Masking and Bone Conduction Testing in Brainstem Response Audiometry

Weber, Bruce A.

doi:10.1055/s-0028-1094196

Cited by 13 publications

(14 citation statements)

References 16 publications

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“…Testing only with air-conducted stimuli may result in a large number of false positives due to transient middle ear pathologies (Weber, 1983;Cone-Wesson, 1995). Hooks & Weber (1984) conducted air and bone ABR testing on a group of infants in an intensive care nursery and concluded that a combination of air-conduction and bone-conduction screenings in the intensive care nursery resulted in a marked reduction of false positive responses in comparison to air-conduction testing alone.…”

Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 97%

“…First, the maximum intensity level for the bone vibrator is 50 to 60 dB nHL, compared to a maximum intensity of 90 to 100 dB nHL for an airconduction click (Mauldin & Jerger, 1979;Weber, 1983;Hall, 1994). This limits the degree of sensorineural hearing loss that can be assessed using a bone-conducted click to about 40 dB nHL.…”

Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 99%

“…This is because the maximum bone-conduction output of most ABR systems for clicks is about 55 dB nHL, and the lowest level at which responses are observed is about 15 dB nHL. Moreover, bone-conduction ABR responses can be important for estimating sensorineural acuity in young children with congenital atresia (Weber, 1983;Hall, 1994).…”

Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 99%

“…Weber (1983) states that the longer latency for bone-conduction stimulation is primarily due to the longer transmission along the basilar membrane as the wave travels to a more apical region of the cochlea. However, several authors have cautioned that the filtering effects of the skull make it difficult to determine the frequency composition of the boneconducted click that reaches the cochlea (Arlinger, 1981;Harder et al, 1983;Weber, 1983;Kramer, 1992;Gorga et al, 1993). Arlinger (1981) states that the output signal from an artificial mastoid has no useful relation to the waveform reaching the cochlea from a bone vibrator.…”

Section: Introductionmentioning

confidence: 99%

“…Auditory sensitivity is usually estimated by finding the lowest intensity that yields an identifiable Wave V. Although air-conducted stimuli are commonly employed, several investigators advocate using bone-conducted stimuli for screening infants with hearing loss or for ascertaining the presence and magnitude of a conductive hearing loss (Kavanagh & Beardsley, 1979;Mauldin & Jerger, 1979;Borg et al, 1981;Weber, 1983;Hooks & Weber, 1984;Tucci et al, 1990;Yang et al, 1993;Hall, 1994;Cone-Wesson, 1995;Muchnik et al, 1995). Hall (1994) suggests that clinicians should routinely conduct bone-conduction ABR testing whenever the air-conduction ABR results are abnormal and there is any suggestion of middle ear pathology.…”

Section: Introductionmentioning

confidence: 99%

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Normative Wave V Latency-Intensity Functions Using the EARTONE 3A Insert Earphone and the Radioear B-71 Bone Vibrator

Beattie

1998

Scandinavian Audiology

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Early auditory evoked response (ABR) audiometry is useful for estimating auditory sensitivity in infants and other difficult-to-test populations. Several investigations advocate using bone-conducted stimuli, in addition to air-conducted stimuli, for screening infants with hearing loss or for ascertaining the presence and magnitude of a conductive hearing loss. The present study was designed to gather normative Wave V latency-intensity data with an insert earphone (EARTONE 3A) and a bone vibrator (Radioear B-71). Forty normal-hearing subjects were tested with air-conducted and bone-conducted clicks at intensities of 55, 40, 30, 20, and 10 dB SL. The stimulus waveforms showed a click onset delay of 0.1 ms for the 3A insert earphone. It is important to note that our ABR latencies were not adjusted to account for these differences. The results revealed that both the air-conduction and bone-conduction functions exhibited Wave V latencies of 7.0 ms at 55 dB SL. Although both functions exhibited increased latencies as intensity decreased to 10 dB SL, the air-conducted clicks yielded somewhat longer latencies than the bone-conducted clicks. To allow direct comparison of the air-conduction and bone-conduction latency-intensity function, the bone-conduction function must be corrected by approximately +0.3 ms at 40 dB, +0.4 ms at 30 dB, +0.5 ms at 20 dB, and +0.8 ms 10 dB nHL. No correction is needed at 55 dB. The present study suggests that it may not be appropriate to apply a single correction value (e.g., 0.5 ms) to the entire latency-intensity function. If clinicians elect to use published latency-intensity data, they must employ procedure similar to those that were used to collect the normative data. Otherwise, individual clinics should generate normative latency-intensity data using well-defined procedures. An alternative to generating latency-intensity functions is to compare ABR air-conduction and bone-conduction thresholds. This procedure is advantageous because threshold responses are not as sensitive as latency measures to slight changes in instrumentation and procedures. The normative air-conduction and/or bone-conduction values presented in this investigation are offered as a baseline for either latency-intensity or threshold comparisons.

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Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 97%

Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 99%

Section: Air and Bone Abr L-i Functions 123mentioning

confidence: 99%