Search

Distortion product otoacoustic emission (DPOAE) level mapping provides a comprehensive picture of cochlear responses over a range of DP frequencies and f2 /f1 ratios. We hypothesized that individuals exposed to high-level sound would show changes detectable by DPOAE mapping, but not apparent on a standard DP-gram. Thirteen normal hearing subjects were studied before and after attending music concerts. Pure-tone audiometry (500-8,000 Hz), DP-grams (0.3-10 kHz) at 1.22 ratio, and DPOAE level maps were collected prior to, as soon as possible after, and the day after the concerts. All maps covered the range of 2,000-6,000 Hz in DP frequency and from 1.3 to -1.3 in ratio using equi-level primary tone stimuli. Changes in the pure-tone audiogram were significant (P ≤ 0.01) immediately after the concert at 1,000 Hz, 4,000 Hz, and 6,000 Hz. The DP-gram showed significant differences only at f2 = 4,066 (P = 0.01) and f2 = 4,348 (P = 0.04). The postconcert changes were readily apparent both visually and statistically (P ≤ 0.01) on the mean DP level maps, and remained statistically significantly different from baseline the day after noise exposure although no significant changes from baseline were seen on the DP-gram or audiogram the day after exposure. Although both the DP-gram and audiogram showed recovery by the next day, the average DPOAE level maps remained significantly different from baseline. The mapping data showed changes in the cochlea that were not detected from the DP-gram obtained at a single ratio. DPOAE level mapping provides comprehensive information on subtle cochlear responses, which may offer advantages for studying and tracking noise-induced hearing loss (NIHL).

Distortion product otoacoustic emission (DPOAE) level mapping may be useful for detecting noise-induced hearing loss (NIHL) early. Employing DPOAE mapping effectively requires knowledge of the optimal mapping parameters to use for detecting noise-induced changes. The goal of this project was to show the map regions that differ most between normal and noise-damaged cochlea to determine the optimal mapping parameters for detecting NIHL. DPOAE level maps were generated for the 2f 1 -f 2 and the 2f 2 -f 1 DPOAEs for 17 normal hearing male subjects and 19 male subjects with NIHL. DPOAEs were measured in DPOAE frequency steps of approximately 44 Hz from 0.5 kHz to 6 kHz using constant f 2 /f 1 ratios incremented in 0.025 steps from 1.025 to 1.5 using both unequal-level (L1,L2 = 65,55 dB sound pressure level (SPL)) and equi-level (L1,L2 = 75,75 dB SPL) stimulus paradigms. Maximal responses for the 2f 2 -f 1 emission at L1,L2 = 65,55 dB SPL were found at lower ratios compared to previous studies. The map regions where NIHL eliminated or reduced DPOAE magnitude were identified. DPOAE level mapping using higher-level, equi-level primaries produced significantly more detectable emissions particularly for the 2f 2 -f 1 emission. The data from this study can be used to optimize DPOAE level mapping parameters for tracking noise-exposed subjects longitudinally.

This study's objective was determining whether gap detection deficits are present in a longstanding cohort of people living with HIV (PLWH) compared to those living without HIV (PLWOH) using a new gap detection modelling technique (i.e. fitting gap responses using the Hill equation and analysing the individual gap detection resulting curves with non-linear statistics). This approach provides a measure of both gap threshold and the steepness of the gap length/correct detection relationship. The relationship between the correct identification rate at each gap length was modelled using the Hill equation. Results were analysed using a nonlinear mixed-effect regression model. 45 PLWH (age range 41–78) and 39 PLWOH (age range 38–79) were enrolled and completed gap detection testing. The likelihood ratio statistic comparing the full regression model with the HIV effects to the null model, assuming one population curve for both groups, was highly significant (p < 0.001), suggesting a less precise relationship between gap length and correct detection in PLWH. PLWH showed degraded gap detection ability compared to PLWOH, likely due to central nervous system effects of HIV infection or treatment. The Hill equation provided a new approach for modelling gap detection ability. [ABSTRACT FROM AUTHOR]

Automated threshold audiometry (ATA) could increase access to paediatric hearing assessment in low- and middle-income countries, but few studies have evaluated test-retest repeatability of ATA in children. This study aims to analyse test-retest repeatability of ATA and to identify factors that affect the reliability of this method. ATA was performed twice in a cohort of Nicaraguan schoolchildren. During testing, the proportion of responses occurring in the absence of a stimulus was measured by calculating a stimulus response false positive rate (SRFP). Absolute test-retest repeatability was determined between the two trials, as well as the impact of age, gender, ambient noise, head circumference, and SRFP on these results. 807 children were randomly selected from 35 schools in northern Nicaragua. Across all frequencies, the absolute value of the difference between measurements was 5.5 ± 7.8 dB. 89.6% of test-retest differences were within 10 dB. Intra-class correlation coefficients between the two measurements showed that lower SRFP was associated with improved repeatability. No effect of age, gender, or ambient noise was found. ATA produced moderate test-retest repeatability in Nicaraguan schoolchildren. Participant testing behaviours, such as delayed or otherwise inappropriate response patterns, significantly impacts the repeatability of these measurements. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate auditory performance of military instructors as part of a training course involving noise and blast exposure. Boothless audiometry was used to estimate the test-retest reliability of the auditory measures under realistic field conditions and to determine risk of acute auditory injury during standard training practices. Thirteen U.S. Marine instructors participated in study activities. An audiologic testing suite embedded in a noise-attenuating headset was used to test various tone detection tasks on subjects after exposure. Acoustic exposures were captured with sound level meters. Boothless audiometry provide highly repeatable results for various tests of auditory performance in the field environment. In this test population, changes in auditory performance pre- and post-noise exposure were minimal for most measures. The notable exception was binaural (NoSπ) tone detection, which showed significant degradations both as a function of pre- and post-noise exposure on the same day and as a result of cumulative noise exposure over the period of the study. Study outcomes are consistent with prior laboratory and epidemiological work and suggest a link between the binaural processes required for NoSπ detection and the hearing-related issues reported by blast-exposed service members. [ABSTRACT FROM AUTHOR]

A series of articles discussing advanced diagnostics that can be used to assess noise injury and associated noise-induced hearing disorders (NIHD) was developed under the umbrella of the United States Department of Defense Hearing Center of Excellence Pharmaceutical Interventions for Hearing Loss working group. The overarching goals of the current series were to provide insight into (1) well-established and more recently developed metrics that are sensitive for detection of cochlear pathology or diagnosis of NIHD, and (2) the tools that are available for characterizing individual noise hazard as personal exposure will vary based on distance to the sound source and placement of hearing protection devices. In addition to discussing the utility of advanced diagnostics in patient care settings, the current articles discuss the selection of outcomes and end points that can be considered for use in clinical trials investigating hearing loss prevention and hearing rehabilitation. [ABSTRACT FROM AUTHOR]

This paper presents reference equivalent threshold sound pressure levels (RETSPLs) for the Wireless Automated Hearing Test System (WAHTS), a recently commercialized device developed for use as a boothless audiometer. Two initial studies were conducted following the ISO 389-9 standard [ISO 389-9 (2009). "Acoustics—Reference zero for the calibration of audiometric equipment. Part 9: Preferred test conditions for the determinations of reference hearing threshold levels" (International Organization for Standardization, Geneva)]. Although the standard recruitment criteria are intended to yield otologically normal test subjects, the recruited populations appeared to have slightly elevated thresholds [5–10 dB hearing level (HL)]. Comparison of WAHTS thresholds to other clinical audiometric equipment revealed bias errors that were consistent with the elevated thresholds of the RETSPL populations. As the objective of RETSPLs is to ensure consistent thresholds regardless of the equipment, this paper presents the RETSPLs initially obtained following ISO 389-9:2009 and suggested correction to account for the elevated HLs of the originally recruited populations. Two additional independent studies demonstrate the validity of these corrected thresholds. [ABSTRACT FROM AUTHOR]

Sampling distortion product otoacoustic emissions (DPOAEs) at multiple f2/f1 ratios and f2 frequency values produces a DPOAE "map." This study examined the efficacy of DPOAE mapping compared with pure tone audiometry and standard DPOAEs for detecting noise effects in subjects exposed to loud sound. A map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study. The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure. After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations. Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive. [ABSTRACT FROM AUTHOR]

Distortion product otoacoustic emission (DPOAE) mapping characterises cochlear function, can include both the 2f1-2f2 and 2f2-2f1 DPOAEs, and shows promise for tracking cochlear changes. DPOAE amplitude measurements are not as repeatable longitudinally as pure-tone audiometry, likely due in part to probe placement sensitivity. We hypothesised that DPOAE level map variation over multiple testing sessions could be minimised by replacing traditional rubber tips with custom-moulded probe tips. Traditional rubber tips (TRT) and custom-moulded probes tips (CMPT) were used to measure DPOAE level maps repeatedly over five sessions. Probe placement was assessed using a frequency sweep in the ear canal. Repeatability of the DPOAE level maps was assessed using a Bland-Altman analysis. Overall map repeatability was assessed by measuring differences in distortion product amplitude over sessions. Crossover study with a convenience sample size of six adults. The CMPT frequency sweeps showed reduced variability in probe placement. The repeatability coefficient for individual DPOAEs measurements improved from 6.9 dB SPL with the TRT to 5.1 dB SPL with the CMPT. Map repeatability improved for most subjects with the CMPT. [ABSTRACT FROM AUTHOR]

Objective: The recent emphasis on outcomes-based medical research has motivated a need for technology that allows researchers and clinicians to reach a larger and more diverse subject population for recruitment and testing. Design: This article reports on open-source mobile software (TabSINT) that enables researchers to administer customised hearing tests and questionnaires on tablets located across multiple sites. Researchers create and modify test protocols using text-based templates and deploy it to the tablets via a cloud-based repository or USB-computer connection. Results are exported locally to the tablet SD card and can also be automatically posted to a cloud-based database. Results: Between 2014 and 2019, TabSINT collected 25,000+ test results using more than 200+ unique test protocols for researchers located worldwide. Conclusions:TabSINT is a powerful software system with the potential to greatly enhance research across multiple disciplines by enabling access to subject cohorts in remote and disparate locations. Released open-source, this software is available to researchers across the world to use and adapt to their specific needs. Researchers with engineering resources can contribute to the repository to extend the capability and robustness of this software. [ABSTRACT FROM AUTHOR]

Objective: To assess the test–retest variability of hearing thresholds obtained with an innovative, mobile wireless automated hearing-test system (WAHTS) with enhanced sound attenuation to test industrial workers at a worksite as compared to standardised automated hearing thresholds obtained in a mobile trailer sound booth.Design: A within-subject repeated-measures design was used to compare air-conducted threshold tests (500–8000 Hz) measured with the WAHTS in six workplace locations, and a third test using computer-controlled audiometry obtained in a mobile trailer sound booth. Ambient noise levels were measured in all test environments.Study sample: Twenty workers served as listeners and 20 workers served as operators.Results: On average, the WAHTS resulted in equivalent thresholds as the mobile trailer audiometry at 1000, 2000, 3000 and 8000 Hz and thresholds were within ±5 dB at 500, 4000 and 6000 Hz.Conclusions: Comparable performance may be obtained with the WAHTS in occupational audiometry and valid thresholds may be obtained in diverse test locations without the use of sound-attenuating enclosures. [ABSTRACT FROM PUBLISHER]

Objective: Our objective was to obtain reliable threshold measurements without a sound booth by using a passive noise-attenuating hearing protector combined with in-ear 1/3-octave band noise measurements to verify the ear canal was suitably quiet. Design: We deployed laptop-based hearing testing systems to Tanzania as part of a study of HIV infection and hearing. An in-ear probe containing a microphone was used under the hearing protector for both the in-ear noise measurements and threshold audiometry. The 1/3-octave band noise spectrum from the microphone was displayed on the operator's screen with acceptable levels in grey and unacceptable levels in red. Operators attempted to make all bars grey, but focused on achieving grey bars at 2000 Hz and above. Study sample: 624 adults and 197 children provided 3381 in-ear octave band measurements. Repeated measurements from 144 individuals who returned for testing on three separate occasions were also analysed. Results: In-ear noise levels exceeded the maximum permissible ambient noise levels (MPANL) for ears not covered, but not the dB SPL levels corresponding to 0 dB HL between 2000-4000 Hz. In-ear noise measurements were repeatable over time. Conclusions: Reliable audiometry can be performed using a passive noise-attenuating hearing protector and in-ear noise measurements. [ABSTRACT FROM AUTHOR]