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.

Introdução: Os motociclistas estão expostos tanto ao ruído ambiental como ao ruído gerado pela própria motocicleta. Tal exposição ao ruído pode provocar lesões na orelha interna, de modo que o registro das emissões otoacústicas por produto de distorção (EOAEPD) pode evidenciar as alterações de forma precoce. Objetivo: Verificar as variações das amplitudes das emissões otoacústicas evocadas por produto de distorção nos carteiros motociclistas normo-ouvintes de acordo com o tempo de exposição a ruído e analisar com trabalhadores normo-ouvintes não expostos a ruído ocupacional. Método: Foram avaliados 148 trabalhadores normo-ouvintes, distribuídos em quatro grupos: grupo I com exposição a ruído menor ou igual a dois anos, o grupo II com mais de dois anos e menos de cinco anos e o grupo III maior ou igual a cinco anos de exposição e o grupo IV não exposto ao ruído. Todos os trabalhadores selecionados foram submetidos ao registro das EOAEPD. Resultados: O grupo I apresentou amplitudes mais elevadas em 7250 Hz e 5128 Hz (p < 0,05), em comparação aos grupos II, III e IV. As menores respostas de amplitudes das EOAEPD ocorreram no grupo controle (grupo IV), sendo estatisticamente significativo nas freqüências entre 5128 Hz e 2588 Hz (p < 0,05). Conclusão: Os resultados sugerem que o monitoramento no início da exposição ao ruído ocupacional, por meio das emissões otoacústicas por produto de distorção, possibilita a detecção de alterações fisiopatológicas precoces da orelha interna por causa da presença de incrementos no registro da amplitude das EOAEPD. Estes incrementos precedem as alterações na audiometria tonal liminar e a ausência ou diminuição na amplitude das EOAEPD / Introduction: The motorcyclists are exposed as much to the environmental noise as to the noise generated by the own motorcycle. Such exposition to noise can provoke lesions in the internal ear and the registration of the distortion product otoacoustic emissions (DPOAEs) can evidence the alterations in a precocious way. Objective: To verify the variations of the amplitudes of the otoacoustic emissions evoked by distortion product in the postmen normo-listeners motorcyclists\' in agreement with the time of exposition to noise and to analyze with normo-listeners workers not exposed to occupational noise. Method: Hundred and forty-eight normo-listeners workers has been evaluated, distributed into four groups: group I - exposed to a smaller noise equivalent to two years noise-exposition; group II - equivalent to more than two years exposition and less than five years; group III - larger or equal to five years exposition; and the group IV - workers not exposed to noise being assigned to the control group. All selecioned workers were submitted to DPOAEs registration. Results: The group I presented higher amplitudes for 7250 Hz and 5128 Hz frequencies (p < 0.05), in comparison with the groups II, III and IV. The lowest values of DPOAEs amplitudes were observed in the control group (group IV), being statistically significantive for frequencies between 5128 Hz and 2588 Hz (p < 0.05). Conclusion: The results suggest that early monitoring of the exposition to occupational noise, through the distortion product otoacoustic emissions, makes possible the detection of precocious physiopathologic alterations of the internal ear due to the presence of increments in the amplitude registration of the DPOAEs. These increments precede the alterations in the preliminary tonal audiometry and the absence or decrease in the amplitude of the DPOAEs

Introdução: Os motociclistas estão expostos tanto ao ruído ambiental como ao ruído gerado pela própria motocicleta. Tal exposição ao ruído pode provocar lesões na orelha interna, de modo que o registro das emissões otoacústicas por produto de distorção (EOAEPD) pode evidenciar as alterações de forma precoce. Objetivo: Verificar as variações das amplitudes das emissões otoacústicas evocadas por produto de distorção nos carteiros motociclistas normo-ouvintes de acordo com o tempo de exposição a ruído e analisar com trabalhadores normo-ouvintes não expostos a ruído ocupacional. Método: Foram avaliados 148 trabalhadores normo-ouvintes, distribuídos em quatro grupos: grupo I com exposição a ruído menor ou igual a dois anos, o grupo II com mais de dois anos e menos de cinco anos e o grupo III maior ou igual a cinco anos de exposição e o grupo IV não exposto ao ruído. Todos os trabalhadores selecionados foram submetidos ao registro das EOAEPD. Resultados: O grupo I apresentou amplitudes mais elevadas em 7250 Hz e 5128 Hz (p < 0,05), em comparação aos grupos II, III e IV. As menores respostas de amplitudes das EOAEPD ocorreram no grupo controle (grupo IV), sendo estatisticamente significativo nas freqüências entre 5128 Hz e 2588 Hz (p < 0,05). Conclusão: Os resultados sugerem que o monitoramento no início da exposição ao ruído ocupacional, por meio das emissões otoacústicas por produto de distorção, possibilita a detecção de alterações fisiopatológicas precoces da orelha interna por causa da presença de incrementos no registro da amplitude das EOAEPD. Estes incrementos precedem as alterações na audiometria tonal liminar e a ausência ou diminuição na amplitude das EOAEPD / Introduction: The motorcyclists are exposed as much to the environmental noise as to the noise generated by the own motorcycle. Such exposition to noise can provoke lesions in the internal ear and the registration of the distortion product otoacoustic emissions (DPOAEs) can evidence the alterations in a precocious way. Objective: To verify the variations of the amplitudes of the otoacoustic emissions evoked by distortion product in the postmen normo-listeners motorcyclists\' in agreement with the time of exposition to noise and to analyze with normo-listeners workers not exposed to occupational noise. Method: Hundred and forty-eight normo-listeners workers has been evaluated, distributed into four groups: group I - exposed to a smaller noise equivalent to two years noise-exposition; group II - equivalent to more than two years exposition and less than five years; group III - larger or equal to five years exposition; and the group IV - workers not exposed to noise being assigned to the control group. All selecioned workers were submitted to DPOAEs registration. Results: The group I presented higher amplitudes for 7250 Hz and 5128 Hz frequencies (p < 0.05), in comparison with the groups II, III and IV. The lowest values of DPOAEs amplitudes were observed in the control group (group IV), being statistically significantive for frequencies between 5128 Hz and 2588 Hz (p < 0.05). Conclusion: The results suggest that early monitoring of the exposition to occupational noise, through the distortion product otoacoustic emissions, makes possible the detection of precocious physiopathologic alterations of the internal ear due to the presence of increments in the amplitude registration of the DPOAEs. These increments precede the alterations in the preliminary tonal audiometry and the absence or decrease in the amplitude of the DPOAEs

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A student manual of audiological procedures with accompanying laboratory assignments does not presently exist at the University of South Florida (USF). In the first year of the four year Au.D. program at USF, students are enrolled in Audiology Laboratory Clinic I, II, and III, in consecutive semesters. Groups of four to six students meet weekly for a 3-1/2 hour clinical laboratory session to receive training in test instruction, test procedures, test application, and test interpretation. The purpose of the first year Audiology laboratory clinic sessions is to prepare the student for clinical experience in year two of the Au.D program at USF. In preparation for these laboratory sessions, it was discovered that materials related to test procedures are currently scattered throughout a variety of texts, journals, manuals, educational software, videos, and web sites. No one source contains all the needed information on any given test procedure. In addition, specific procedures outlined in documents [American Standards Institute (ANSI) and the American Speech-Language-Hearing Association (ASHA)] are not consistently used by the different sources. Thus, there is no standard procedural manual containing laboratory assignments that lead to the development of appropriate clinical testing skills by a first year Au.D student. A standard test procedural manual for pure tone audiometry, speech audiometry, and immittance testing, with assignments, was developed to assist in the cultivation of the students testing skills. The manual contains test history, purposes, procedures, scoring guidelines, interpretations, and limitations for each test. Laboratory assignments include practice exercises using a computer simulator, classmates, and volunteers. Each assignment is accompanied by discussion questions to enhance and augment student understanding. A reference list is available to obtain further information on each topic area. This manual will be made available to the first year Au.D student as well as to the advanced Au.D student who would benefit from an all-inclusive, updateable source providing the best possible clinical procedures. The final product will be available for a fee in a notebook type format to allow for the inclusion of additional topics and updates as the standards of practice in Audiology change.

KwaZulu-Natal has been ranked as having the fourth highest incidence of transmitted Multiple Drug Resistant-Tuberculosis (MDR-TB) in sub-Saharan Africa. Substantial literature exists indicating the permanent damage that MDR-TB medication has on hearing abilities. The purpose of this study was to describe the hearing function of adults on long term MDR-TB treatment from Murchison Hospital MDR-TB unit in the Ugu District in rural KwaZulu-Natal. The primary aim of the study was to review the possible changes in hearing function in a group of adults on long-term treatment for MDR-TB. Secondly, the study aimed to estimate the number of adults who may present with changes following MDR-TB treatment and establish if relationships exist between the audiological findings and factors such as age and gender. The design of the study was a retrospective comparative data review of 68 patient records, all of which underwent audiological investigations from the start of MDR-TB treatment over a five-month period. The study made use of descriptive and inferential statistics to analyse the data. Specific inferential statistical analysis included analysis of covariance as well as regression analysis. Results from the study showed changes in hearing function in Distortion Product Otoacoustic Emissions (DPOAEs) and Pure Tone Audiometry (PTA) results at all five audiological sessions and across a range of frequencies. 84% of the total sample presented with overall refer readings for DPOAEs and 98.53% of the group of adults presented with criteria indicative of ototoxic hearing loss, specifically a bilateral mild-profound sloping SNHL on clinical PTA results. In the total sample of patient records reviewed in this study, all 68 records showed a change in hearing function, be that changes in DPOAE function and/or changes in PTA thresholds, following long-term treatment for MDR-TB. Variations in the effects of gender and ear difference were minimal and non-significant in all results. Similar presentation, to ototoxic hearing loss, of other degenerative conditions exists; however these conditions were accounted for as exclusion criteria in this study. Therefore the only remaining cause of possible hearing deficit was that of ototoxicity. The study provided valuable data regarding hearing function in a population of adults on long-term MDR-TB treatment in South Africa. Furthermore, the study has highlighted the need for the establishment of standardised audiological monitoring programmes sensitive to ototoxic hearing loss, within the South African context where the incidence of Tuberculosis (TB) and MDR-TB is reportedly high.

Made available in DSpace on 2016-04-27T18:12:24Z (GMT). No. of bitstreams: 1 Kelly Cristina de Souza Fernandes.pdf: 272473 bytes, checksum: fd1b99ff0dcaf5e12bdb0ad1b9c2912e (MD5) Previous issue date: 2007-10-09 / INTRODUCTION: Many situations may difficult the obtaining of thresholds for each ear, separately, in pure tone audiometry, demanding the use of masking. The plateau method, developed by Hood (1960) has being the most utilized for more than four decades. Nevertheless, Turner (2004) has suggested a masking protocol with a different method, called optimized, which could replace the previous one with efficacy in specific cases. PURPOSE: To verify if there is a difference among air and bone conduction hearing thresholds, using the two clinical masking methods: plateau and optimized. METHOD: Forty individuals aged from 15 to 65 years old, with either unilateral or bilateral hearing losses, considering unilateral, bilateral, symmetrical and just bone, proposed by Turner s classification, have participated of this study. They underwent air and bone conduction pure tone audiometry for both ears, without and with the use of the two masking methods. RESULTS: There was a 6.1% difference between the results for the air conduction threshold retest and a 15.1 % for the bone conduction threshold retest, taking into consideration the symmetrical model and a 12.8% for the bone conduction retest, considering the just bone model. There was no statistically significant difference between the air and bone conduction hearing thresholds with the two masking methods, considering unilateral and bilateral models. CONCLUSION: The plateau method can be utilized for all models and the optimized one is the most efficient for unilateral and bilateral models, having no indication for the symmetrical model. Therefore, both masking methods have presented advantages and disadvantages, implying that the audiologist must have knowledge of them in order to choose correctly the masking method to be used / INTRODUÇÃO: Na realização da audiometria tonal, determinadas situações dificultam a obtenção dos limiares para cada orelha separadamente, havendo a necessidade de utilização do mascaramento. O Método Platô, desenvolvido por Hood (1960), vem sendo o mais utilizado há mais de quatro décadas. Contudo, em 2004, Turner sugeriu um protocolo de mascaramento no qual um diferente método, denominado Método Otimizado, poderia substituí-lo de forma eficaz em casos específicos. OBJETIVO: Verificar se há diferença entre os limiares auditivos obtidos, por via aérea e via óssea, utilizando-se dois métodos de mascaramento clínico: o Método Platô e o Otimizado. MÉTODO: Participaram deste estudo 40 indivíduos, com idades entre 15 e 65 anos, que apresentavam perda auditiva unilateral ou bilateral, considerando os modelos unilateral, bilateral, simétrico e somente-ósseo, propostos pela classificação de Turner (2004). Foram realizados os procedimentos de audiometria tonal liminar por via aérea e óssea, para ambas as orelhas, sem e com a utilização dos dois métodos de mascaramento. RESULTADOS: Não houve diferença estatisticamente significante entre os limiares auditivos obtidos com os dois métodos de mascaramento por via aérea e via óssea considerando-se os modelos, unilateral e bilateral. No entanto, houve diferença de 6,1% dos resultados para o re-teste dos limiares por via aérea e de 15,1% para o re-teste por via óssea, considerando o modelo simétrico e de 12,8% para o re-teste de via óssea, considerando o modelo somente-ósseo. CONCLUSÃO: O Método Platô pode ser utilizado para todos os modelos e o Otimizado é mais eficaz para os modelos unilateral e bilateral, não sendo indicado para o modelo simétrico. Diante disso, ambos os métodos de mascaramento apresentaram vantagens e desvantagens, sugerindo que o audiologista tenha conhecimento destas para que proceda a seleção do método de forma consciente

Objective The purposes of the study were: (1) To evaluate the intrasession test-retest reliability of pure-tone thresholds measured in the 0.5–16 kHz frequency range for a group of otologically healthy subjects using Sennheiser HDA 200 circumaural and Etymotic Research ER-2 insert earphones and (2) to compare the data with existing criteria of significant threshold shifts related to ototoxicity and noise-induced hearing loss. Design Auditory thresholds in the frequency range from 0.5 to 6 kHz and in the extended high-frequency range from 8 to 16 kHz were measured in one ear of 138 otologically healthy subjects (77 women, 61 men; mean age, 24.4 yr; range, 12–51 yr) using HDA 200 and ER-2 earphones. For each subject, measurements of thresholds were obtained twice for both transducers during the same test session. For analysis, the extended high-frequency range from 8 to 16 kHz was subdivided into 8 to 12.5 and 14 to 16 kHz ranges. Data for each frequency and frequency range were analyzed separately. Results There were no significant differences in repeatability for the two transducer types for all frequency ranges. The intrasession variability increased slightly, but significantly, as frequency increased with the greatest amount of variability in the 14 to 16 kHz range. Analyzing each individual frequency, variability was increased particularly at 16 kHz. At each individual frequency and for both transducer types, intrasession test-retest repeatability from 0.5 to 6 kHz and 8 to 16 kHz was within 10 dB for >99% and >94% of measurements, respectively. The results indicated a false-positive rate of Conclusion Repeatability was similar for both transducer types. Intrasession test-retest repeatability from 0.5 to 12.5 kHz at each individual frequency including the frequency range susceptible to noise-induced hearing loss was excellent for both transducers. Repeatability was slightly, but significantly poorer in the frequency range from 14 to 16 kHz compared with the frequency ranges from 0.5 to 6 or 8 to 12.5 kHz. Measurements in the extended high-frequency range from 8 to 14 kHz, but not up to 16 kHz, may be recommended for monitoring purposes.

The purpose of this study was to evaluate an updated list of digitally recorded Speech Recognition Threshold (SRT) materials for test-retest reliability. Chipman (2003) identified 33 psychometrically equated spondaic words that are frequently occurring in English today. These digitally recorded words were used to determine the SRT of 40 participants using the American Speech-Language Hearing Association guidelines. The participants were between the ages of 19 and 83 years and presented with hearing impairment ranging from normal to severe. The individual's pure-tone averages classified 16 participants with normal hearing to slight loss, 12 participants with mild loss, and 12 participants with moderate to severe hearing loss. The speech materials were presented to participants in one randomly selected ear. The SRT was measured for the same ear in both the test and retest conditions. The average SRT for the test condition was 22.7 dB HL and 22.8 dB HL in the retest condition with an improvement of 0.1 dB for retest but no significant difference was identified. Using a modified variance equation to determine test-retest reliability resulted in a 0.98, indicating almost perfect reliability. Therefore the test-retest reliability was determined to be exceptional for the new SRT words.

Professional research project (Au.D.)--University of South Florida, 2001. / Title from PDF of title page. / Document formatted into pages; contains 146 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: A student manual of audiological procedures with accompanying laboratory assignments does not presently exist at the University of South Florida (USF). In the first year of the four year Au.D. program at USF, students are enrolled in Audiology Laboratory Clinic I, II, and III, in consecutive semesters. Groups of four to six students meet weekly for a 3-1/2 hour clinical laboratory session to receive training in test instruction, test procedures, test application, and test interpretation. The purpose of the first year Audiology laboratory clinic sessions is to prepare the student for clinical experience in year two of the Au.D program at USF. In preparation for these laboratory sessions, it was discovered that materials related to test procedures are currently scattered throughout a variety of texts, journals, manuals, educational software, videos, and web sites. No one source contains all the needed information on any given test procedure. / ABSTRACT: In addition, specific procedures outlined in documents [American Standards Institute (ANSI) and the American Speech-Language-Hearing Association (ASHA)] are not consistently used by the different sources. Thus, there is no standard procedural manual containing laboratory assignments that lead to the development of appropriate clinical testing skills by a first year Au.D student. A standard test procedural manual for pure tone audiometry, speech audiometry, and immittance testing, with assignments, was developed to assist in the cultivation of the students testing skills. The manual contains test history, purposes, procedures, scoring guidelines, interpretations, and limitations for each test. Laboratory assignments include practice exercises using a computer simulator, classmates, and volunteers. Each assignment is accompanied by discussion questions to enhance and augment student understanding. / ABSTRACT: A reference list is available to obtain further information on each topic area. This manual will be made available to the first year Au.D student as well as to the advanced Au.D student who would benefit from an all-inclusive, updateable source providing the best possible clinical procedures. The final product will be available for a fee in a notebook type format to allow for the inclusion of additional topics and updates as the standards of practice in Audiology change. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.