Pressurized Wideband Acoustic Stapedial Reflex Thresholds: Normal Development and Relationships to Auditory Function in Infants

Hunter, Lisa L.; Keefe, Douglas H.; Feeney, M. Patrick; Fitzpatrick, Denis

doi:10.1007/s10162-016-0595-3

Cited by 12 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These group results in adult ears with normal function are described in Feeney et al (2016). Group results obtained in infant ears with normal function and with hearing loss are described in Hunter et al (2016). Finally, the ASRT was classified as NR in all the adult and infant ears in the present study that were expected to have an ASR absent.…”

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Aural Acoustic Stapedius-Muscle Reflex Threshold Procedures to Test Human Infants and Adults

Keefe

Feeney

Hunter

et al. 2016

JARO

Self Cite

View full text Add to dashboard Cite

Power-based procedures are described to measure acoustic stapedius-muscle reflex threshold and supra-threshold responses in human adult and infant ears at frequencies from 0.2 to 8 kHz. The stimulus set included five clicks in which four pulsed activators were placed between each pair of clicks, with each stimulus set separated from the next by 0.79 s to allow for reflex decay. Each click response was used to detect the presence of reflex effects across frequency that were elicited by a pulsed broadband-noise or tonal activator in the ipsilateral or contralateral test ear. Acoustic reflex shifts were quantified in terms of the difference in absorbed sound power between the initial baseline click and the later four clicks in each set. Acoustic reflex shifts were measured over a 40-dB range of pulsed activators, and the acoustic reflex threshold was objectively calculated using a maximum 10 likelihood procedure. To illustrate the principles underlying these new reflex tests, reflex shifts in absorbed sound power and absorbance are presented for data acquired in an adult ear with normal hearing and in two infant ears in the initial and follow-up newborn hearing screening exams, one with normal hearing and the other with a conductive hearing loss. The use of absorbed sound power was helpful in classifying an acoustic reflex shift as present or absent. The resulting reflex tests are in use in a large study of wideband clinical diagnosis and monitoring of middle-ear and cochlear function in infant and adult ears.

show abstract

Section: Discussionmentioning

confidence: 80%

“…Group results using this new ASR test are described in Hunter et al (2016) for infant ears and in Feeney et al (2016) for adult ears with normal function.…”

Section: Introductionmentioning

confidence: 99%

Aural Acoustic Stapedius-Muscle Reflex Threshold Procedures to Test Human Infants and Adults

Keefe

Feeney

Hunter

et al. 2016

JARO

Self Cite

View full text Add to dashboard Cite

show abstract

“…ASR responses were measured in the present study in terms of WB reflex shifts in absorbed sound power across frequency using procedures described in Keefe et al (2017). Hunter et al (2017) reported that ASRTs in newborn infant ears passing a newborn hearing screening examination were significantly elevated in an ambient ASRT test compared with a pressurized ASRT test at TPP. They found that pressurized WB ASRTs measured in the real ear to broad band noise were significantly elevated in newborn infant ears with conductive and sensorineural hearing loss, thus demonstrating the clinical value of these tests.…”

Section: Acoustic Stapedius Muscle Reflex (Asr) Responsesmentioning

confidence: 99%

Identifying Otosclerosis with Aural Acoustical Tests of Absorbance, Group Delay, Acoustic Reflex Threshold, and Otoacoustic Emissions

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background Otosclerosis is a progressive middle-ear disease that affects conductive transmission through the middle ear. Ear-canal acoustic tests may be useful in the diagnosis of conductive disorders. This study addressed the degree to which results from a battery of ear-canal tests, which include wideband reflectance, acoustic stapedius muscle reflex threshold (ASRT), and transient evoked otoacoustic emissions (TEOAEs), were effective in quantifying a risk of otosclerosis and in evaluating middle-ear function in ears after surgical intervention for otosclerosis. Purpose To evaluate the ability of the test battery to classify ears as normal or otosclerotic, measure the accuracy of reflectance in classifying ears as normal or otosclerotic, and evaluate the similarity of responses in normal ears compared with ears after surgical intervention for otosclerosis. Research Design A quasi-experimental cross-sectional study incorporating case control was used. Three groups were studied: one diagnosed with otosclerosis before corrective surgery, a group that received corrective surgery for otosclerosis, and a control group. Study Sample The test groups included 23 ears (13 right and 10 left) with normal hearing from 16 participants (4 male and 12 female), 12 ears (7 right and 5 left) diagnosed with otosclerosis from 9 participants (3 male and 6 female), and 13 ears (4 right and 9 left) after surgical intervention from 10 participants (2 male and 8 female). Data Collection and Analysis Participants received audiometric evaluations and clinical immittance testing. Experimental tests performed included ASRT tests with wideband reference signal (0.25–8 kHz), reflectance tests (0.25–8 kHz), which were parameterized by absorbance and group delay at ambient pressure and at swept tympanometric pressures, and TEOAE tests using chirp stimuli (1–8 kHz). ASRTs were measured in ipsilateral and contralateral conditions using tonal and broadband noise activators. Experimental ASRT tests were based on the difference in wideband-absorbed sound power before and after presenting the activator. Diagnostic accuracy to classify ears as otosclerotic or normal was quantified by the area under the receiver operating characteristic curve (AUC) for univariate and multivariate reflectance tests. The multivariate predictor used a small number of input reflectance variables, each having a large AUC, in a principal components analysis to create independent variables and followed by a logistic regression procedure to classify the test ears. Results Relative to the results in normal ears, diagnosed otosclerosis ears more frequently showed absent TEOAEs and ASRTs, reduced ambient absorbance at 4 kHz, and a different pattern of tympanometric absorbance and group delay (absorbance increased at 2.8 kHz at the positive-pressure tail and decreased at 0.7–1 kHz at the peak pressure, whereas group delay decreased at positive and negative-pressure tails from 0.35–0.7 kHz, and at 2.8–4 kHz at positive-pressure tail). Using a multivariate predictor with...

show abstract

“…Using this power-based ASRT test in an ipsilateral mode, the present study describes the first reports on the mean ASRTs at TPP in a group of normal adult ears, and the test-retest reliability of the ASRT. Hunter et al (in press) presented group data for the ASRT in infants with normal, conductive and sensorineural hearing loss using procedures described in Keefe et al (in press).…”

Section: Introductionmentioning

confidence: 99%

Normative Wideband Reflectance, Equivalent Admittance at the Tympanic Membrane, and Acoustic Stapedius Reflex Threshold in Adults

et al. 2017

Self Cite

View full text Add to dashboard Cite

Objectives Wideband acoustic immittance (WAI) measures such as pressure reflectance, parameterized by absorbance and group delay, equivalent admittance at the tympanic membrane (TM), and acoustic stapedius reflex threshold (ASRT) describe middle-ear function across a wide frequency range, compared to traditional tests employing a single frequency. The objective of this study was to obtain normative data using these tests for a group of normal hearing adults and investigate test-retest reliability using a longitudinal design. Design A longitudinal prospective design was used to obtain normative test and retest data on clinical and WAI measures. Subjects were 13 males and 20 females (mean age = 25 y). Inclusion criteria included normal audiometry and clinical immittance. Subjects were tested on two separate visits approximately one month apart. Reflectance and equivalent admittance at the TM were measured from 0.25 to 8.0 kHz under three conditions: at ambient pressure in the ear canal and with pressure sweeps from positive to negative pressure (downswept) and negative to positive pressure (upswept). Equivalent admittance at the TM was calculated using admittance measurements at the probe tip which were adjusted using a model of sound transmission in the ear canal and acoustic estimates of ear-canal area and length. Wideband ASRTs were measured at tympanometric peak pressure (TPP) derived from the average TPP of downswept and upswept tympanograms. Descriptive statistics were obtained for all WAI responses, and wideband and clinical ASRTs were compared. Results Mean absorbance at ambient pressure and TPP demonstrated a broad band-pass pattern typical of previous studies. Test-retest differences were lower for absorbance at TPP for the downswept method compared to ambient pressure at frequencies between 1.0 and 1.26 kHz. Mean tympanometric peak-to-tail differences for absorbance were greatest around 1.0 to 2.0 kHz and similar for positive and negative tails. Mean group delay at ambient pressure and at TPP were greatest between 0.32 and 0.6 kHz at 200 to 300 μs, reduced at frequencies between 0.8 and 1.5 kHz, and increased above 1.5 kHz to around 150 μs. Mean equivalent admittance at the TM had a lower level for the ambient method than at TPP for both sweep directions below 1.2 kHz, but the difference between methods was only statistically significant for the comparison between the ambient method and TPP for the upswept tympanogram. Mean equivalent admittance phase was positive at all frequencies. Test-retest reliability of the equivalent admittance level ranged from 1 to 3 dB at frequencies below 1.0 kHz, but increased to 8 to 9 dB at higher frequencies. The mean wideband ASRT for an ipsilateral broadband noise activator was 12 dB lower than the clinical ASRT, but had poorer reliability. Conclusions Normative data for the WAI test battery revealed minor differences for results at ambient pressure compared to tympanometric methods at TPP for reflectance, group delay, and equivalent admittance level at the TM f...

show abstract

Pressurized Wideband Acoustic Stapedial Reflex Thresholds: Normal Development and Relationships to Auditory Function in Infants

Cited by 12 publications

References 30 publications

Aural Acoustic Stapedius-Muscle Reflex Threshold Procedures to Test Human Infants and Adults

Aural Acoustic Stapedius-Muscle Reflex Threshold Procedures to Test Human Infants and Adults

Identifying Otosclerosis with Aural Acoustical Tests of Absorbance, Group Delay, Acoustic Reflex Threshold, and Otoacoustic Emissions

Normative Wideband Reflectance, Equivalent Admittance at the Tympanic Membrane, and Acoustic Stapedius Reflex Threshold in Adults

Contact Info

Product

Resources

About