Clinical reliability of bone conduction audiometry

Carhart, Raymond; Hayes, Claude S.

doi:10.1002/lary.5540591003

Cited by 46 publications

(10 citation statements)

References 5 publications

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“…This phenomenon was first reported by Carhart [1] in 1949. Later, he demonstrated an improvement in the BC threshold after successful fenestration surgery for otosclerosis, and this depression in the BC threshold was designated the Carhart notch.…”

Section: Introductionmentioning

confidence: 81%

Evaluation of the Carhart Effect in Congenital Middle Ear Malformation with Both an Intact External Ear Canal and a Mobile Stapes Footplate

Sakamoto

Kakigi²,

Kashio³

et al. 2011

ORL

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The medical charts of 41 ears with congenital middle ear malformation with both an intact external ear canal and a mobile stapes footplate were reviewed retrospectively to study the Carhart effect. The operations were categorized as successful or unsuccessful according to the extent of decrease in the average air-bone gap. Statistically significant differences were observed between the 2 groups with respect to the changes in pure-tone average and the changes in the bone conduction (BC) threshold at 1 and 2 kHz. Linear regression analysis revealed weak correlations between the change in the BC threshold and the postoperative BC threshold at an overall level and at the 4 frequencies tested. Stapes ankylosis is a main cause of the Carhart effect. The present study showed that in congenital middle ear malformation, the Carhart effect was caused not only by stapes ankylosis but also by other types of disruption in the ossicular chain.

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Section: Introductionmentioning

confidence: 81%

Evaluation of the Carhart Effect in Congenital Middle Ear Malformation with Both an Intact External Ear Canal and a Mobile Stapes Footplate

Sakamoto

Kakigi²,

Kashio³

et al. 2011

ORL

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“…This means that in otosclerosis, BC thresholds do not always reflect sensorineural cochlear function. In 1949, Carhart already assumed the BC hearing loss in otosclerosis to be at least in part a mechanical suppression of inner ear function due to the fixed stapes footplate [Carhart and Hayes, 1949]. This was demonstrated after successful fenestration surgery, when the postoperative audiograms showed improved BC hearing (on average by 5 dB at 500 Hz, 10 dB at 1000 Hz, 15 dB at 2000 Hz and 5 dB at 4000 Hz).…”

Section: Introductionmentioning

confidence: 89%

Influence of a Totally Open Oval Window on Bone Conduction in Otosclerosis

et al. 2010

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Objective: The aim of this study was to evaluate changes in bone conduction thresholds before, during and after total stapedectomy. Study Design: Prospective clinical study. Methods: In 27 ears of 26 patients undergoing stapedectomy under local anesthesia, bone conduction was measured before surgery, during surgery under open oval window conditions, and after the insertion of a steel wire connective tissue prosthesis. Statistical data analysis was performed on the audiometric results. Results: Under open oval window conditions, bone conduction hearing was found to be improved between 500 and 2000 Hz, but not at 4000 Hz. After insertion of the prosthesis, an additional improvement was evident at 500 and 1000 Hz, but a loss was seen at 2000 and 4000 Hz. Conclusion: This is the first investigation reported in which audiometry was performed under open oval window conditions during stapes surgery. Our results demonstrate that at least part of the preoperative bone conduction hearing loss in otosclerosis must be of mechanical, but not of sensorineural origin, as already suspected by Carhart. The fixed footplate suppresses cochlear micromechanics mainly at frequencies between 500 to 2000 Hz. Furthermore, the loss in bone conduction hearing at 2000 and 4000 Hz after insertion of the prosthesis indicates that rather than the surgical procedure of total removal of the footplate, other factors such as the handling of the prosthesis or its mechanical properties after insertion cause high-frequency hearing loss after stapes surgery.

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“…The study of test-retest variability of pure tone thresholds has a long history (Carhart & Hayes, 1949; Atherley & Dingwall-Fordyce, 1963; Dobie, 1983), and some have argued that the high variability of pure tone thresholds obtained in occupational settings compromise the usefulness of such data (Hetu, 1979; Atherley & Johnston, 1981). This position is inarguable in cases where inconsistent procedures, inadequate test environments and hardware, etc.…”

mentioning

confidence: 99%

Short-term variability of pure-tone thresholds obtained with TDH-39P earphones

Flamme

Stephenson

Deiters

et al. 2014

International Journal of Audiology

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Objective To estimate the short-term variability and correlates of variability in pure-tone thresholds obtained using audiometric equipment designed for occupational use, and to examine the justification for excluding 8 kHz as a mandatory threshold in occupational hearing conservation programs. Method Pure-tone thresholds and other hearing-related tests (e.g., noise dosimetry, otoscopy, middle ear assessment) were conducted with a group of 527 adults between 20 and 69 years of age. A total of five measurement visits were completed by participants within a 14-day period. Results The 50 % critical difference boundaries were −5 and 0 dB at 4 kHz and below and −5 and 5 dB at 6 and 8 kHz. The likelihood of spurious notches due to test-retest variability was substantially lower than the likelihood of failing to detect a notched configuration when present. Correlates of variability included stimulus frequency, baseline threshold, acoustic reflectance of the ear, average noise exposure during the previous 8 hours, age, and the tester’s level of education in audiology. Conclusion The short-term variability in 8 kHz pure tone thresholds obtained with the TDH-39P earphone was slightly greater than at other frequencies, but this difference was not large enough to justify the disadvantages stemming from the inability to detect a 6 kHz notch.

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Clinical reliability of bone conduction audiometry

Cited by 46 publications

References 5 publications

Evaluation of the Carhart Effect in Congenital Middle Ear Malformation with Both an Intact External Ear Canal and a Mobile Stapes Footplate

Evaluation of the Carhart Effect in Congenital Middle Ear Malformation with Both an Intact External Ear Canal and a Mobile Stapes Footplate

Influence of a Totally Open Oval Window on Bone Conduction in Otosclerosis

Short-term variability of pure-tone thresholds obtained with TDH-39P earphones

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