Search

Objectives: This document presents the fundamentals of speech audiometry in noise, general requirements for implementation and criteria for choice among the tests available in French according to the health-professional's needs., Material and Methods: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors, audiologists and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence., Results: Eight tests of speech audiometry in noise can be used in France., Conclusion: To be complete, evaluation of hearing status requires testing understanding of speech in noise. The examination must begin with a minimum of two measurements familiarizing the subject with the test procedure. For initial diagnosis, adaptive procedures establishing the 50% speech reception threshold (SRT50) in noise are to be preferred in order to obtain a rapid and standardized measurement of perception of speech in noise. When the aim is to measure real-life speech comprehension, tests based on sentences, cocktail-party noise and free-field stimulation are to be preferred. Prosthetic gain is evaluated exclusively in free field. This is the only way to evaluate the contribution of binaurality and to measure perception in noise in an environment as close as possible to real life. In order to avoid acoustic interference in free field, at least five loudspeakers should be used, in particular for evaluating the effectiveness of directional microphones, CROS devices enabling sounds picked up in the damaged ear to be rerouted to the functional ear, or bimodal fitting (i.e., when hearing is enabled by two modalities: for example, hearing aid for one ear, cochlear implant for the other)., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Introduction: French Society of ENT (SFORL) good practice guidelines for audiometric examination in adults and children., Methods: A multidisciplinary working group performed a review of the scientific literature. Guidelines were drawn up, reviewed by an independent reading group, and finalized in a consensus meeting., Results: Audiometry should be performed in an acoustically controlled environment (<30dBA); audiometer calibration should be regularly checked; and patient-specific masking rules should be systematically applied. It should be ensured that masking is not overmasking. Adult pure-tone audiometry data should be interpreted taking account of clinical data, speech audiometry and impedancemetry. In case of discrepancies between clinical and pure-tone and speech audiometry data, objective auditory tests should be perform. In children aged 2 years or younger, subjective audiometry should be associated to behavioral audiometry adapted to the child's age. In suspected hearing impairment, behavioral audiometry should be systematically supplemented by objective hearing tests to determine and confirm the level and type of hearing impairment., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

A method first described in 1978, and improved since that date, is a reliable mean of assessing gain in hearing from prosthetic aids by the use of brain stem early auditory evoked potentials. The type of signal used with the prosthesis must be the click and click type with a high-pass filter, and the principle of shunt potentials must be applied.

The authors describe the results of click at a recurrence frequency of 10 C/S in evoked responses of the brain stem, firstly in twenty normal individuals, with headphones or in a free area, making it possible to define a range of physiological responses to the different intensities, then in seventeen pathological individuals consisting of six cases of conduction deafness and eleven of perceptive deafness. On the basis of this study, they attempt to demonstrate the value of this type of examination not only in the determination of objective auditory threshold, but also in that of the type of deafness: conductive or perceptive. The method even makes it possible to approximately define the general appearance of the frequency distribution at the threshold according to the slope of the different latencies of P5. In the opinion of the authors, the chief advantages are the decrease in the time required for the test and the possibility of its use in the study of prosthetic gain.