Smartphone-Based Hearing Test as an Aid in the Initial Evaluation of Unilateral Sudden Sensorineural Hearing Loss

Abstract

Sudden sensorineural hearing loss (SSNHL) can cause significant morbidity. Treatment with steroids can improve outcome. Delay in initiation of treatment reduces the chance to regain hearing. For this reason SSNHL is considered an emergency. Diagnosis is based on history, physical examination and a standard audiogram, the latter requiring specialized equipment and personnel. Standard audiogram may not be available at the time and place of patient presentation. A smartphone or tablet computer-based hearing test may aid in the decision to prescribe steroids in this setting. In this study the uHear™ hearing test application was utilized. The output of this ear-level air conduction hearing test is reported in hearing grades for 6 frequencies ranging from 250 to 6000 Hz. A total of 32 patients with unilateral SSNHL proven by a standard audiogram were tested. The results of standard and iPod hearing tests were compared. Based on the accepted criterion of SSNHL (at least 30 dB loss - or 2 hearing grades - in 3 consecutive frequencies) the test had a sensitivity of 0.76 and specificity of 0.91. Using a less stringent criterion of a loss of 2 hearing grades over at least 2 frequencies the sensitivity was 0.96 and specificity 0.86. The correlation coefficient for the comparison of the average hearing grade across the 6 measured frequencies of the study and standard audiogram was 0.83. uHear more accurately reflected hearing thresholds at mid and high tones. Similarly to previously published data, low frequency thresholds could be artificially elevated. In conclusion, uHear can be useful in the initial evaluation of patients with single-sided SSNHL by providing important information guiding the decision to initiate treatment before a standard audiogram is available.

Smartphone Based Audiometric Test for Confirming the Level of Hearing; Is It Useable in Underserved Areas?

“…These hearing applications were successful in demonstrating the close correspondence of the threshold values to those obtained via conventional audiometry. A different group of patients with unilateral sudden sensorineural hearing loss were tested with both conventional and smartphone-based audiometry by Handzel et al [22] . The results showed that the application test had a sensitivity of 76% and specificity of 91%.…”

Hearing loss in the developing world: Evaluating the iPhone mobile device as a screening tool

“…They reported large deviations in the lower frequencies, standard deviations of >10 dB at individual thresholds and a 34% increased pick-up rate of hearing loss. The third study, by Handzel et al, [26] tested participants with unilateral sudden sensorineural hearing loss using the uHear on an iPodTouch, and reported a sensitivity of 76% and a specificity of 91% when compared with a formal audiogram. Inaccurately elevated thresholds at low frequencies using uHear were also detected, corroborating the findings of the previous study.…”

“…[24,26] Secondly, even though low frequencies may be inaccurately elevated, [24][25][26] the degree of hearing loss in the participant with abnormal hearing can possibly be predicted in the high frequencies. [24,26] …”

Technology for hearing loss – as We Know it, and as We Dream it

“…In some instances, they are already utilized to provide an access point for services that include information/education, screening, and possibly diagnosis and interventions [29,30,31]. Future developments in telehealth for audiology will look to capitalize on the widespread penetration of smartphones and on their increasingly advanced capabilities alongside the rapidly expanding global reach of connectivity.…”