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Otology
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Jameel Muzaffar, Chloe Swords, Adnan Darr, Karan Jolly, Manohar Bance, Sanjiv Bhimrao
Investigations: Audiometry: Rollover phenomenon: Reduction in word recognition score (speech recognition score) with increasing intensityPhonemic regression: Disproportionate speech recognition when compared to pure tone thresholdsTone decay/fatigue: Decreased auditory perception with sustained signal stimulus – retro-cochlear pathologyABR: Interaural latency on wave V (sensitive only to tumours >1.5 cm), or increased I–V latencyImaging: CT may show widening of IAC, and bone resorption (unlike hyperostosis in meningioma)MRI: Iso/hypo-intense on T1, T2. Hyperintense on Ga contrast, arising from IAC, with cystic component
Psychoacoustic and Objective Assessment of Hearing
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Josephine Marriage, Marina Salorio-Corbetto
Audiometry is the measurement of hearing detection levels for pure tones in each ear across frequencies. Results indicate the type and degree of hearing loss and give a basic indication of the impact of ear pathology on hearing.
The Role of the Audiologist in Life Care Planning
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
William D. Mustain, Carolyn Wiles Higdon
Pure tone audiometry is performed to determine if hearing is normal or impaired. An audiologist, using a calibrated electronic device, called an audiometer, and standardized procedures, measures hearing sensitivity. The individual being tested initially wears earphones and the audiologist presents tones of varying frequencies and intensities to each ear. When the individual hears the tone, they respond by raising their hand or pressing a response button. The lowest intensity level at which the tone is heard two out of three times is called threshold. This process is then repeated with the individual wearing a bone vibrator placed on the mastoid bone. When thresholds using earphones are outside the normal range, a comparison with the bone vibrator thresholds will indicate which part of the auditory system is responsible for the hearing loss.
Considering hearing loss as a modifiable risk factor for dementia
Published in Expert Review of Neurotherapeutics, 2022
Katharine K. Brewster, Jennifer A. Deal, Frank R. Lin, Bret R. Rutherford
The ability to hear depends on the precise encoding of sound into a neural signal by the peripheral auditory system followed by decoding of the signal into meaning by the brain. When used in the context of this review and unless stated otherwise, ‘hearing loss’ refers to impairments of the peripheral auditory system (cochlea) that affect the precise peripheral encoding of sound. Audiometry is the most common method used to assess hearing ability, and audiometric measures reflect the sensitivity of the peripheral auditory system to detect pure tones. Importantly, detection of pure tones does not substantively depend on higher-order cortical processing [11], meaning that audiometry can be reliably performed in adults with early dementia [12]. Age-related HL is the most common form of HL observed in adults and reflects progressive, irreversible damage to cells within the cochlea. The cochlea is particularly susceptible to damage over time given that most of the inner ear is post-mitotic (and hence incapable of regeneration), with risk factors for HL being age, race, sex, and noise exposure. Animal models of age-related HL as well as postmortem human temporal bone specimens from older adults demonstrate loss of sensory inner and outer hair cells, damage to the stria vascularis, and loss of cochlear nerve fibers [13]. The end result of accumulated damage to the cochlea (‘sensorineural HL’) is impaired encoding of sound and transmission of an impoverished and degraded auditory signal to the brain [14].
Speech perception 30 years after cisplatin-based chemotherapy in adults: limited clinical relevance of long-term ototoxicity?
Published in Acta Oncologica, 2021
J. Skalleberg, M. Myhrum, M. C. Småstuen, T. A. Osnes, S. D. Fosså, M. Bunne
Pure tone audiometry is a useful tool for detecting ototoxic damage both during and after CBCT. The pure tone average (PTA) refers to the average of hearing thresholds at the frequencies most important for speech perception. Although PTA provides an indication of expected speech perception, which is a clinically important outcome, PTA does not assess speech perception directly. Thus, specific tests are needed. Further, speech perception is different in quiet and in noisy conditions. Speech audiometry is a test of word recognition, often performed together with pure tone audiometry. Both are performed in quiet conditions and thus do not match real life conditions. Difficulties with speech perception in noise is a common problem among patients with high-frequency hearing loss, experienced both after CBCT and with Age-Related Hearing Loss (ARHL). Comparative studies are therefore needed to evaluate the true impact of CBCT on long-term hearing and speech perception. However, studies reporting long-term speech perception after adult-onset cancer are lacking.
Effects of primary arterial hypertension on cochlear function
Published in Acta Oto-Laryngologica, 2021
We determined the air-conduction hearing thresholds between 0.125 and 16 kHz, and the bone-conduction hearing thresholds in both ears of all participants between 0.5 and 4 kHz. Audiometry was performed by an audiologist. A clinical audiometer (AC 40 model, Interacoustics, Otometrics, Taastrup, Denmark) and supra-aural Telephonics TDH-39P earphones were used for the conventional audiometry at 0.125, 0.25, 0.5, 1, 2, 4, 6, and 8 kHz (conventional thresholds). The ultra-high frequency (UHF) audiometry was performed with the same audiometer at 10, 12.5, 14, and 16 kHz and Koss HV/1A + circumaural earphones. Audiometer was calibrated with the ANSI S3.6-2004 standard. All hearing thresholds were determined by a standard Hughson-Westlake procedure (steps: 10 dB down, 5 dB up; 2 out of 3). All audiological tests were performed in a soundproof booth. The middle ear function was measured by tympanometry with a 226 Hz probe tone (AZ26 clinical impedance audiometer, Interacoustics, Assens, Denmark).