Extended high-frequency audiometry: hearing thresholds in adults
Michaela ŠkerkováMartina KovaľováTomáš RychlýHana TomáškováHana ŠlachtováZdeněk ČadaRastislav MaďarEva Mrázková
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This study aimed to determine hearing thresholds in an otologically normal population without occupational noise exposure aged 18 to 64 years using extended high-frequency audiometry (EHFA).Individuals from the general population who have never had hearing problems and whose job was not associated with noise exposure were included in the study and classified by age into 5 categories: 18-24 and, further, by 10 years of age. Each of these groups was further divided according to gender. All subjects underwent tympanometry, conventional pure-tone audiometry within the 0.125-8 kHz range, and extended high-frequency audiometry within the 9-16 kHz range, performed according to the standards. The significance level for statistical testing was set at 5%.Here, we established hearing thresholds in an otologically healthy population within the extended high-frequency (EHF) range (9-16 kHz). We found the EHFA to be a highly sensitive method for early detection of hearing loss, with hearing thresholds decreasing as soon as 35 years of age. In males, the hearing thresholds grew with age more rapidly than in women. The ability to respond at EHF gradually decreased with age and increasing frequency.Our results can help improve the knowledge of EHF hearing thresholds for individual sexes and age groups. So far, the standard 7029:2017 is not binding and, moreover, it only reaches up to the frequency of 12.5 kHz. EHFA is a highly sensitive method for the evaluation of hearing loss depending on age and sex.Keywords:
Tympanometry
Pure tone audiometry
Tympanometry
Pure tone audiometry
Audiogram
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Abstract Results of standard audiometry and tympanometry were compared with the Welch Allyn ‘Audioscope’ and ‘Microtymp’, in the diagnosis of secretory otitis media, in 100 children. Standard pure tone audiometry had a specificity of 92 per cent and sensitivity of 51.6 per cent. The Welch Allyn ‘Audioscope’ a specificity of 84.2 per cent and sensitivity of 57.5 per cent; standard tympanometry a specificity of 71 per cent and sensitivity of 88 per cent; the Welch Allyn ‘Microtymp’ a specificity of 63 per cent and sensitivity of 90 per cent. In view of cost, portability, and speed of testing the Welch Allyn instruments would be particularly suitable for community screening. Pure tone audiometry with a pass threshold of 25 dB, at 2 and 4 kHz is a poor indicator of effusion.
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Otitis media with effusion is the most common cause of fluctuating hearing loss in children. Pure-tone audiometry is the current mandated standard to determine hearing loss in public-school children in most states. Students who fail pure tone audiometry are at risk for otitis media with effusion because it is asymptomatic. Tympanometry, which assesses middle ear status, is used to detect hidden otitis media with effusion. This longitudinal study evaluated pure tone audiometry and tympanometry in preschool and elementary children (n = 141). Results found 12 children (23 ears) who failed either a second threshold or tympanometry. The study also showed that a greater number of ears were identified with otitis media with effusion (n = 19) by using pure tone audiometry and tympanometry than by using pure tone audiometry alone (n = 4).
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Background Epidural analgesia is commonly used for pain management during labor. Sometimes, accidental dural puncture ( ADP ) occurs causing severely debilitating headache, which may be associated with transient hearing loss. We investigated if auditory function may be impaired several years after ADP treated with epidural blood patch ( EBP ). Methods Sixty women ( ADP group) without documented hearing disability, who received EBP following ADP during labor between the years 2005–2011 were investigated in 2013 for auditory function using the following tests: otoscopic examination, tympanometry, pure tone audiometry, and transient‐evoked otoacoustic emissions. Additionally, they responded to a questionnaire, the Speech, Spatial and Qualities ( SSQ ) of hearing, concerning perceived hearing impairment. The results were compared to a control group of 20 healthy, non‐pregnant women in the same age group. Results The audiometric test battery was performed 5.2 (1.9) years after delivery. No significant differences were found between the ADP and the control groups in tympanometry or otoacoustic emissions. Pure tone audiometry revealed a significant but small (< 5 dB) difference between the ADP and control groups ( P < 0.05). The ability to hear speech in noise as measured by SSQ was significantly reduced in the ADP group compared to the control group ( P < 0.05). Conclusions A minor hearing loss was detected in the ADP group compared to the control group in pure tone audiometry in some women and during speech‐in‐noise component several years after accidental dural puncture treated with an epidural blood patch. This small residual hearing loss has minor clinical significance.
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Using the impedance audiometry, screening of children in the first grade of an elementary school was performed. The children were investigated with pure tone andiometry, impedance audiometry and otoscopy. Screening using pure tone audidnetry was performed at frequencies of 1 and 4 kHz. The hearing threshold more than 20 dB HL was considered pathological in one or both of the frequencies. Screening impedance audiometry was performed with the Madsen impedance bridge ZO 70 (probe tone 220 Hz) and the pressure in the external ear canal was variated from -400 to +200 mmH2O. The screening was performed by tympanometry and measurement of acoustic impedance or static compliance. Out of 145 children, 6 children (4. 1%) with secretory otitis media were discovered by impedance audiometry. Out of these 6 cases, only one was found by pure tone audiometry. Five out of these six children had no subjective symptoms. The results indicated that the screening using impedance audiometry (tympanometry) was more efficient than the screening using pure tone audiometry and otoscopy in the detection of secretory otitis media. In this study, some problems, such as cost of the instrument, time-consumptiveness and high over-referral rate, were pointed out to introduce the impedance audiometry for school screening. However, tympanometry is recommended as a complement of pure tone screening in screening of children.
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This descriptive study defined an effective hearing testing protocol for elementary school-aged children (N = 41). It compared the identification of hearing loss and middle ear disease using pure tone threshold audiometry with tympanometry to using pure tone threshold audiometry. Betty Neuman's Systems Model was used as the conceptual framework for this study. Results showed that a greater number of ears were identified with middle ear disease using the research protocol (n = 22) than would have been identified with middle ear disease (n = 9) using pure tone audiometry alone. The same number of ears (n = 26) were identified with hearing loss using either method. The study further demonstrates a difference between the first and second hearing test results using the specified protocol that validates the necessity for repeating the two tests after 4 weeks before making referrals.
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The aim of this study was to assess the performance of clinical methods, viz. otoscopy, pure-tone audiometry, and tympanometry in diagnosing middle ear effusions (MEEs) using magnetic resonance imaging as a reference standard.A retrospective study of 46 patients with newly diagnosed nasopharyngeal carcinoma was performed comparing clinical evaluation and audiometry results with magnetic resonance imaging findings obtained before radiation therapy.Twenty-two (25%) of the temporal bones imaged had both MEE and mastoid effusions, 24 (27%) had only middle ear fluid, and 29 (33%) had mastoid fluid alone. The sensitivity for tympanometry, audiometry, and otoscopy in detecting fluid in the middle ear was 96%, 92%, and 80%, respectively. Although tympanometry was most sensitive in diagnosing MEE, there was no statistically significant difference when comparing the overall accuracy of pure-tone audiometry air-bone gap and tympanometry (p = 0.7, chi-square test). Flat curve tympanograms (type B) only achieved a sensitivity of 45% but were of high specificity (92%). Forty-nine percent with negative pressure tympanograms (mean air pressures > -100 daPa) had no MEE.Using magnetic resonance imaging as a reference standard, tympanometry is the most sensitive audiologic test in detecting the presence of MEE. The overall accuracy of tympanometry, pure-tone audiometry air-bone gap, and otologic examination was, however, not significantly different.
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Tympanometry
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Conductive hearing loss
Eustachian tube
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Otitis media with effusion is the most common cause of fluctuating hearing loss in children. Pure-tone audiometry is the current mandated standard to determine hearing loss in public-school children in most states. Students who fail pure tone audiometry are at risk for otitis media with effusion because it is asymptomatic. Tympanometry, which assesses middle ear status, is used to detect hidden otitis media with effusion. This longitudinal study evaluated pure tone audiometry and tympanometry in preschool and elementary children ( n = 141). Results found 12 children (23 ears) who failed either a second threshold or tympanometry. The study also showed that a greater number of ears were identified with otitis media with effusion ( n = 19) by using pure tone audiometry and tympanometry than by using pure tone audiometry alone ( n = 4).
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Pure tone audiometry
Audiogram
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It is generally held that exposure to both high-pressure and long-lasting contact with water makes diving a potentially hazardous sports activity as far as the ears are concerned. There is a number of research investigating the condition of the middle ear in a short period following diving; however, the knowledge regarding the long-term effects of regularly repeated diving remains limited.The aim of this study is to evaluate the function of the middle ear after a diving season in a group of 31 adults diving regularly (1-17 years) by means of the following methods: 1) interview, 2) otoscopy, 3) pure tone audiometry, 4) classic tympanometry, and 5) wideband tympanometry.Periodic problems with pressure equalization in the middle ear were observed in 12 individuals (38.7%). In all the analyzed cases, the authors found a normal condition of the external auditory canal and the tympanic membrane in otoscopy, normal hearing in pure tone audiometry, curve type A, and normal gradient in both classic and wideband tympanometry.Safe diving (according to safety precautions) does not have any long-term negative effects on the condition of the middle ear. However, these observations should be verified in a larger group of divers. Int J Occup Med Environ Health. 2021;34(6):779-88.
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