Fones de inserção: aplicação no colabamento de meato acústico externo Insert earphones: application to avoid collapse of the external auditory canal

ABSTRACT Purpose: To determine the efficacy of insert earphones in cases of collapsed external auditory canals. Methods: Twenty-one elderly individuals with air-bone gaps greater than 10 dBHL at frequencies of 3 kHz and/or 4 kHz underwent anamnesis, pure tone audiome-try, speech audiometry, and immittance test. Pure tone audiometry and speech audiometry were performed with both supra-aural and insert earphones. Results: Air conduction thresholds were lower with insert earphones at all frequencies except 1 kHz. The magnitude of the air-bone gap was also lower with the insert earphones, and there was a air-bone coupling with this transducer. Conclusion: Insert earphones ER-3A allowed significant improvement in air conduction hearing thresholds in elderly individuals, reducing or even eliminating the air-bone gap in cases of collapsed external auditory canals, especially at higher frequencies. Keywords: Hearing; Audiometry; Auditory threshold; Ear canal; Aged REFERENCIAS 1. Bryde RL, Feldman AS. An approach to the management of the collapsing ear canal. Detroit: American Speech-Language-Hearing Association Convention; 1980. 2. Jerger J, Jerger S, Mauldin L. Studies in impedance audiometry. I. Normal and sensorineural ears. Arch Otolaryngol. 1972;96(6):513-23. 3. McCarthy PA. Rehabilitation of the hearing impaired geriatric client. In: Alpiner JG, McCarthy PA. Rehabilitative audiology: children and adults. Baltimore: The Williams & Wilkins; 1987. p.370-409. 4. Clemis JD, Ballad WJ, Killion MC. Clinical use of an insert earphone. Ann Otol Rhinol Laryngol. 1986;95(5 Pt 1):520-4. 5. Killion MC, Villchur E. Coments on “Earphones in Audiometry” [Zwislocki et al., J Acoust Soc Am. 1988;83:1688-9]. J Acoust Soc Am. 1989;85(4):1775-9. 6. Lilly DJ, Purdy JK. On the routine use of tubephone insert earphones. Am J Audiol. 1993;2:17-20. 7. Yantis EA. Pure tone air conduction threshold testing. In: Katz J. Handbook of clinical audiology. 4th ed. Baltimore: The Williams & Wilkins; 1994, p.97-108. 8. Ventry IM, Chaiklin JB, Boyle WF. Collapse of the ear canal during audiometry. Arch Otolaryngol. 1961:73(6):727-31. 9. Creston JE, Tice RE. Collapse of the ear canal during audiometry. Observation in siblings. Arch Otolaryngol. 1964:79:389-92. 10. Ross M, Tucker CA. A case study of collapse of the ear canal during audiometry. Laryngoscope. 1965:75:65-7. 11. Chaiklin JB, McClellan ME. Audiometry management of collapsible ear canals. Arch Otolaryngol. 1971:93(4):397-407. 12. Schow RL, Nerbonne MA. Hearing levels among elderly nursing home residents. J Speech Hear Disord. 1980;45(1):124-32. 13. Marshall L, Gossman MA. Management of ear-canal collapse. Arch Otolaryngol. 1982;108(6):357-61. 14. Gil D, Borges AC. Fones de insercao: um estudo em individuos audiologicamente normais. Rev Bras Otorrinolaringol. 2001;67(4 Pt 1):480-7. 15. Wilber LA, Kruger B, Killion MC. Reference thresholds for the ER-3A insert earphone. J Acoust Soc Am. 1988;83(2):669-76. 16. Clark JL, Roeser RJ. Three studies comparing performance of the ER-3A tubephone with the TDH-50P earphone. Ear Hear. 1988;9(5):268-74. 17. Schmuziger N, Probst R, Smurzynski J. Test-retest reliability of pure-tone thresholds from 0.5 to 16kHz using Sennheiser HDA 200 and Etymotic Research ER-2 earphones. Ear Hear. 2004;25(2):127-32. 18. Stuart A, Stenstrom R, Tompkins C, Vandenhoff S. Test-restest variability in audiometric threshold with supraaural and insert earphones among children and adults. Audiology. 1991;30(2):82-90.