Audiometric Testing With Pulsed, Steady, and Warble Tones in Listeners With Tinnitus and Hearing Loss

Lentz, Jennifer J.; Walker, M.; Short, Ciara E.; Skinner, Kimberly G.

doi:10.1044/2017_aja-17-0009

Cited by 9 publications

(12 citation statements)

References 7 publications

(19 reference statements)

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“…The aided thresholds ( Figure 2b , c, e, f) were determined for warble tones as these tones do not produce standing wave patterns in the room. Note that thresholds to warble tones are similar to pure-tone thresholds for the frequencies of interest in our study (within 2 dB; Dockum & Robinson, 1975 ; Lentz et al, 2017 ).…”

Section: Methodssupporting

confidence: 74%

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

Sharma

Mens²,

Snik

et al. 2023

Trends in Hearing

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Many cochlear implant users with binaural residual (acoustic) hearing benefit from combining electric and acoustic stimulation (EAS) in the implanted ear with acoustic amplification in the other. These bimodal EAS listeners can potentially use low-frequency binaural cues to localize sounds. However, their hearing is generally asymmetric for mid- and high-frequency sounds, perturbing or even abolishing binaural cues. Here, we investigated the effect of a frequency-dependent binaural asymmetry in hearing thresholds on sound localization by seven bimodal EAS listeners. Frequency dependence was probed by presenting sounds with power in low-, mid-, high-, or mid-to-high-frequency bands. Frequency-dependent hearing asymmetry was present in the bimodal EAS listening condition (when using both devices) but was also induced by independently switching devices on or off. Using both devices, hearing was near symmetric for low frequencies, asymmetric for mid frequencies with better hearing thresholds in the implanted ear, and monaural for high frequencies with no hearing in the non-implanted ear. Results show that sound-localization performance was poor in general. Typically, localization was strongly biased toward the better hearing ear. We observed that hearing asymmetry was a good predictor for these biases. Notably, even when hearing was symmetric a preferential bias toward the ear using the hearing aid was revealed. We discuss how frequency dependence of any hearing asymmetry may lead to binaural cues that are spatially inconsistent as the spectrum of a sound changes. We speculate that this inconsistency may prevent accurate sound-localization even after long-term exposure to the hearing asymmetry.

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Section: Methodssupporting

confidence: 74%

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

Sharma

Mens²,

Snik

et al. 2023

Trends in Hearing

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show abstract

“…Hence, we expected that the range of elevations of TEN threshold that we observed would be shifted downward relative to those obtained from the regular TEN(HL) test. This lowering would also be true for the absolute thresholds obtained by pulsed tones, and has been reported, on average to be approximately 2 dB (Lentz et al 2017). The decision in this article to use the more conservative figure of 15 dB HL as the upper bound for "normal" hearing is based on this finding (where the absolute threshold was obtained by pulsed tones).…”

Section: Methodsmentioning

confidence: 78%

“…However, some pilot trials showed that participants with tinnitus performed more reliably when the probe tone was pulsed, rather than the usual continuous-presentation method. Lentz et al (2017 ) recommend the use of pulsed tones over warble or steady tones when tinnitus is present to obtain more accurate audiograms. The tones were therefore presented pulsed.…”

Section: Methodsmentioning

confidence: 99%

Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the “Normal” Audiogram Range

et al. 2022

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Objectives:The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear "dead regions" (i.e., regions of loss of inner hair cell [IHC] connectivity), using a "pass/fail" criterion based on the degree of elevation of a masked threshold in a tonedetection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a "fail" diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells.Design: One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their puretone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience.Results: Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of "normal" hearing (absolute thresholds ≤15 dB HL).Conclusions: Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically "normal" hearing. Results from the TEN test residing between "pass" and "fail" are dominated by processes not related to IHCs. The TEN test for IHCrelated function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.

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“…The consistency of the performance of the subjects was determined using two measures, the false alarm rate and the steepness of the psychometric function. The two subjects who produced false positives at a rate of 10% or more both reported having tinnitus, and this may have contributed to their relatively high false-positive rates, if the pitch of their tinnitus was close to that of the signal (see also Lentz, Walker, Short, & Skinner, 2017 ). For the other subjects, the false alarm rate of 1% on average was exactly the fixed value that was applied in Equation 1 .…”

Section: Discussionmentioning

confidence: 99%

A Hearing-Model-Based Active-Learning Test for the Determination of Dead Regions

2018

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This article describes a Bayesian active-learning procedure for estimating the edge frequency, fe, of a dead region, that is, a region in the cochlea with no or very few functioning inner hair cells or neurons. The method is based on the psychophysical tuning curve (PTC) but estimates the shape of the PTC from the parameters of a hearing model, namely fe, and degree of outer hair cell loss. It chooses the masker frequency and level for each trial to be highly informative about the model parameters in the context of previous data. The procedure was tested using 14 ears from eight subjects previously diagnosed with high-frequency dead regions. The estimates of fe agreed well with estimates obtained using “Fast PTCs” or more extensive measurements from an earlier study. On average, 33 trials were needed for the estimate of fe to fall and stay within 0.3 Cams of the final “true” value on the equivalent rectangular bandwidth-number scale. The time needed to obtain a reliable estimate was 5 to 8 min. This is comparable to the time required for Fast PTCs and short enough to be used when fitting a hearing aid. Compared with Fast PTCs, the new method has the advantage of using yes-no judgments rather than continuous Békésy tracking. This allows the slope of a subject’s psychometric function and thus the reliability of his or her responses to be estimated, which in turn allows the test duration to be adjusted so as to achieve a given accuracy.

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Audiometric Testing With Pulsed, Steady, and Warble Tones in Listeners With Tinnitus and Hearing Loss

Cited by 9 publications

References 7 publications

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the “Normal” Audiogram Range

A Hearing-Model-Based Active-Learning Test for the Determination of Dead Regions

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