seconds.
- The person signals each time a change in loudness is noticed.
- The audiologist calculates the score from the number of increments detected, out of 20.
In normal individuals, the score rises gradually as the carrier tone level increases, reaching 100% at about 60 dB above threshold. In sensory hearing loss, the maximum score is reached much earlier, at around 30 dB above threshold. Scores of 70% to 100% at lower levels are generally considered positive for a cochlear lesion.
Why is the SISI test useful?
As a cochlear lesion test, it helps distinguish cochlear (sensory) hearing loss from retrocochlear causes. Its findings, combined with pure tone audiometry and speech audiometry, give a clearer diagnostic picture.
Who may need a SISI test?
- People with sensorineural hearing loss needing further evaluation
- Those showing signs of loudness discomfort or recruitment
- Individuals referred for site-of-lesion testing
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