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PubMed1979

High-frequency audiometry. Age and sex variations.

286 normal subject representing both sexes and seven age groups from 10 to greater than or equal to 70 years were tested with both conventional pure tone audiometry and high frequency audiometry (4--20 kHz) using a previously described free field system. The subjects were selected according to very strict criteria. Results from conventional audiometry are similar to other findings in presbycusis studies, though sex difference was seen for the oldest age groups, but only at the frequencies 4 and 5 kHz where the male population showed a significantly poorer hearing. The same sex difference was observed by high frequency audiometry at 4 and 8 kHz. From 10--20 kHz no sex difference was present. At the high frequencies there is an abrupt decrease in hearing sensitivity already from youth. Hitherto, no international standard for zero dB hearing level exists for frequencies above 8 kHz. It is questioned whether a general standard is meaningful at all and that normative data for various age groups should instead be used as a reference level.

Adolescent↗
PubMed1988

[Clinical trial of BOBCAT: 1st report on the reliability and validity of computerized pure-tone audiometry].

Computerized diagnostic audiometry is quickly emerging as a viable productivity tool in the audiology clinic. To date, there has been little reported on its reliability and validity with the hearing-impaired. The 'Battery of Basic Computerized Audiometric Tests' (BOBCAT) is a computer program which puts a wide variety of clinical hearing tests under computer control. The purpose of the present study was to ascertain the reliability and validity of BOBCAT in the measurement of hearing sensitivity. A field study was conducted in a group of 92 workers exposed to noise to measure air- and bone-conduction thresholds. Coefficients of reliability of 0.85 and higher were obtained between air and bone thresholds for both methods of testing; that is, manual and computer-controlled audiometry. The same measurement between manual and computerized air-conduction pure-tone thresholds gave values ranging from 0.93 to 0.98. A principal-components analysis documented content validity of computerized audiometry. These results are interpreted as clear evidence of both reliability and validity of the BOBCAT procedure, with one exception: 6.7% of all observations are showing air-conduction computerized thresholds of -10 dB at one or more frequencies, with no confirmation by manual audiometry. This is attributed to insufficient randomization of intervals between stimuli, a problem which should be taken care of by new versions of the software.

Adult↗
PubMed2006

An alternative strategy for universal infant hearing screening in tertiary hospitals with a high delivery rate, within a developing country, using transient evoked oto-acoustic emissions and brainstem evoked response audiometry.

OBJECTIVE: To formulate an alternative strategy for universal infants hearing screening in an Indian tertiary referral hospital with a high delivery rate, which could be extended to similar situations in other developing countries. The system should be able to diagnose, in a timely fashion, all infants with severe and profound hearing losses. METHODS: One thousand newborn were randomly selected. All underwent testing with transient evoked oto-acoustic emissions (TEOAE) in the first 48 hours of life. All TEOAE failures were followed up and repeat tests were performed at three weeks, three months and six months of age. Infants with acceptable TEOAE results at any of the four ages were discharged from the study. Infants with unacceptable TEOAE results at all the four ages underwent brainstem evoked response audiometry and oto-endoscopy. The 'pass rate' for TEOAE testing was calculated for all four ages. The time taken to perform TEOAE and brainstem evoked response audiometry was recorded for all subjects. These recordings were statistically analysed to find the most suitable strategy for universal hearing screening in our hospital. RESULTS: The pass rate for TEOAE was 79.0 per cent at < or =48 hours, 85.0 per cent at three weeks, 97.0 per cent at three months and 98.0 per cent at six months. The average time taken to perform the test was 12 minutes for TEOAE and 27 minutes for brainstem evoked response audiometry. Obstructed and collapsed external auditory canals were the two factors that significantly affected the specificity of TEOAE in infants < or =48 hours old. CONCLUSION: The concept of screening all neonates within the first 48 hours of life is impractical because the specificity of TEOAE is lowest at that age. Many false positive results are generated, such that a larger number must undergo brainstem evoked response audiometry, wasting time and resources. This can easily be avoided by delaying TEOAE screening until three months of age, when it has a substantially lower false positive outcome. We expect that implementation of this alternative strategy in our hospital will maximise the benefits of such a programme.

Audiometry↗
PubMed2001

A comparison of self-reported hearing loss and audiometry in a cohort of New York farmers.

The New York State Farm Family Health and Hazard Surveillance was conducted to assess the health status and safety practices among year-round adult farmers and farm residents in New York State and included a telephone interview survey of 1,727 persons from 552 farms. To determine the extent to which self-reported hearing loss is in agreement with audiometry, a subset of 376 participants who completed a hearing loss interview and pure-tone audiometry was analyzed. Thirty-six percent of the participants had self-reported hearing loss, defined as at least some difficulty hearing in one or both ears. The prevalence of audiometric hearing impairment, defined as a threshold average greater than 25 dB hearing level, was 9% for the binaural low-frequency average (500, 1000, and 2000 Hz), 29% for the binaural mid-frequency average (1000, 2000, 3000, and 4000 Hz), and 47% for the binaural high-frequency average (3000, 4000, 6000, and 8000 Hz). Agreement between self-report and audiometry was highest for the binaural mid-frequency average (kappa statistic 55%, sensitivity 77%, and specificity 82%). Self-reported hearing loss was found to be a moderately good measure of hearing impairment. We conclude that a simple questionnaire focusing on hearing difficulty is a useful and valid tool for conducting epidemiologic studies of farmers. Whenever possible, a substudy using audiometry should be conducted.

Adult↗
PubMed1996

[Recruitment detection--a comparison of category loudness scaling and classical supra-threshold audiometry].

BACKGROUND: The assessment and localization of hearing impairments require reliable and valid recruitment indicators. Although many diagnostic tests are available, which of these tests are most important is still the subject of controversy. METHOD: To compare the efficacy of various diagnostic audiometric tests, 51 subjects with monaural sensorineural hearing loss were submitted to the following tests at 500 and 2000 Hz: category loudness scaling of narrowband noise bursts, alternate binaural loudness balance (ABLB), intensity difference limen test, SISI test, fixed frequency Békésy audiometry, and contralateral determination of the acoustic reflex threshold for pure tones. RESULTS: Using the findings of the ABLB test as reference, the results of the present study revealed that category loudness scaling and acoustic reflex audiometry are reliable quantitative recruitment indicators. This holds for the intensity difference limen test to a lesser extend as well. However, the recruitment selectivity of the SISI test and Békésy audiometry turned out to be considerably poorer. CONCLUSIONS: Category loudness scaling has proven to be a valuable element in the conventional recruitment test battery particularly for patients with symmetrical hearing loss. Therefore, category loudness scaling, ABLB test (when feasible), acoustic reflex measurement, and to a lesser extend the intensity difference limen test should be given the highest priority when selecting appropriate diagnostic audiometric tests. The efficacy of the SISI test and Békésy audiometry should be comprehensively reevaluated on the basis of expanded data. Until such material is available and a final judgement of the clinical value is possible, both these tests should be used and interpreted carefully.

Audiometry, Pure-Tone↗
PubMed1992

Evaluation of pure tone audiometry and impedance screening in infant schoolchildren.

STUDY OBJECTIVE: The aims were (1) to evaluate impedance measurements against pure tone audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method. DESIGN: The study involved two stage screening in which both methods were offered, pure tone audiometry being carried out by school nurses and impedance screening by a doctor. SETTING: 18 infant or primary schools in Langbaurgh, Cleveland, UK. PARTICIPANTS: 610 previously unscreened infant school children took part in the study. MEASUREMENTS AND MAIN RESULTS: Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone audiometry. CONCLUSIONS: The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses.

Acoustic Impedance Tests↗
PubMedDate not supplied

Békésy audiometry in evaluation of hearing in cases of raised intracranial pressure.

The paper reports findings in a Békésy audiometry study on 50 ears of 27 patients with raised intracranial pressure. The Békésy audiometry was done both preoperatively and after operation when the raised intracranial pressure had been controlled. The study showed a significant hearing loss in Békésy audiometry due to raised intracranial pressure. However, only low frequencies of 125-250-500 Hz showed a reversal of hearing loss which was statistically significant. The type II pattern of Békésy audiometry changed to type I after control of the raised intracranial pressure. The type IV and V patterns had a tendency to change to Békésy I or II, on control of the raised intracranial pressure.

Audiometry↗
PubMedDate not supplied

Evoked cerebral potential audiometry and hearing threshold.

Audiometric testing by means of the nonspecific evoked cerebral potential (NECP) was performed in 20 children (11 with normal hearing, 6 with conductive and 3 with sensorineural hearing loss). The threshold as determined by this method was 20-30 dB higher than the threshold of the subjective tonal audiograms in the majority of the cases. Only in two cases the difference was up to 70 dB. There were no significant differences between the results of the methods in the three groups of children. The possible reasons for the described discrepancy between the thresholds of the ECP audiometry and the subjective tonal audiometry are discussed. It is pointed out that either of the two methods explores one of two different functional systems: the nonspecific activating system of the brain stem and the auditory pathway. It is suggested that the observed discrepancy between the results of the two methods may mainly be due to different thresholds of the two systems. To avoid false negative results of the ECP audiometry in subjects with 'constitutionally' low amplitude of the NECP it is proposed to routinely determine the amplitude of the NECP produced by somatosensory stimuli. Careful evaluation of the recorded data can improve the diagnostic value of ECP audiometry.

Acoustic Stimulation↗
PubMed1993

Clinical use of BOBCAT: testing reliability and validity of computerized pure-tone audiometry with noise-exposed workers, children and the aged.

An investigation was conducted to determine the feasibility of implementing computerized audiometry in various clinical groups, using the Battery of Basic Computerized Audiometry Tests (BOBCAT). Reliability, validity and speed of execution were assessed as a function of hearing loss in a group of noise-exposed workers. Children and the aged were also included to represent potentially 'more-difficult-to-test' patients due to fluctuating attention, motivation and/or response behavior. Children were aged 7.5-12 years; seniors, 65-80 years. Reliability was assessed by calculating reliability coefficients between air conduction pure-tone thresholds (0.5, 1, 2, 3, 4 and 6 kHz) obtained under two test modalities namely, computerized audiometry and conventional testing performed by a small panel of trained examiners. Both procedures followed ANSI S3.21 1978 standards. Content validity was measured using measures of central tendency and correlations. Coefficients of reliability remained equally high across frequencies regardless of degree of hearing loss and group. As well, group means and correlations between conventional and computerized audiometry indicated that the two methods measured pure-tone hearing sensitivity with the same degree of accuracy; that is, within +/- 0.5 dB. Finally, speed of execution was found to be slower using BOBCAT, in particular with noise-exposed workers. This finding was interpreted as evidence that trained examiners have used shortcuts when they expect consistent and/or unbiased response behavior.

Acoustic Impedance Tests↗
PubMed1992

Background noise in rooms used for pure-tone audiometry in disability assessment.

Background noise limits for audiometry are determined by the effects of masking and are specified in international standards. The standards provide for audiometric testing over a range of audiometric frequencies extending down to 500 Hz or lower. The lowest frequency of testing is an important factor determining the admissible noise, and for certain applications it is appropriate to consider the limits applicable to testing over a more restricted range. Assessment of hearing disability in the UK is generally based on a consideration of pure-tone hearing threshold levels in the frequency range 1 kHz upwards. A modification of the standardized noise limits is proposed which allows some relaxation appropriate to this higher minimum frequency. For air-conduction audiometry, these modifications affect only the permissible background noise in the frequency range below 1 kHz. Where bone-conduction audiometry is required in order to quantify a conductive component of the hearing loss, the measurements need to be made on both ears with the non-test ear masked in both cases; the external background noise will thus only be heard monaurally and this justifies a correction to the noise limits compared with those appropriate to bone-conduction audiometry without masking.

Audiometry, Pure-Tone↗
PubMed1995

[A study on the reliability of evoked response audiometry in infants below one year of age; a long-term follow-up].

The reliability of brainstem evoked response audiometry (ERA) as an objective audiometric study was evaluated in long term follow-up infants with moderate to severe sensorineural hearing loss. None of the infants had either brain damage (cerebral palsy, mental retardation) or other severe complications (genetic diseases). The thresholds of ERA at 1 kHz and 4 kHz were measured in 234 infants below one year of age, from 1983 to 1990, in our hospital. These infants were followed-up to the age when conditioned oriented response audiometry (COR) and play audiometry could be conducted. Pure tone thresholds obtained by COR and play audiometry were compared with those of ERA. In addition, speech problems in these patients were evaluated. In all of those infants, hearing aids were fitted before one year of age to achieve early habilitation. As a results, ERA was found to be a reliable and efficacious test for determining auditory thresholds, and providing hearing aids for early habilitation in one-year old infants with moderate to severe sensorineural hearing loss.

Audiometry, Evoked Response↗
PubMed1975

Symposium on sensorineural hearing loss in children: early detection and intervention. Behavioral audiometry with children.

Our purpose in this discussion has been to present practical information about behavioral audiometry with infants and young children as a critical part of the comprehensive audiologic assessment. The introductory discussion focused on eight critical audiometric variables and the application of operant conditioning. These variables and operant principles were related to behavior observation audiometry, threshold audiometry (including play, visually reinforced and tangibly reinforced), and speech audiometry (including the speech awareness threshold, the speech reception threshold, and word discrimination). It is concluded that through careful application of these principles and procedures, meaningful audiometric data can be obtained from any child regardless of age or developmental disability.

Acoustic Stimulation↗
PubMed2003

[Study on distortion product otoacoustic emissions and expanded high frequency audiometry in noise exposure workers].

OBJECTIVE: To analyse the relationship of distortion product otoacoustic emissions(DPOAE), conventional pure tone audiometry and expanded high frequency audiometry, and discuss the originated mechanism of DPOAE and value in early diagnosis and detection noise-induced deafness. METHOD: DPOAE, conventional pure tone audiometry and expanded high frequency audiometry were performed in 42 young adults with normal hearing of control group and 20 noise exposure workers of test group. DPOAE amplitudes, conventional pure tone hearing thresholds and expanded high frequency hearing thresholds were compared. RESULT: In noise exposure workers against young adults with normal hearing, the pure tone hearing thresholds at 6.0 kHz and expanded high frequency area declined significantly(P < 0.05), DPOAE amplitudes at frequency from 4.0 to 6.0 kHz and 11.2 kHz declined significantly too(P < 0.05), but there existed no significantly difference at frequency from 12.5 to 16.0 kHz between the two groups(P > 0.05). CONCLUSION: DPOAE is potential implement to early diagnose and detect noise-induced deafness. It seems likely that the origination of DPOAE not limited to the outer hair cell in corresponding cochlear area. The originated area and mechanism of DPOAE should be solved by further studies.

Adolescent↗
PubMed2003

[Findings of standard and high-frequency audiometry in workers exposed to occupational noise for long durations].

OBJECTIVES: Changes in hearing thresholds were determined by standard and high-frequency audiometry in subjects exposed to occupational noise for long durations. PATIENTS AND METHODS: Hearing thresholds were measured between 250 and 16000 Hz frequencies by standard and high-frequency audiometry in 64 male workers (mean age 42 years; range 31 to 55 years) of a hydroelectric power plant and in 30 age- and sex-matched controls with no hearing problems. The workers were divided into three groups according to the noise level and into four groups according to the duration of exposure. RESULTS: The mean hearing thresholds of workers showed significant increases in all frequencies from 4000 to 16000 Hz (p<0.005), the most affected frequencies being 4000, 6000, 14000, and 16000 Hz (p<0.0005). Increases in hearing thresholds were significantly correlated with the noise level and duration of exposure to noise (p<0.05). CONCLUSION: The results suggest that high-frequency audiometry should be used together with standard audiometry in the detection and follow-up of individuals who are at potential risks for hearing losses.

Adult↗
PubMed2003

[Evaluation of glycerol test in Meniere's disease with pure tone audiometry and distortion product otoacoustic emission].

The purpose of the work was to follow up changes in the pure tone audiometry and distortion products otoacoustic emissions (DPOAE) after glycerol administration in Meniere's patients. Twenty patients with Meniere's disease and 16 with cochlear hearing loss without vestibular symptoms were subjected to the glycerol test following the complete audiological evaluation. Glycerol was administered orally 1.5 ml/kg of body weight dissolved in the equal amount of the physiological saline. The results of the glycerol test were analyzed with reference to changes in the pure tone threshold and DPOAE testing. Both investigations were performed in four series: as an initial testing before the glycerol intake and next--one, two and three hours after the glycerol administration. DPOAE included DP-gram registration (L1 = L2 = 70 dB; f2/f1 = 1.22; 1/2 octave) and input/output (I/O) function at 2, 4 and 6 kHz. The glycerol test was regarded as positive in the audiometry if the pure tone threshold improved at least 15 dB at minimum 3 frequencies. Positive result of the glycerol test in DPOAE was judged if DP amplitude increased more than 5dB at 2 or more frequencies in DP-gram and/or DP-threshold lowered at least 10dB in minimum two I/O registrations. In the subjects with Meniere's disease, 11 positive and 9 negative glycerol tests in audiometry and 10 positive and 10 negative DPOAE glycerol tests were obtained. In the reference group, one audiometric glycerol test and two DPOAE glycerol tests were regarded as positive. Much conformity, making 85%, between audiometric and DPOAE tests results is observed. The dynamics of the parameter changing in the consecutive test hours was also similar in both pure tone audiometry and DPOAE. These studies suggest that distortion product otoacoustic emission could be useful in diagnostics of Meniere's disease and would be a valuable diagnostic tool as an objective examination.

Acoustic Stimulation↗
PubMed1991

The development of Malay speech audiometry.

Speech audiometry is a method for assessing the ability of the auditory system using speech sounds as stimuli. A list of phonemically balanced bisyllabic consonant-vowel-consonant-vowel (c-v-c-v) Malay words was produced. All the bisyllabic words (c-v-c-v) thought to be commonly used in everyday conversations were listed from the Dewan Bahasa dictionary and their suitability assessed. The chosen words were divided into 25 groups containing 10 words each. The list was then recorded by a professional male newscaster in a sound proof studio. A normal speech audiometry curve was obtained by testing 60 normal hearing subjects using the prerecorded speech material. The result of the study showed that the normal Malay speech audiometry curve was comparable to those of English and Arabic speech audiometry, in which it was sigmoidal with the optimum discrimination score of 40 dB and half peak level of 17.5 dB.

Audiometry, Speech↗
PubMed1990

[Calculation of percentage of hearing loss in speech audiometry].

In a previous paper the authors explained, based on statistical analysis, the use of mixed Czech verbal audiometry for the percentage evaluation of auditory losses. In the present work the above problems are discussed and an actual example of calculation of auditory losses is given. Based on statistical processing of more than 200 sound and verbal audiograms a table was prepared where the number is inserted corresponding to the sum of 50% and 100% comprehensibility of a mixed verbal set in dB. A reading of the percentage hearing loss is then taken. In case of discrimination loss in verbal audiometry its value is added to the sum of 50% and maximum attained comprehensibility. If the thus calculated percentage hearing loss in verbal audiometry differs from the hearing loss assessed according to Fowler and Sabine in sound audiometry, in the final evaluation the mean of the two percentage values is used.

Adult↗
PubMed1989

[High frequency audiometry].

The authors have performed a series of high frequency audiograms in order to assess its value in routine otological practice. Initially, they conducted a statistical study on subjects with so-called normal hearing in order to establish standardised normal values. As in the earlier studies, a physiological alteration was observed in the high frequencies which was progressively accentuated with age. Audiometric results should therefore always be considered in relation to the patient's age. A standard graph is proposed for the presentation of the results. The authors subsequently performed high frequency audiometry in patients with internal ear disorders. High frequency audiometry allowed early detection of an alteration in the internal ear, when conventional audiometry was normal. The authors believe that high frequency audiometry should be part of the otological assessment as its allows early detection of internal ear disease.

Adult↗