Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

This investigation was concerned with measurements of middle ear muscle activity. Specifically, the investigation was designed: (a) to compare reflex thresholds for pure tone(PT), octave band noise(OBN), and one-third octave band noise(TQBN); (b) to study middle ear muscle activity during a five minute exposure to these stimuli at 114 dB SPL; and (c) to compare middle ear muscle activity for stimuli of different frequencies. Eighteen subjects were divided into two groups. Group I subjects were exposed to a 700 Hz PT, to OBN with center frequency 500 Hz, and TOBN with center frequency 630 Hz; Group II subjects were exposed to a 1400 Hz PT, to OBN with center frequency 1000 Hz, and TOBN with center frequency 1250 Hz. A Madsen Electroacoustic Impedance Bridge and graphic recorder were used to record impedance changes during stimulation with the above stimuli. These impedance changes were assumed to reflect muscle activity. Thresholds for the acoustic reflex were determined using standard procedures. Analysis of results indicated muscle activity decreased progressively during stimulation. Reflex decay was significantly greater for stimulation with PT than for stimulation with OBN(Groups I and II) and TOBN(Group II). It was noted that reflex decay was less during stimulation with a 700 Hz PT than during stimulation with a 1400 Hz PT. Finally, it was observed that reflex thresholds were higher for PT than for OBN and TOBN. Decrease in muscle activity during acoustic stimulation was discussed in terms of adaptation and possibly central mechanisms; the characteristics of the stimuli were compared and discussed, as a possible explanation for differences in results obtained for tones and noise. / Medicine, Faculty of / Audiology and Speech Sciences, School of / Graduate

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 2 uppsatser.

Background: For the past 50+ years, audiologists have been taught to measure the pure-tone thresholds at the interoctave frequencies when the thresholds at adjacent octave frequencies differ by 20 dB or more. Although this so-called 20 dB rule is logical when enhanced audiometric resolution is required, the origin of the rule is elusive, and a thorough literature search failed to find supporting scientific data. Purpose: This study purposed to examine whether a 20 dB difference between thresholds at adjacent octave frequencies is the critical value for whether the threshold of the interoctave frequency should be measured. Along this same line of questioning is whether interoctave thresholds can be predicted from the thresholds of the adjacent or bounding octave frequencies instead of measured, thereby saving valuable time. Research Design: Retrospective, descriptive, correlational, and cross-sectional. Study Sample: Audiograms from over a million veterans provided the data, which were archived at the Department of Veterans Affairs, Denver Acquisition and Logistics Center. Data Collection and Analysis: Data from the left and right ears were independently evaluated. For each ear three interoctave frequencies (1500, 3000, and 6000 Hz) were studied. For inclusion, thresholds at the interoctave frequency and the two bounding octave frequencies had to be measurable, which produced unequal numbers of participants in each of the six conditions (2 ears by 3 interoctave frequencies). Age tags were maintained with each of the six conditions. Results: Three areas of analyses were considered. First, relations among the octave-frequency thresholds were examined. About 62% of the 1000-2000 Hz threshold differences were ≥20 dB, whereas about 74% of the 4000-8000 Hz threshold differences were <20 dB. About half of the threshold differences between 2000 and 4000 Hz were <20 dB and half were >20 dB. There was an inverse relation between frequency and the percent of negative slopes between octave-frequency thresholds, ranging from 89% at 1500 Hz to 54% at 6000 Hz. The majority of octave-frequency pairs demonstrated poorer thresholds for the higher frequency of the pair. Second, interoctave frequency thresholds were evaluated using the median metric. As the interoctave frequency increased from 1500 to 6000 Hz, the percent of thresholds at the interoctave frequencies that were not equal to the median threshold increased from ∼9.5% (1500 Hz) to 15.6% (3000 Hz) to 28.2% (6000 Hz). Bivariate plots of the interoctave thresholds and the mean octave-frequency thresholds produced 0.85-0.91 R2 values and 0.79-0.92 dB/dB slopes. Third, the predictability of the interoctave thresholds from the mean thresholds of the bounding octave frequencies was evaluated. As expected, as the disparity between octave-frequency thresholds increased, the predictability of the interoctave threshold decreased; for example, using a ±5 dB criterion at 1500 Hz, 53% of the thresholds were ±5 dB when the octave thresholds differed by ≥20 dB, whereas 77% were ±5 dB when the octave thresholds differed by <20 dB. Conclusions: The current findings support the 20 dB rule for testing interoctave frequency thresholds and suggest the rule could be increased to 25 dB or more with little adverse effect.

Auditory filters were derived in 20 normal-hearing human listeners at center frequencies (CFs) of 913, 1095, 3651, and 4382 Hz using the roex (p,r) method. Comparisons were made between slopes of the filters' skirts at the neighboring CFs with filter output levels of 45 and 70 dB. The same comparisons were made with regard to filter equivalent rectangular bandwidth (ERB). In the 1000-Hz region, the low-frequency slopes (Pl) of filters centered at 913 and 1095 Hz were significantly correlated at both stimulus levels, while the high-frequency slopes (Pu) were similar only at the high test level. In the 4000-Hz region, for sinusoids of 3651 and 4382 Hz, the level effect was clearer as both Pu and Pl values diverged at the low level but were related at high levels. The ERBs centered at the same CFs displayed a similar level dependence. At the stimulus level most likely to be affected by an active feedback mechanism, auditory filters centered at nearly the same frequency displayed quite distinct frequency selectivity, and this trend was stronger in the 4000-Hz region than the 1000-Hz region. The findings suggest that a saturating, active cochlear mechanism may not be distributed evenly, or contribute to peripheral tuning with equal effectiveness throughout the length of the partition.

OBJECTIVES: Acoustic stapedius reflex threshold (ART) tests are included in a standard clinical acoustic immittance test battery as an objective cross-check with behavioral results and to help identify site of lesion. In traditional clinical test batteries, middle-ear admittance of a 226 Hz probe is estimated using ear-canal measurements in the presence of a reflex-activating stimulus. In the wideband (WB) acoustic immittance ART test used in this study, the pure-tone probe is replaced by a WB probe stimulus and changes in absorbed power are estimated using ear-canal measurements in the presence of the activator. The ART is defined as the lowest level at which a criterion change in admittance (clinical) or absorbed power (WB) is observed in the presence of the activator. In the present study, ARTs were obtained in adults with normal hearing using the clinical, manual method and with a new WB automated adaptive threshold detection method. It was hypothesized that the WB test would result in lower ARTs than the clinical test because reflex-related changes in power absorbance could be observed across multiple frequency bands in the WB test compared with a single frequency in the traditional test. DESIGN: Data were collected in a prospective research design. ARTs were obtained in ipsilateral and contralateral conditions using 500, 1000, 2000 Hz, and broadband noise (BBN) activators on a clinical system and on an experimental WB system. The bandwidth of the BBN activator was 125 to 4000 Hz on the clinical system and 200 to 8000 Hz on the wideband system. ARTs were estimated at both tympanometric peak pressure (TPP) and ambient pressure on the WB system. Data were collected in both ears of 39 adults (21 males) of mean age 47.7 years (range 23-72 years). Differences in ARTs among the three threshold estimation methods (clinical, WB at TPP, WB at ambient) were examined using the general linear model repeated measures test in SPSS. Post-hoc pairwise comparisons were completed with Bonferroni correction for multiple comparisons. Statistical significance was defined as p < 0.05 for all analyses. RESULTS: ARTs obtained on the WB system at TPP and ambient pressure were significantly lower than obtained on the clinical system. ARTs obtained on the WB system at TPP were significantly higher than at ambient pressure in the 500 and 2000 Hz ipsilateral conditions. CONCLUSIONS: WB automated adaptive ARTs in normal-hearing adults were lower than for clinical methods when measured at TPP and ambient pressure. Lower presentation levels required to estimate ART in the WB test may be more tolerable to patients. Patients with ARTs that are not present at the maximum level of a traditional reflex test may have present ARTs with a WB ART test, which may reduce the need to refer for additional testing for possible retrocochlear involvement. Automation of the test may allow clinicians more time to attend to the other requisite tasks of a hearing evaluation and make the system useful for telehealth applications.