-
European Annals of Otorhinolaryngology,... Dec 2016The diagnosis of hearing loss, especially in the context of newborn hearing screening, is mostly based on auditory brainstem response (ABR). According to the official...
The diagnosis of hearing loss, especially in the context of newborn hearing screening, is mostly based on auditory brainstem response (ABR). According to the official CCAM nomenclature, ABR consists of recording early auditory evoked potentials to detect thresholds, study conduction times and measure amplitudes (corresponding to codes CDQP006 when performed without general anesthesia, and CDQP014 when performed with general anesthesia). ABR must be rigorously performed and interpreted, always in combination with a complete ENT examination and behavioral audiometry as soon as possible. In order to obtain good quality recordings, ABR must be performed with the infant totally immobile, during a nap. Several protocols can be used according to the child's age in order to obtain good quality sleep. ABR contribute to a precise hearing diagnosis, allowing early management by the first months of life.
Topics: Acoustic Stimulation; Anesthesia, General; Audiometry, Evoked Response; Child; Evoked Potentials, Auditory, Brain Stem; Hearing Loss; Hearing Tests; Humans; Hypnotics and Sedatives
PubMed: 27453092
DOI: 10.1016/j.anorl.2016.05.004 -
Ear and Hearing 2020When one ear of an individual can hear significantly better than the other ear, evaluating the worse ear with loud probe tones may require delivering masking noise to...
OBJECTIVES
When one ear of an individual can hear significantly better than the other ear, evaluating the worse ear with loud probe tones may require delivering masking noise to the better ear to prevent the probe tones from inadvertently being heard by the better ear. Current masking protocols are confusing, laborious, and time consuming. Adding a standardized masking protocol to an active machine learning audiogram procedure could potentially alleviate all of these drawbacks by dynamically adapting the masking as needed for each individual. The goal of this study is to determine the accuracy and efficiency of automated machine learning masking for obtaining true hearing thresholds.
DESIGN
Dynamically masked automated audiograms were collected for 29 participants between the ages of 21 and 83 (mean 43, SD 20) with a wide range of hearing abilities. Normal-hearing listeners were given unmasked and masked machine learning audiogram tests. Listeners with hearing loss were given a standard audiogram test by an audiologist, with masking stimuli added as clinically determined, followed by a masked machine learning audiogram test. The hearing thresholds estimated for each pair of techniques were compared at standard audiogram frequencies (i.e., 0.25, 0.5, 1, 2, 4, 8 kHz).
RESULTS
Masked and unmasked machine learning audiogram threshold estimates matched each other well in normal-hearing listeners, with a mean absolute difference between threshold estimates of 3.4 dB. Masked machine learning audiogram thresholds also matched well the thresholds determined by a conventional masking procedure, with a mean absolute difference between threshold estimates for listeners with low asymmetry and high asymmetry between the ears, respectively, of 4.9 and 2.6 dB. Notably, out of 6200 masked machine learning audiogram tone deliveries for this study, no instances of tones detected by the nontest ear were documented. The machine learning methods were also generally faster than the manual methods, and for some listeners, substantially so.
CONCLUSIONS
Dynamically masked audiograms achieve accurate true threshold estimates and reduce test time compared with current clinical masking procedures. Dynamic masking is a compelling alternative to the methods currently used to evaluate individuals with highly asymmetric hearing, yet can also be used effectively and efficiently for anyone.
Topics: Adult; Aged; Aged, 80 and over; Audiometry; Audiometry, Pure-Tone; Auditory Threshold; Hearing; Hearing Loss; Humans; Machine Learning; Middle Aged; Perceptual Masking; Young Adult
PubMed: 33136643
DOI: 10.1097/AUD.0000000000000891 -
European Archives of... Jun 2024To evaluate the effect of piston diameter in patients undergoing primary stapes surgery on audiometric results and postoperative complications.
PURPOSE
To evaluate the effect of piston diameter in patients undergoing primary stapes surgery on audiometric results and postoperative complications.
METHODS
A retrospective single-center cohort study was performed. Adult patients who underwent primary stapes surgery between January 2013 and April 2022 and received a 0.4-mm-diameter piston or a 0.6-mm-diameter piston were included. The primary and secondary outcomes were pre- and postoperative pure-tone audiometry, pre- and postoperative speech audiometry, postoperative complications, intraoperative anatomical difficulties, and the need for revision stapes surgery. The pure-tone audiometry included air conduction, bone conduction, and air-bone gap averaged over 0.5, 1, 2 and 3 kHz.
RESULTS
In total, 280 otosclerosis patients who underwent 321 primary stapes surgeries were included. The audiometric outcomes were significantly better in the 0.6 mm group compared to the 0.4 mm group in terms of gain in air conduction (median = 24 and 20 dB, respectively), postoperative air-bone gap (median = 7.5 and 9.4 dB, respectively), gain in air-bone gap (median = 20.0 and 18.1 dB, respectively), air-bone gap closure to 10 dB or less (75% and 59%, respectively) and 100% speech reception (median = 75 and 80 dB, respectively). We found no statistically significant difference in postoperative dizziness, postoperative complications and the need for revision stapes surgery between the 0.4 and 0.6 mm group. The incidence of anatomical difficulties was higher in the 0.4 mm group.
CONCLUSION
The use of a 0.6-mm-diameter piston during stapes surgery seems to provide better audiometric results compared to a 0.4-mm-diameter piston, and should be the preferred piston size in otosclerosis surgery. We found no statistically significant difference in postoperative complications between the 0.4- and 0.6-mm-diameter piston. Based on the results, we recommend always using a 0.6-mm-diameter piston during primary stapes surgery unless anatomical difficulties do not allow it.
Topics: Humans; Stapes Surgery; Retrospective Studies; Male; Otosclerosis; Female; Middle Aged; Adult; Audiometry, Pure-Tone; Postoperative Complications; Bone Conduction; Treatment Outcome; Ossicular Prosthesis; Aged; Prosthesis Design; Reoperation; Audiometry, Speech
PubMed: 38273045
DOI: 10.1007/s00405-023-08407-w -
Fa Yi Xue Za Zhi Jun 2020Objective The tests of three types of auditory evoked potentials (AEPs) were performed on normal young adults, to understand the frequency characteristics of...
Objective The tests of three types of auditory evoked potentials (AEPs) were performed on normal young adults, to understand the frequency characteristics of different testing methods and the relationship between response threshold and pure tone audiometry threshold of different methods, and to discuss the forensic value of 3 types of AEPs to evaluate hearing function. Methods Twenty normal young adults were selected, their standard pure tone audiometry threshold, short-term pure tone audiometry threshold and the response threshold of 3 types of AEPs (tone burst-auditory brainstem response, 40 Hz auditory event-related potential and slow vertex response) at 0.5 kHz, 1.0 kHz, 2.0 kHz and 4.0 kHz were recorded. The relationship between the response threshold and standard pure tone audiometry threshold, short-term pure tone audiometry threshold of 3 types of AEPs at different frequencies as well as the differences between different types of AEPs were analyzed. Results The short-term pure tone audiometry threshold was higher than the standard pure tone audiometry threshold at each frequency. The response threshold and standard pure tone audiometry threshold of the 3 types of AEPs all had a certain correlation, and the response threshold of the 3 types of AEPs was higher than short-term pure tone audiometry threshold and standard pure tone audiometry threshold at each frequency. The differences in the differences between the response threshold and standard pure tone audiometry threshold of the 3 types of AEPs at different frequencies had statistical significance. Linear regression mathematical models were established to infer the standard pure tone audiometry threshold (hearing level) from response threshold (sound pressure level) of 3 types of AEPs of normal young adults. Conclusion When using response threshold of different types of AEPs to estimate pure tone audiometry threshold, conversion and correction are needed. Combined use of different types of AEPs could improve the accuracy of hearing function evaluation.
Topics: Audiometry, Evoked Response; Audiometry, Pure-Tone; Auditory Threshold; Evoked Potentials, Auditory; Evoked Potentials, Auditory, Brain Stem; Hearing; Humans; Young Adult
PubMed: 32705841
DOI: 10.12116/j.issn.1004-5619.2020.03.003 -
The Journal of International Advanced... Jul 2021Fibromyalgia syndrome is a disorder of widespread pain with unknown etiology. These patients frequently suffer from otologic complaints. This study aims to analyze the...
OBJECTIVES
Fibromyalgia syndrome is a disorder of widespread pain with unknown etiology. These patients frequently suffer from otologic complaints. This study aims to analyze the audiovestibular functions in patients with fibromyalgia syndrome.
METHODS
The study included 33 fibromyalgia patients and 33 healthy volunteers. All the study subjects underwent audiological assessment, multifrequency tympanometry, transient otoacoustic emission, and ocular and cervical vestibular-evoked myogenic potentials tests.
RESULTS
Pure-tone hearing thresholds of right and left ears were found to be decreased in fibromyalgia patients compared to controls (P < 0.05). Middle ear resonance frequency values were significantly decreased in patients with fibromyalgia syndrome compared to controls (P < .05). The values for signal-to-noise ratios were higher in controls than in the FMS patients. The difference was significant for 1000, 2000, and 4000 Hz (P > .005). Cervical vestibular-evoked myogenic potential waves were obtained in all controls, but could not be obtained in 5 right ears and 4 left ears of the fibromyalgia patients (P < .05). Also, ocular vestibular-evoked myogenic potentials were obtained in all controls, but could not be obtained in 7 right ears and 10 left ears of the patients with fibromyalgia syndrome (P < .05).
CONCLUSION
Our findings support the presence of audiovestibular dysfunction in patients with fibromyalgia. Further research that focuses on the pathogenesis of these dysfunctions is required.
Topics: Acoustic Impedance Tests; Audiometry; Fibromyalgia; Humans; Otoacoustic Emissions, Spontaneous; Vestibular Evoked Myogenic Potentials
PubMed: 34309557
DOI: 10.5152/JIAO.2021.8709 -
Otolaryngology--head and Neck Surgery :... Aug 2022Electrocochleography (ECochG) is increasingly being used during cochlear implant (CI) surgery to detect and mitigate insertion-related intracochlear trauma, where a drop...
OBJECTIVE
Electrocochleography (ECochG) is increasingly being used during cochlear implant (CI) surgery to detect and mitigate insertion-related intracochlear trauma, where a drop in ECochG signal has been shown to correlate with a decline in hearing outcomes. In this study, an ECochG-guided robotics-assisted CI insertion system was developed and characterized that provides controlled and consistent electrode array insertions while monitoring and adapting to real-time ECochG signals.
STUDY DESIGN
Experimental research.
SETTING
A research laboratory and animal testing facility.
METHODS
A proof-of-concept benchtop study evaluated the ability of the system to detect simulated ECochG signal changes and robotically adapt the insertion. Additionally, the ECochG-guided insertion system was evaluated in a pilot in vivo sheep study to characterize the signal-to-noise ratio and amplitude of ECochG recordings during robotics-assisted insertions. The system comprises an electrode array insertion drive unit, an extracochlear recording electrode module, and a control console that interfaces with both components and the surgeon.
RESULTS
The system exhibited a microvolt signal resolution and a response time <100 milliseconds after signal change detection, indicating that the system can detect changes and respond faster than a human. Additionally, animal results demonstrated that the system was capable of recording ECochG signals with a high signal-to-noise ratio and sufficient amplitude.
CONCLUSION
An ECochG-guided robotics-assisted CI insertion system can detect real-time drops in ECochG signals during electrode array insertions and immediately alter the insertion motion. The system may provide a surgeon the means to monitor and reduce CI insertion-related trauma beyond manual insertion techniques for improved CI hearing outcomes.
Topics: Animals; Audiometry, Evoked Response; Cochlea; Cochlear Implantation; Cochlear Implants; Craniocerebral Trauma; Hearing; Humans; Labyrinth Diseases; Sheep
PubMed: 34609909
DOI: 10.1177/01945998211049210 -
International Journal of Environmental... May 2021Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment...
BACKGROUND
Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment and, therefore, go undiagnosed for an extended period before realizing they have hearing loss. This study presents a self-administered, low-cost, smartphone-based hearing test application (HearTest) to quantify the pure-tone hearing thresholds of a user. The HearTest application can be used with commercially available smartphone devices and an earphone with the mentioned specification.
METHODS
Air-conduction-based pure-tone audiometry for the smartphone application was designed and implemented to detect hearing thresholds using a traditional "10 dB down and 5 dB up" approach. Employed smartphone-earphone combination was calibrated with respect to a GSI-61 audiometer and insert earphone ER-3A to maintain clinical standards with the help of subjective testing on 20 normal-hearing (NH) participants.
RESULTS
Further subjective testing on 14 participants with NH and retesting on five participants showed that HearTest achieves high-accuracy audiogram within clinically acceptable limits (≤10 dB HL mean difference) when compared with the reference clinical audiometer. Hardware challenges and limitations in air-conduction-based hearing tests through smartphones and ways to improve their accuracy and reliability are discussed.
CONCLUSION
The proposed smartphone application provides a simple, affordable, and reliable means for people to learn more about their hearing health without needing access to a formal clinical facility.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Humans; Quality of Life; Reproducibility of Results; Smartphone
PubMed: 34064080
DOI: 10.3390/ijerph18115529 -
HNO Jan 2024One of the main treatment goals in cochlear implant (CI) patients is to improve speech perception. One of the target parameters is speech intelligibility in quiet....
BACKGROUND
One of the main treatment goals in cochlear implant (CI) patients is to improve speech perception. One of the target parameters is speech intelligibility in quiet. However, treatment results show a high variability, which has not been sufficiently explained so far. The aim of this noninterventional retrospective study was to elucidate this variability using a selected population of patients in whom etiology was not expected to have a negative impact on postoperative speech intelligibility.
MATERIALS AND METHODS
Audiometric findings of the CI follow-up of 28 adult patients after 6 months of CI experience were evaluated. These were related to the preoperative audiometric examination and evaluated with respect to a recently published predictive model for the postoperative monosyllabic score.
RESULTS
Inclusion of postoperative categorical loudness scaling and hearing loss for Freiburg numbers in the model explained 55% of the variability in fitting outcomes with respect to monosyllabic word recognition.
CONCLUSION
The results of this study suggest that much of the cause of variability in fitting outcomes can be captured by systematic postoperative audiometric checks. Immediate conclusions for CI system fitting adjustments may be drawn from these results. However, the extent to which these are accepted by individual patients and thus lead to an improvement in outcome must be subject of further studies, preferably prospective.
Topics: Adult; Humans; Cochlear Implants; Retrospective Studies; Prospective Studies; Cochlear Implantation; Audiometry; Speech Perception
PubMed: 37812257
DOI: 10.1007/s00106-023-01317-7 -
Ear and HearingSingle-ear hearing measurements, such as better-ear, worse-ear or left/right ear, are often used as outcomes in auditory research, yet, measurements in the two ears of...
OBJECTIVE
Single-ear hearing measurements, such as better-ear, worse-ear or left/right ear, are often used as outcomes in auditory research, yet, measurements in the two ears of the same individual are often strongly but not perfectly correlated. We propose a both-ear method using the Generalized Estimating Equation approach for analysis of correlated binary ear data to evaluate determinants of ear-specific outcomes that includes information from both ears of the same individual.
DESIGN
We first theoretically evaluated bias in odds ratio (OR) estimates based on worse-ear and better-ear hearing outcomes. A simulation study was conducted to compare the finite sample performances of single-ear and both-ear methods in logistic regression models. As an illustrative example, the single-ear and both-ear methods were applied to estimate the association of Dietary Approaches to Stop Hypertension adherence scores with hearing threshold elevation among 3135 women, aged 48 to 68 years, in the Nurses' Health Study II.
RESULTS
Based on statistical theories, the worse-ear and better-ear methods could bias the OR estimates. The simulation results led to the same conclusion. In addition, the simulation results showed that the both-ear method had satisfactory finite sample performance and was more efficient than the single-ear method. In the illustrative example, the confidence intervals of the estimated ORs for the association of Dietary Approaches to Stop Hypertension scores and hearing threshold elevation using the both-ear method were narrower, indicating greater precision, than for those obtained using the other methods.
CONCLUSIONS
The worse-ear and better-ear methods may lead to biased estimates, and the left/right ear method typically results in less-efficient estimates. In certain settings, the both-ear method using the Generalized Estimating Equation approach for analyses of audiometric data may be preferable to the single-ear methods.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Female; Hearing; Humans
PubMed: 35302530
DOI: 10.1097/AUD.0000000000001216 -
Journal of the Association For Research... Jun 2022Using electrocochleography, the summating potential (SP) is a deflection from baseline to tones and an early rise in the response to clicks. Here, we use normal hearing...
Using electrocochleography, the summating potential (SP) is a deflection from baseline to tones and an early rise in the response to clicks. Here, we use normal hearing gerbils and gerbils with outer hair cells removed with a combination of furosemide and kanamycin to investigate cellular origins of the SP. Round window electrocochleography to tones and clicks was performed before and after application of tetrodotoxin to prevent action potentials, and then again after kainic acid to prevent generation of an EPSP. With appropriate subtractions of the response curves from the different conditions, the contributions to the SP from outer hair cells, inner hair cell, and neural "spiking" and "dendritic" responses were isolated. Like hair cells, the spiking and dendritic components had opposite polarities to tones - the dendritic component had negative polarity and the spiking component had positive polarity. The magnitude of the spiking component was larger than the dendritic across frequencies and intensities. The onset to tones and to clicks followed a similar sequence; the outer hair cells responded first, then inner hair cells, then the dendritic component, and then the compound action potential of the spiking response. These results show the sources of the SP include at least the four components studied, and that these have a mixture of polarities and magnitudes that vary across frequency and intensity. Thus, multiple possible interactions must be considered when interpreting the SP for clinical uses.
Topics: Action Potentials; Audiometry, Evoked Response; Cochlear Microphonic Potentials; Cochlear Nerve; Hair Cells, Auditory, Inner; Hair Cells, Auditory, Outer
PubMed: 35254541
DOI: 10.1007/s10162-022-00842-6