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PubMed1980

[Forward and backward Békésy audiometry in neurosensorial hearing loss (author's transl)].

Békésy audiometry was utilized to show that an abnormal separation of forward and reverse frequency tracing is to be referred to an abnormal fatigability in neurosensorial hearing loss (presbycusis and noise-induced hearing loss). The ascending and descending threshold with continuous tone was compared to fixed frequency per-stimulatory threshold that has been determinated using interrupted and continuous tone. During the study has been evaluated the gap between the continuous and interrupted tone and the excursion amplitude in interrupted and continuous tone. The results are than an abnormal separation between forward and reverse frequency tracings is connected to an abnormal fatigability. Thus, according to other authors, forward-backward Békésy audiometry can be used to show a retrocochlear pathology in the considered hearing loss.

Audiometry↗
PubMed1981

[A practical application of brainstem evoked response audiometry (author's transl)].

After a brief review of Brainstem Evoked Response Audiometry (BERA) for clinical diagnosis of middle and inner ear hearing losses (Fig. 2, 3) and retrocochlear damages a new practical application is presented: Brainstem Evoked Response Audiometry in Tympanoplasty. Recordings of acoustically evoked brainstem potentials have been made in middle ear surgery in order to get direct objective information about the mobility of the stapes (Fig. 4) and the sound conducting mechanism of the middle ear after tympanoplasty (Fig. 5). Because of the damping factor of the middle ear after tympanoplastic reconstruction quantitative evaluation of sound transmission to the internal ear. Via brainstem potentials evoked by loudspeakers or probe tubes is difficult. Therefore, a special mechanical vibrating system for direct stimulation of the middle ear apparatus at various locations will have to be developed.

Audiometry↗
PubMed1976

The cross-check principle in pediatric audiometry.

We discuss a method of pediatric audiologic assessment that employs the "cross-check principle". That is, the results of a single test are cross-checked by an independent test measure. Particularly useful in pediatric evaluations as cross-checks of behavioral test results are impedance audiometry and brain-stem-evoked response audiometry (BSER). We present five cases highlighting the value of the cross-check principle in pediatric audiologic evaluation.

Acoustic Stimulation↗
PubMed1976

Brief-tone audiometry in pseudohypacusis.

Brief-tone audiometry was administered to two groups of listeners. The first group consisted of five sophisticated subjects with normal hearing, who were tested under normal and simulated hearing-loss conditions. The second group consisted of five patients with true pseudohypacusis. Results under simulated and true pseudohypacusic conditions were similar, but were different from those obtained from the normal listeners under normal conditions, which further extends the diagnostic value of brief-tone audiometry.

Acoustic Stimulation↗
PubMed1989

Aminoglycoside ototoxicity in cystic fibrosis. Evaluation by high-frequency audiometry.

In this study, we sought to determine the clinical usefulness of high-frequency audiometry (8000 to 20,000 Hz) in detecting aminoglycoside-induced increases in pure-tone hearing thresholds before they are noticed in conventionally tested frequencies. We measured hearing thresholds from 250 to 20,000 Hz in 22 patients with cystic fibrosis who were treated with aminoglycosides. The audiograms were age-matched and were compared with those from 13 patients with cystic fibrosis and 38 subjects without cystic fibrosis, all of whom had never received aminoglycoside therapy. In patients with cystic fibrosis who were treated with aminoglycosides (younger than 20 years), there were statistically significant elevations only in frequencies higher than 16,000 Hz. Patients with cystic fibrosis who were treated with aminoglycosides who were 20 years and older had elevated thresholds in all frequencies tested. Patients with cystic fibrosis who were not treated with aminoglycosides did not differ statistically from controls. High-frequency audiometry may serve as a useful measure of elevation in pure-tone hearing thresholds that precede noticeable loss of auditory acuity in patients with cystic fibrosis who are receiving long-term aminoglycoside therapy.

Adolescent↗
PubMedDate not supplied

Electrical response audiometry (ERA) in infants.

The electric response audiometry is a useful diagnostic technique for identifying hearing loss in infants. Among the various electrical responses, the BSER enables us to arrive at an accurate early clinical diagnosis of hearing loss in infants so that effective auditory input, which is the prime requisite for the conceptual foundation for the growth of communication, can be provided through appropriate intervention programmes. The electric response audiometry provides information regarding the physiologic state of the peripheral organs and auditory pathways but however, cannot ascertain whether the infant can hear, in terms of perceiving auditory information. Inspite of this major limitation, the growing acceptance of brainstem electrical potentials in clinics and laboratories throughout the world attests to their increasing importance especially in the assessment of hearing sensitivity of infants.

Audiometry, Evoked Response↗
PubMed2001

[Rare audiometry findings in progressive, monosymptomatic low frequency deafness].

BACKGROUND: Objective audiometric methods such as the measurement of otoacoustic emissions and auditory evoked potentials (click evoked and notched-noise auditory evoked brainstem potentials, auditory evoked cortical potentials) can provide helpful information. However, information derived from the individual test is limited and each method contains specific restrictions. To illustrate the possible audiometric pitfalls this work presents a case history. CASE REPORT: The puretone audiometry showed a severe hearing loss at low frequencies up to 2 kHz, a slight hearing loss for higher frequencies up to 6 kHz and almost normal hearing thresholds above 6 kHz. Transitory evoked otoacoustic emissions could not be detected. While the auditory evoked brainstem responses (ABR) using click-stimuli showed a normal pattern no reproducible responses could be derived using the notched-noise technique. Auditory evoked cortical potentials exhibited a normal N1/P2-complex and were detectable down to stimulus levels 0-20 dB above the individual hearing threshold. DISCUSSION: Click-evoked auditory evoked brainstem potentials are widely regarded as the "gold-standard" of objective audiometry. The example presented in this work shows that in special cases it may provide false negative results. In these special cases auditory tone-evoked cortical potentials may provide better objective information. When objectively assessing the determination of the hearing threshold it may be necessary not only to use all electrophysiological measurements but also to know their methodical restrictions and pitfalls.

Adult↗
PubMed1999

A video-based performance in noise test for measuring audio-visual disability in young school children: test development, with validation by trained teachers, parents and audiometry as relative standards for disability.

BACKGROUND: impaired ability to detect target sounds in noisy surroundings is a particular feature of children with a history of otitis media with effusion (OME). Children with current OME are also likely to experience difficulty in speech reception in classrooms where a high level of background noise has been recorded. No tests are currently available which are feasible in primary care and which objectively measure school-related disabilities. The effects of speech in noise and the extent to which this is offset by speech reading contribute important dimensions to disability. METHODS: a video-based speech reception test has been developed using the same principles in 227 English and 182 Danish 4-8 year-old children. Distribution data was collected for both language versions of the test. The test has been compared with audiometry and teacher and parents assessments to establish its validity. INTERPRETATION: there are no gold standards for audio-visual disability in current clinical use. The poor positive predictive value of audiometry for likely classroom functioning is a cause for concern, particularly in relation to inappropriate referral of children by primary care physicians.

Audiometry↗
PubMed1980

Brainstem evoked response audiometry in confirmed eighth nerve tumors.

Brainstem evoked response audiometry has been described as an effective predictor of eighth nerve disease. This study reports audiologic findings in 52 cases of surgically confirmed eighth nerve and cerebellopontine angle tumors. The results of brainstem audiometry were consistent with an eighth nerve lesion in 51 cases. Its use in site of lesion tests is highly recommended.

Audiometry, Evoked Response↗
PubMedDate not supplied

Pure-tone audiometry and auditory brainstem responses in noise-induced deafness.

PURPOSE: The objective of this study is to find the relationship between pure-tone audiometry results and the auditory brainstem response wave abnormalities. SUBJECTS AND METHODS: The pure-tone audiometry (PTA) and auditory brainstem responses (ABRs) from 22 patients (44 ears) with diagnosed noise-induced permanent hearing loss were studied. Three indices of PTA were average thresholds of 0.5 kHz/, /1 kHz, and 2 kHz (PTA1); 2 kHz and 4 kHz (PTA2); and 4 kHz (PTA3) were subdivided into 3 thresholds of hearing. Their relationships with ABR results were analysed. The patterns of PTA from various groups of ABR wave patterns were studied. RESULTS: In this study, the abnormal ABR wave patterns were detected in 72.7% of the ears. The ears with prolonged ABR wave latency, absent early waves, prolong interpeak wave I-V latency was 20.5%, 18.2%, and 21.1%, respectively. Normal ABRs were recorded in 27.3% of the ears despite marked thresholds elevation of the PTA at high frequencies. Other relationships between PTA results and ABR wave results were discussed. CONCLUSION: There were relationships between severity of noise-induced hearing loss indicated by PTA and the patterns of ABR wave abnormalities among workers with noise-induced permanent hearing loss.

Aged↗
PubMedDate not supplied

Phone positioning influence in high-frequency audiometry.

UNLABELLED: Research considers high frequency tonal audiometry as a tool for the early diagnosis of auditory alterations derived from etiological agents. AIM: to investigate possible differences in high frequency audiometry of individuals with normal hearing, based on the person who places the earphone. PATIENTS AND METHOD: clinical and experimental study with 55 undergraduate students from a country side branch of the São Paulo State University, with normal hearing, underwent two tests each; for the first, the evaluator positioned the earphone on the participant; for the second one, the participant did it by him/herself. An AC40 audiometer calibrated to emit pure tone was used in the frequencies of 10, 12.5, and 16 kHz. RESULTS: The kappa(k) coefficient statistical analysis was used to verify the agreement between the two ways of earphone positioning of earphone, bearing a [FORMULA: SEE TEXT]0.70 kappa value as a criterion. Results attained for both ears were below this criterion, with k average of 0.50. DISCUSSION: results indicate a risk of compromising the exam reliability when the patient him/herself adjusts phone to his/her own ear. CONCLUSION: when performing audiometric assessment, this variable must be considered in order to attain reliable results.

Adolescent↗
PubMed2005

Auditory screening in the elderly: comparison between self-report and audiometry.

UNLABELLED: Despite its high prevalence in the aged, hearing loss has been poorly investigated. Audiometry is the gold standard for evaluation of hearing loss, but large-scale use of the procedure involves operational difficulties. Thus, self-report may be an alternative. AIM: To determine if a single global question is valid for use in epidemiologic research. STUDY DESIGN: Systematic review. MATERIAL AND METHOD: A search of the medical literature from 1990 to 2004 was performed using MEDLINE and LILACS. The references of the articles identified in the electronic search were also reviewed. STUDY SELECTION AND DATA EXTRACTION: The articles that compared the results obtained with self-report to a single global question with those obtained by pure tone audiometry were selected. Data about the prevalence of hearing loss, and sensitivity, specificity and predictive values were extracted. DATA SYNTHESIS: Ten longitudinal studies were included. A single global question seems to be an acceptable indicator of hearing loss, sensitive and reasonably specific, mainly if the hearing loss is identified as the tone average that includes frequencies up to 2 or 4 kHz, at 40 dBHL level, in the best ear. CONCLUSION: A single global question shows good performance in identifying older persons with hearing loss and can be recommended for an epidemiologic study if audiometric measurements cannot be performed.

Aged↗
PubMed1978

Speech audiometry in acoustic neuroma.

The importance of speech audiometry in cases of sensori-neural deafness has been stressed. Four cases have been described clearly elucidating this point. Speech audiometry is within the means of most practising otologists. The appropriate apparatus is not expensive, nor is the method excessively time-consuming. In acoustic neuroma the damage to the cochlear nerve fibres may produce very little reduction in the hearing threshold level for pure tones, but a disproportionately large reduction in the discrimination score, often when the tumour is large enough to be causing brain stem compression. The disproportion is an important indicator to the presence of retro-cochlear pathology, of which acoustic neuroma is the most likely cause, a diagnosis which must be considered in every case of unilateral sensori-neural deafness.

Adult↗
PubMed1999

Clinical masking in speech audiometry: a simplified approach.

The optimal masking level during speech audiometry is one that falls above the minimum and below the maximum masking levels. The goal is to select a masking level that falls at the middle of the masking plateau. This article presents a simplified approach to selecting an appropriate level of contralateral masking during suprathreshold speech audiometry. The underlying theoretical concepts and prerequisite conditions are reviewed. The advantages of insert earphones when using the simplified approach are discussed.

Adult↗
PubMed1979

[Possibilities of assessing cerebrovascular disease by audiometry: Comparison with Doppler ultrasound in the assessment of extracranial vascular occlusion (author's transl)].

Discrimination loss in the speech-audiogram (one-syllable test) was tested on 61 patients with cerebrovascular disease due to extracranial vessel stenosis in the area of the carotid artery distribution. In 44 of the patients (extracranial vessel stenosis or occlusion) the results were compared with the carotid angiogram and Doppler ultrasonography. There was agreement between loss of discrimination, localisation by angiography, ultrasound results and the relevant clinical findings in 32 of 36 patients. In 17 patients audiometry was performed before and after surgical reconstruction of the internal carotid artery. Among 13 patients in whom the results could be assessed, discrimination improved postoperatively in 11 (at least 20% in six, at least 10% in five). The combination of ultrasound and audiometry can be used as a screening method in unclear cases to evaluate suspected cerebrovascular disease, simplify indications for carotid angiography, and used serially, follow any further development of the vascular disease.

Aged↗
PubMed2004

[200 years testing hearing disorders with speech, 50 years german speech audiometry -- a review].

FROM THE BEGINNIGS TO CLASSICAL SPEECH TESTS: The need for classification of different degrees of hearing disorders first arose when it seemed possible to treat deafness. Grapengiesser in Berlin 1801 had applied galvanic current to the ears of deaf children and reported some success. Pfingsten in Kiel in 1804 using this method was the first to use speech in diagnosing different degrees of deafness. He divided speech sounds into three classes: vowels, voiced consonants and voiceless consonants. Itard in Paris in 1821 gave a classification of five classes according to which sounds could be perceived, starting from normal speech to thunder and the bang of a gun. Schmalz in Dresden 1846 noted the range within which speech was understood thus introducing the concept of hearing distance. Helmholtz in 1863 had demonstrated that vowels are composed of pure tones. Wolf in Frankfurt 1871 tried to align all speech sounds from the lowest frequency (tongue-R = 16 Hz) to the highest (sh = 4096 Hz) and measured the hearing distance for each sound. Following these suggestions word lists based on the predominant frequencies were compiled in a number of languages including Japanese. SPEECH AUDIOMETRY: This chapter is devoted to Karl Heinz HahIbrock, Freiburg, who was the founder of the German speech audiometry. Hahlbrock followed the American authors of the Psycho-acoustic Laboratory at Harvard, in particular J. P. Egan (1948), using statistical methods for composing lists of words based on the relative frequency of speech sounds and phonetically balanced between the different groups. He finally presented a test comprising groups of two-digit numbers and monosyllabic words. Hahlbrock died in 2003 exactly fifty years after the presentation of his test. A short account of his life is given. THE FOLLOWING DEVELOPMENT: In the following years various other types of speech tests were elaborated using sentences, distorted speech, diotic and dichotic presentation partly aimed at fitting hearing aids, partly with the aim to diagnose central hearing disorders. Hahlbrock's test, however, remained the standard for evaluating speech reception and discrimination. DISCUSSION: One of the fundamental problems in testing speech discrimination is that there is no catalogue of phonemes common to all languages or regional accents. Untrained not native speakers often do no perceive certain sounds having a partial auditory agnosia. They cannot distinguish between e. g. 'hand' and 'and' or 'end' and 'ant', but the examiner must decide if the word presented was repeated correctly or not.

Audiometry, Speech↗
PubMed1992

[Comparative speech audiometry studies with compact disk].

We compared the results of speech audiometry, performed with recorded tape and CD, respectively, in 21 subjects with bone conduction hearing loss, and in 27 subjects with sensorineural hearing loss. In all cases, speech audiometry was performed by using the German Freiburg speech test material, recorded in 1969 on the basis of the German DIN standard 45626. In subjects with an air-bone gap, the hearing loss for speech is 2.3 dB smaller if tested by use of CD, and the speech recognition is 10.5 points better, respectively. Smaller differences could be found in sensorineural HL: For CD, the hearing loss is 1.2 dB smaller, and the speech recognition score is raised by only 1 point. These differences are statistically not significant, and the calculation of hearing impairment and individual hearing handicap from the tables commonly used in Germany in medicolegal expert opinions must not be corrected, if records on CD are used basing on the recordings from 1969 according to DIN 45626. The handling of compact discs has many advantages in relation to the handling of tapes.

Adult↗