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PubMed1993

Development of a hearing test protocol for profoundly involved multi-handicapped children.

The purpose of the present study was to develop a protocol for use in testing the hearing of profoundly involved multi-handicapped children. Behavioral observation audiometry, visual reinforcement audiometry, auditory brain stem response (ABR), and noise-tone-difference tests were administered to 156 children with multiple handicaps. Eighty-three percent of the children with normal middle ear function were estimated to have normal hearing or, at worst, a mild hearing loss, by one or more of the tests. ABR was the single best test, followed by behavioral observation audiometry and noise-tone-difference. However, only 65% of the children would have passed had they only been tested with ABR. If agreement among two of the tests had been required, hearing loss would have been ruled out in only 34% of the children. A factor analysis revealed that the various hearing tests were associated with different medical and physical conditions which might influence threshold estimation for multi-handicapped children. These results support use of a series-positive test battery protocol in which individual tests are used sequentially with the purpose of ruling out moderate-profound sensorineural hearing loss.

Acoustic Stimulation↗
PubMed2004

Incorporating vision and hearing tests into aged care assessment: methods and the pilot study.

PURPOSE: Vision and hearing impairments are frequent in older people and may contribute to their reliance on aged care services. This study aims to assess whether incorporating vision and hearing screening into routine aged care assessments and provision of appropriate health care services will influence health outcomes of older individuals. METHODS: The proposed project is a 2 x 2 factorial design randomized controlled trial. The pilot study recruited 208 participants aged 65+ years attending an aged care assessment center at Westmead Hospital, Sydney, who were randomly allocated to one of four groups: vision and hearing tests, vision tests only, hearing tests only, or neither. Face-to-face interviews with all participants were conducted. Questionnaires included Activity of Daily Living (ADL), 36-item Short-Form health survey (SF-36), Mini-Mental State Exam (MMSE) and questions about use of health care and community support services. Participants will be re-examined after 12 months to assess changes over time in quality-of-life, physical and cognitive function, incident falls and use of health and community aged care services.

Aged↗
PubMedDate not supplied

Sound-field hearing tests.

Facilities for sound-field testing of hearing and calibration procedures are described.

Audiometry↗
PubMed1994

Correlation between the American Academy of Otolaryngology-Head and Neck Surgery five-minute hearing test and standard audiologic data.

The American Academy of Otolaryngology-Head and Neck Surgery recently developed a questionnaire called the "Five-Minute Hearing Test" and distributed it to many primary care physicians. Our literature review suggests that the test characteristics (i.e., sensitivity and specificity) of this screening instrument have not been published. The purpose of this study was to examine the validity of the test by correlating the "Five-Minute Hearing Test" results to various audiologic results obtained for the same patients and to analyze the test characteristics with pure-tone measures as a standard criterion. An original version of the "Five-Minute Hearing Test" was administered to 70 patients older than 55 years, and a revised version of the test was administered to additional 74 elderly patients. The "Five-Minute Hearing Test" scores in both original and revised versions significantly correlated with all audiologic measures, especially with the pure-tone measures. However, the American Academy of Otolaryngology-Head and Neck Surgery's recommended cutoff score for a referral yielded a high false-positive rate. If the cutoff score were changed, the "Five-Minute Hearing Test" would be a reliable hearing screening tool for identification of hearing loss among the elderly population. Specific recommendations include adjustment of the cutoff score to at least 15 and revision of a few selected test items.

Aged↗
PubMed2000

Bilateral sensorineural hearing disorders in children: etiology of deafness and evaluation of hearing tests.

OBJECTIVE: The purpose of this study was to determine the etiology of bilateral sensorineural hearing disorders in children and to evaluate the performed hearing tests by comparison of the results of the objective and subjective tests. METHODS: The medical history and the hearing tests (behavioral observation audiometry, acoustic evoked potentials and pure tone audiometry) of 106 bilaterally hearing impaired children were analyzed in a retrospective follow-up study. RESULTS: The total group included 52 males and 54 females. The ages at first diagnosis ranged from 4 months to 11 years with a mean age of 42 months and a median of 33 months. The degree of hearing loss for the better hearing ear was mild in one child, moderate in 28 children, severe in 29 children, profound in 32 children and total in 16 children. The delay between the first examination and diagnosis ranged from 0 to 597 days with a mean of 83 days and a median of 28 days. In 47 children (44%) no cause of hearing impairment could be determined. Nineteen children (18%) had a history of familial hearing loss, 40 (38%) suffered from acquired hearing loss (seven children had prenatal causes, 21 perinatal and 12 postnatal). A comparison between behavioral observation audiometry and brainstem evoked response audiometry revealed a statistically good agreement. Twenty-nine children (32%) showed progressive hearing loss, which was defined as a threshold shift of +10 dB or more in the pure tone average in at least one ear. CONCLUSIONS: In a significant number of children with early hearing impairments the etiology still remains uncertain. Further research in the field of genetic disorders will diminish this number. Evaluation of hearing tests showed that behavioral observation audiometry still is an excellent tool in the hands of an experienced examiner. The age at identification of hearing disorders in industrialized countries still is unacceptably high. To obtain ideal care of hearing impaired children, universal neonatal hearing screening programs are mandatory.

Age Distribution↗
PubMed1999

[New hearing test for functional deafness--the procedure to estimate the genuine hearing threshold].

This report describes a new procedure for examining functional deafness with binaural sound stimulation. This new hearing test can estimate the genuine pure tone hearing threshold quantitatively at every frequency by using the ordinary audiometer. In the case of the nonorganic deafness, even if the hearing disorders are bilateral or hemilateral, we believe that measuring auditory threshold separately, causes the deterioration of the threshold. Therefore, this procedure is designed so that the subject may not be aware of testing the auditory acuity of each ear, and utilizes the response of the phantom sound image in the head by simultaneous binaural presentation of sound stimulation. Our strategy is based on the following facts. If the normal subject has the same pure tone threshold level in both ears, the phantom sound image is formed in the median plane of the head by the equal suprathreshold tone level presented simultaneously in each ear. In the case of a unilateral auditory disorder, the sound image is localized to the center of the head only when sound stimulation louder than the threshold level of affected ear is given to both ears at the same time. Simultaneous binaural sound stimulation at a lower level than the threshold of the affected ear forms a lateralized sound image to the unaffected ear in the head. For patients with bilaterally similar hearing loss, the sound image is not formed if the stimulation is less than the threshold level of the pure tone. The band noise in the phase of each frequency with 50 dB HL was given binaurally to 10 normal hearing subjects, and the localization of the sound image formation was examined. This experiment confirmed that around the occipital region of the median plane in all subjects. Furthermore, comparing the formation threshold of the median plane image with the pure tone auditory threshold, proved that there was no significant difference statistically in either value. As a next step, 15 patients with unilateral sensorineural deafness were examined with this technique and we knew that the median sound images would not be formed with stimulation less than the pure tone auditory threshold of the affected ear. For clinical application, patients were classified into two groups with unilateral (6) and bilateral (2) functional deafness, and examined. Midline sound images definitely were formed with the lower magnitude of sound than the pure tone threshold by hemilateral nonorganic deafness. The difference of the forming threshold of the median sound image and the average of pure tone hearing level of the affected ear were maximum 100 dB, minimum 35 dB, and mean 69.4 dB. Furthermore, the difference of the median image forming threshold and the average hearing level of the unaffected ear were maximum 35 dB, minimum 0 dB, and mean 15.4 dB. In bilateral disorders, the midline plane sound image was formed with the corresponding level of the pure tone value in one subject, though the other one was determined by the maneuver method because it did not form a midline sound image. In conclusion, this examination can be readily used to estimate the genuine hearing threshold of the functional deafness.

Acoustic Stimulation↗
PubMedDate not supplied

Vestibular findings in sensorineural hearing disorders. Results of caloric, oculomotor and hearing tests in 205 patients with unilateral hearing dysfunction.

In 205 patients with unilateral hearing loss, 117 of cochlear and 88 of retrocochlear origin, thorough audiovestibular examinations were performed to establish the occurrence and severity of vestibular dysfunction. The results were also analysed with the aim of determining the relationships between the severity of the hearing loss, the etiology and the topical location of the hearing disorder, on the one hand, and vestibular dysfunction, recorded as reduced caloric sensitivity and occurrence of oculomotor disturbances, on the other. No correlation was found between severity of hearing loss and recordable vestibular dysfunction, in either the cochlear or retrocochlear group of patients, or in the etiological subgroups of these main groups. With respect to the relations between the topic locations of the lesions and the results of vestibular tests, distinct characteristics were observed. In the affected ears, totally extinguished caloric reactions were more than six times as frequent in the retrocochlear group as in the cochlear group and appeared as a specific but rather insensitive sign of acoustic neurinoma. Oculomotor disturbances were only exceptionally observed in patients with cochlear lesions, but were noted in nearly half of the retrocochlear group; when only those patients with lesions of the brain stem or cerebellum were considered, all were found to exhibit such disturbances. The relations between audiometric hearing test pattern, caloric sensitivity and oculomotor disturbances seem to form interesting diagnostic paradigms of great value for the topical localization of audiovestibular disorders.

Auditory Pathways↗
PubMedDate not supplied

A survey of hearing test rooms.

Octave-band and broad-band sound level measurements were made on 46 hearing test rooms in physicians' and audiologists' offices, hospitals, and audiology clinics. The data were evaluated against the ANSI 1977 ears open and ears covered standards for hearing test rooms. Five of the rooms met the ANSI 1977 ears open standard, and 18 met the ANSI 1977 ears covered standard. Neither dBA or dBC measurements nor difference between dBA and dBC values is a satisfactory way of specifying a room that meets a given standard. A double-wall hearing test room does not assure a test area that meets ANSI 1977 standard. Sound room ventilating fans seem to be a significant source of noise in many rooms.

Acoustics↗
PubMed1971

Notes on hearing tests.

A short review of current practical hearing tests is given. Tests to differentiate conductive and sensorineural types of hearing loss are mentioned. Basic concepts are given which subdivide sensorineural hearing losses into those arising in the cochlea and those arising more centrally. The information is given as a simplified resume intended to be understandable by all interested in birth defects.

Deafness↗
PubMed1983

After the hearing test--what then?

The credibility of industrial hearing test data should be established before it is evaluated for follow-up action. Once this is done, subsequent evaluation should determine 1) whether or not there is need for referral to a professional, 2) whether or not there has been a significant threshold shift (STS), and 3) provide for necessary within-company administrative follow-up, as appropriate. Caution should be used in releasing data to employees; however such release should be prompt and complete. Use of the term 'normal hearing' should be minimized; with 'satisfactory hearing' being substituted. Use of this term should include the criteria upon which it is based. There is some confusion on what is not meant by STS, and specific criteria pertaining thereto have been recommended. Using a computer to assist in the above processes can result in increased accuracy and economy, while at the same time providing for easy access to the collective data base thereafter.

Audiometry↗
PubMed1993

[Otoacoustic emissions. A futuristic objective hearing test].

In a third of all persons with normal hearing, the inner ear emits sounds that are caused by movements of the hair cells. By applying an acoustic stimulus, otoacoustic emissions can be provoked in all healthy ears. These transitory evoked otoacoustic emissions (TEOAE) and the distortion products of otoacoustic emissions (DPOAE) can be utilized by two different procedures for testing hearing. The latter parameter reflects possible damage to the inner ear. Such hearing tests are quick, harmless, and can be performed irrespective of patient age. For this reason, they are particularly suitable for use in the screening of the newborn. In addition, they are also suitable for the early diagnosis of hearing impairment and the effects of ototoxic agents, as also for differentiating sensorineural hearing loss.

Hair Cells, Auditory↗