Comparative Study on Method of Threshold Estimation: Distortion Product Threshold Test versus Pure Tone Threshold Test

Abstract Introduction Distortion product otoacoustic emissions (DPOAEs) can be helpful in estimating the hearing thresholds by extrapolating the DPOAE input/output function with the help of scissor paradigm, and thus the following study aims at assessing its reliability by comparing DPOAE thresholds with those obtained by behavioral responses at pure tones on various frequencies. Materials and Methods Fifty participants having normal hearing sensitivity were included in the study. Pure tone (PT) audiometry was carried out on all participants to determine PT thresholds in both ears. DPOAE threshold test was administered and thresholds at 1, 2, 4, and 8 kHz were compared accordingly. Results The result indicated significant difference between the two methods of threshold estimation where the mean difference was found to be 3 decibel (dB) and 4 dB for left and right ears, respectively. Shapiro-Wilk test revealed normal distribution (p > 0.05) of the data. Hence, parametric paired t-test was performed, which revealed significant difference between PT and distortion product thresholds. Conclusion Study concludes as having good clinical applicability in assessing neonates and infants.

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Hubungan ototoksisitas dan kemoterapi neoadjuvan pada karsinoma nasofaring berdasarkan ASHA, CTCAE, dan DPOAE

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v47i2.219 ◽

2018 ◽

Vol 47 (2) ◽

pp. 102

Author(s):

Meyrna Heryaning Putri ◽

Pudji Rahaju ◽

Dyah Indrasworo

Keyword(s):

Neoadjuvant Chemotherapy ◽

Early Detection ◽

Adverse Events ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Distortion Product Otoacoustic Emissions ◽

Hearing Level ◽

Type Iii ◽

Distortion Product ◽

Significant Difference

Latar belakang: Kemoterapi neoadjuvan adalah induksi kemoterapi sebelum radioterapi dengan regimen cisplatin dan 5-Fluorouracil. Kemoterapi cisplatin bersifat ototoksik pada pendengaran sensorineural bilateral progresif dan bersifat irreversible. Kriteria dari American Speech-Language Hearing Association (ASHA) dan Common Terminology Criteria for Adverse Events (CTCAE) merupakan kriteria untuk mengidentifikasi ototoksisitas dengan menggunakan audiometri, selain pemeriksaan Distortion Product Otoacoustic Emissions (DPOAE). Tujuan: Mengidentifikasi hubungan ototoksisitas dengan kemoterapi neoadjuvan pada penderita karsinoma nasofaring (KNF) WHO tipe III menggunakan ASHA, CTCAE, serta DPOAE. Metode: Studi ini adalah penelitian observasional dengan desain cohort. Kriteria inklusi penelitian yaitu penderita baru KNF WHO tipe III, yang mendapatkan kemoterapi regimen standar dan berusia <60 tahun. Kriteria pemeriksaan DPOAE adalah penderita dengan ambang dengar ≤40 dB. Percontoh dilakukan pemeriksaan timpanometri, audiometri, dan DPOAE. Hasil: Terdapat 9 sampel percontoh penelitian. Uji repeated-ANOVA menunjukkan tidak ditemukan perbedaan bermakna pada tiga hasil pengukuran audiometri antara pascakemoterapi pertama, kedua, dan ketiga (p>0,05). Deteksi awal ototoksisitas menggunakan kriteria ASHA menunjukkan sensitivitas sebesar 67% dan dan CTCAE 44%, dibandingkan baku emas menggunakan DPOAE. Kesimpulan: Ototoksisitas cisplatin ditemukan sejak kemoterapi pertama dengan menggunakan pemeriksaan DPOAE walaupun tidak bermakna secara statistik. Kemampuan DPOAE untuk mendeteksi awal ototoksisitas lebih baik dibandingkan kriteria ASHA dan CTCAE yang menggunakan audiometri nada murni.Kata kunci: Karsinoma nasofaring, ototoksisitas sisplatin, DPOAE, CTCAE, ASHA ABSTRACT Introduction: Neoadjuvant chemotherapy is induction chemotherapy before radiotherapy with cisplatin and 5-Fluorouracyl regiment. Chemotherapy cisplatin is ototoxic, leads to frequently progresive and irreversible bilateral sensorineural hearing loss. American Speech-Language Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE) are the criteria to determine ototoxicity with audiometry, beside Distortion Product Otoacoustic Emissions (DPOAE). Purpose: To identify the relationship between ototoxicity with neoadjuvant chemotherapy in patients NPC WHO type III using ASHA, CTCAE, and DPOAE. Method: This observational study approach with cohort design. Inclusion criteria: new patients NPC WHO type III who consented to undergo standard regiment chemotherapy, and age <60 year-old. For DPOAE examination: hearing level ≤40 dB. Exclucion criteria: NPC WHO type III patients who underwent chemotherapy with unconventional standard regiment. Examinations for hearing function conducted with tympanometry, pure tone audiometry, and Distortion Product Otoacoustic Emissions (DPOAE). Result: There were 9 sample in this study. The result of Repeated-ANOVA test showed no significant difference in three audiometry measurements among three series of chemotherapies. Early detection of ototoxicity using ASHA and CTCAE criterias showed sensitivity of 67% and 44% (compared with DPOAE as a gold standard). Conclusion: Cisplatin ototoxicity had occured since the first chemotherapy and detected with DPOAE, but statistically was not significantly related. Early detection of cisplatin ototoxicity with DPOAE was much better than with criteria American Speech-Language Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE), which used pure tone audiometry.Keywords: Nasopharyngeal carcinoma, cisplatin ototoxicity, DPOAE, CTCAE, ASHA

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Acute Alcohol Intake Deteriorates Hearing Thresholds and Speech Perception in Noise

Audiology and Neurotology ◽

10.1159/000510694 ◽

2020 ◽

pp. 1-8

Author(s):

Hyo Geun Choi ◽

Sung Kwang Hong ◽

Hyo-Jeong Lee ◽

Jiwon Chang

Keyword(s):

Speech Perception ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Alcohol Intake ◽

Human Subjects ◽

Pure Tone Audiometry ◽

Distortion Product Otoacoustic Emission ◽

Speech Perception In Noise ◽

Distortion Product ◽

Hearing Thresholds

Objectives: The hearing process involves complex peripheral and central auditory pathways and could be influenced by various situations or medications. To date, there is very little known about the effects of alcohol on the auditory performances. The purpose of the present study was to evaluate how acute alcohol administration affects various aspects of hearing performance in human subjects, from the auditory perceptive threshold to the speech-in-noise task, which is cognitively demanding. Methods: A total of 43 healthy volunteers were recruited, and each of the participants received calculated amounts of alcohol according to their body weight and sex with a targeted blood alcohol content level of 0.05% using the Widmark formula. Hearing was tested in alcohol-free conditions (no alcohol intake within the previous 24 h) and acute alcohol conditions. A test battery composed of pure-tone audiometry, speech reception threshold (SRT), word recognition score (WRS), distortion product otoacoustic emission (DPOAE), gaps-in-noise (GIN) test, and Korean matrix sentence test (testing speech perception in noise) was performed in the 2 conditions. Results: Acute alcohol intake elevated pure-tone hearing thresholds and SRT but did not affect WRS. Both otoacoustic emissions recorded with DPOAE and the temporal resolution measured with the GIN test were not influenced by alcohol intake. The hearing performance in a noisy environment in both easy (−2 dB signal-to-noise ratio [SNR]) and difficult (−8 dB SNR) conditions was decreased by alcohol. Conclusions: Acute alcohol elevated auditory perceptive thresholds and affected performance in complex and difficult auditory tasks rather than simple tasks.

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Tinnitus in adolescents: the start of the vulnerability of the auditory pathways

CoDAS ◽

10.1590/2317-1782/20152013045 ◽

2015 ◽

Vol 27 (1) ◽

pp. 5-12 ◽

Cited By ~ 6

Author(s):

Tanit Ganz Sanchez ◽

Juliana Casseb Oliveira ◽

Márcia Akemi Kii ◽

Katya Freire ◽

Jaci Cota ◽

...

Keyword(s):

Private School ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Common Symptom ◽

Distortion Product ◽

Hearing Thresholds ◽

High Frequency Audiometry ◽

Significant Difference ◽

Hearing Damage

INTRODUCTION: Although tinnitus is an increasingly common symptom, few studies have assessed its prevalence or incidence among adolescents. PURPOSE: To assess whether the presence of tinnitus in adolescents is associated with minimal hearing damage, evaluated through high-frequency audiometry (HFA), otoacoustic emission (OAE), and loudness discomfort level (LDL). METHODS: The sample comprised 168 adolescents of a private school (61.3% boys; mean age 14.1 years old; standard deviation=2). All of them completed a questionnaire about tinnitus and hypersensitivity to sounds (sound intolerance), and then underwent otoscopy, pure-tone audiometry, HFA, LDL, transient and distortion product otoacoustic emissions (TOAE and DPOAE), and tinnitus pitch/loudness matching (the latter only in those with tinnitus). Participants were later divided into three groups: with no tinnitus (n=73, 43.4%), with sporadic tinnitus (n=47, 28%), and with constant tinnitus (n=48, 28.6%). RESULTS: No significant difference was observed between the groups regarding audiometry thresholds in frequencies from 0.25 to 16 kHz, or TOAE and DPOAE. However, the LDL in adolescents with constant tinnitus was significantly lower than that in other groups, suggesting hypersensitivity to sounds. CONCLUSION: There was no evidence of minimal hearing damage in the audiometry and OAE. Nonetheless, the decreased LDL in adolescents with constant tinnitus suggests that their auditory system is more sensitive. Therefore, this may be the first sign of vulnerability to sounds. Future medium- to long-term monitoring of these students may show whether they will begin a process of functional impairment, altering hearing thresholds, and OAE.

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Noise Levels Among Spectators at an Intercollegiate Sporting Event

American Journal of Audiology ◽

10.1044/1059-0889(2013/12-0071) ◽

2014 ◽

Vol 23 (1) ◽

pp. 71-78 ◽

Cited By ~ 6

Author(s):

Beau England ◽

Jeffery Blythe Larsen

Keyword(s):

Otoacoustic Emissions ◽

Noise Exposure ◽

Sporting Events ◽

Noise Levels ◽

Hearing Sensitivity ◽

Distortion Product ◽

Sound Levels ◽

Basketball Game ◽

Hearing Thresholds ◽

The Impact

Purpose The intensity of noise levels in a basketball arena during games, as well as the hearing sensitivity of attendees, was measured for the purpose of assessing the impact of the noise on hearing thresholds. Method Noise levels at 10 intercollegiate basketball games were measured with a dosimeter affixed on the shoulders of attendees. Hearing thresholds and distortion product otoacoustic emissions were measured for 20 participants just before attending a basketball game and within an hour of the end of the game to determine whether changes in hearing thresholds resulted from exposure to the sound levels within the arena during the games. Results Participants demonstrated temporary shifts in pure-tone thresholds and reductions in the intensity of their otoacoustic emissions after attendance at 1 of the basketball games. Dosimeter measurements showed that noise at 6 of the 10 basketball games exceeded acceptable intensity levels when compared with a national workplace noise exposure standard. Conclusion Although noise intensities, on average, did not exceed workplace exposure standards, universities would be wise to be proactive in warning spectators about the potential dangers of noise exposure at sporting events, make earplugs available to interested spectators, and implement a hearing conservation program for employees working in noise.

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Evaluation of the effects of Covid-19 on cochleovestibular system with audiovestibular tests

Ear Nose & Throat Journal ◽

10.1177/01455613211069916 ◽

2022 ◽

pp. 014556132110699

Author(s):

Kazım Bozdemir ◽

Elif Ersoy Çallıoğlu ◽

Yüce İslamoğlu ◽

Mehmet Kadir Ercan ◽

Fatma Eser ◽

...

Keyword(s):

Otoacoustic Emissions ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Semicircular Canals ◽

Outer Hair Cells ◽

Head Impulse Test ◽

Control Group ◽

Caloric Test ◽

Distortion Product ◽

Significant Difference

Purpose The purpose of the present study was to investigate the effects of COVID-19 on audiovestibular system with Transiently Evoked Distortion Otoacoustic Emissions (TOAE), Distortion Product Otoacoustic Emissions (DPOAE), video head impulse test (vHIT) and caloric test. Methods Audiovestibular findings of 24 patients with moderate/severe COVID-19 and 24 healthy controls were compared using pure tone audiometry, tympanometry, TOAE, DPOAE, caloric test, and vHIT. Results On audiometry, the pure tone averages of the COVID-19 patients were higher than the controls ( P = .038). The TEOAE amplitudes at 4000 and 5000 Hz ( P = .006 and P < .01), and DPOAE amplitudes at 3000, 6000, and 8000 Hz ( P < .001, P = .003 and P < .001) were significantly lower in COVID-19 patients compared to the controls. On vestibular tests, there was no significant difference between the caloric test results of the patients and the controls ( P > .05). On vHIT testing, amplitudes of right semicircular canal was found to be significantly lower in COVID-19 group compared to the control group ( P = .008). Conclusion COVID-19 may affect inner ear functions causing a subtle damage in the outer hair cells and lateral semicircular canals. It must be kept in mind that COVID-19 may cause cochleovestibular problems.

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Effects of Bluetooth device electromagnetic field on hearing: pilot study

The Journal of Laryngology & Otology ◽

10.1017/s0022215112000047 ◽

2012 ◽

Vol 126 (4) ◽

pp. 345-348 ◽

Cited By ~ 5

Author(s):

R Balachandran ◽

N Prepagaran ◽

O Rahmat ◽

A B Zulkiflee ◽

K S Hufaida

Keyword(s):

Electromagnetic Field ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Otoacoustic Emission ◽

Distortion Product ◽

Emission Testing ◽

Hearing Function ◽

Hearing Thresholds ◽

Low Emission ◽

Full Power

AbstractBackground:The Bluetooth wireless headset has been promoted as a ‘hands-free’ device with a low emission of electromagnetic radiation.Objective:To evaluate potential changes in hearing function as a consequence of using Bluetooth devices, by assessing changes in pure tone audiography and distortion production otoacoustic emissions.Design:Prospective study.Materials and methods:Thirty adult volunteers were exposed to a Bluetooth headset device (1) on ‘standby’ setting for 6 hours and (2) at full power for 10 minutes. Post-exposure hearing was evaluated using pure tone audiography and distortion production otoacoustic emission testing.Results:There were no statistically significant changes in hearing, as measured above, following either exposure type.Conclusion:Exposure to the electromagnetic field emitted by a Bluetooth headset, as described above, did not decrease hearing thresholds or alter distortion product otoacoustic emissions.

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The Effects of Short-Term and Long-term Hearing Changes on Music Exposure: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062091 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2091 ◽

Cited By ~ 1

Author(s):

Sunghwa You ◽

Tae Hoon Kong ◽

Woojae Han

Keyword(s):

Effect Size ◽

Otoacoustic Emissions ◽

Meta Analysis ◽

Scientific Evidence ◽

Short Term ◽

Hearing Sensitivity ◽

Distortion Product ◽

Hearing Thresholds ◽

Hearing Outcomes

The present study explores the scientific evidence on whether music exposure temporarily or permanently affects hearing sensitivity in young adults. Six electronic databases were searched using related keywords for the four categories of personal listening devices, listening habits, hearing outcomes, and age. The Hedges’ g and its 95% confidence intervals (CIs) were estimated. A Higgins I2 was also used to check for heterogeneity. To test for publication bias, funnel plots were drawn using Egger’s regression. Based on the inclusion criteria, 16 studies were divided into two groups to identify short-term hearing changes (n = 7) and long-term hearing changes (n = 9). In the short term, there was no significant immediate change in the thresholds or amplitudes after the music exposure, although pure-tone thresholds (PTAs) and distortion product otoacoustic emissions (DPOAEs) did show the highest effect size (−0.344, CI −0.727 to 0.038) and (0.124, CI −0.047 to 0.296) at 4 kHz. On the other hand, for long-term hearing changes, the PTA provided the highest effect size at 6 kHz (−0.525, CI −0.897 to −0.154) and 8 kHz (–0.486, CI −0.819 to −0.152), while also implying that habitual and repeated personal listening device (PLD) usage can act on some significant hearing changes in audiological tests. We conclude that the use of a PLD produces a few temporary hearing changes at 4 kHz after its use but that the changes are then reversed. However, it is important to note heavy PLD users’ experience regarding permanent changes in their hearing thresholds at high frequencies, and the public should be educated on this issue.

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Pure-Tone Hearing Thresholds and Otoacoustic Emissions in Students of Music Academies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031313 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1313

Author(s):

Małgorzata Pawlaczyk-Łuszczyńska ◽

Małgorzata Zamojska-Daniszewska ◽

Adam Dudarewicz ◽

Kamil Zaborowski

Keyword(s):

Otoacoustic Emissions ◽

Pure Tone ◽

Noise Exposure ◽

Signal To Noise Ratio ◽

Pure Tone Audiometry ◽

Music Students ◽

Control Group ◽

Exposure Level ◽

Distortion Product ◽

Hearing Thresholds

The objective of this study was to assess the hearing of music students in relation to their exposure to excessive sounds. A standard pure-tone audiometry, transient-evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were determined in 163 students of music academies, aged 22.8 ± 2.6 years. A questionnaire survey and sound pressure level measurements during solo and group playing were also conducted. The control group comprised 67 subjects, mainly non-music students, aged 22.8 ± 3.3 years. Study subjects were exposed to sounds at the A-weighted weekly noise exposure level (LEX,w) from 75 to 106 dB. There were no significant differences in the hearing thresholds between groups in the frequency range of 4000–8000 Hz. However, music students compared to control group exhibited lower values of DPOAE amplitude (at 6000 and 7984 Hz) and signal-to-noise ratio (SNR) (at 984, 6000, and 7984 Hz) as well as SNR of TEOAE (in 1000 Hz band). A significant impact of noise exposure level, type of instrument, and gender on some parameters of measured otoacoustic emissions was observed. In particular, music students having LEX,w ≥ 84.9 dB, compared to those with LEX,w < 84.9 dB, achieved significantly lower DPOAE amplitude at 3984 Hz. Meanwhile, both TEOAE and DPOAE results indicated worse hearing in students playing percussion instruments vs. wind instruments, and wind instrument players vs. students playing stringed instruments.

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Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20184353 ◽

2018 ◽

Vol 4 (6) ◽

pp. 1417

Author(s):

Subodh Kumar ◽

Awadhesh Kumar Mishra ◽

Ajay Mallick ◽

Ashwani Sethi

Keyword(s):

Hearing Loss ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Tertiary Care ◽

Care Hospital ◽

Distortion Product ◽

Significant Difference ◽

Group A ◽

Group B

Background: A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.Methods: We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated. Results: Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.Conclusions: Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.

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Evaluation of Efferent Auditory System and Hearing Quality in Parkinson's Disease: Is the Difficulty in Speech Understanding in Complex Listening Conditions Related to Neural Degeneration or Aging?

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-20-00337 ◽

2020 ◽

pp. 1-9

Author(s):

Nuriye Yıldırım Gökay ◽

Bülent Gündüz ◽

Fatih Söke ◽

Recep Karamert

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Auditory System ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Auditory Pathway ◽

Normal Hearing ◽

System Function ◽

Distortion Product

Purpose The effects of neurological diseases on the auditory system have been a notable issue for investigators because the auditory pathway is closely associated with neural systems. The purposes of this study are to evaluate the efferent auditory system function and hearing quality in Parkinson's disease (PD) and to compare the findings with age-matched individuals without PD to present a perspective on aging. Method The study included 35 individuals with PD (mean age of 48.50 ± 8.00 years) and 35 normal-hearing peers (mean age of 49 ± 10 years). The following tests were administered for all participants: the first section of the Speech, Spatial and Qualities of Hearing Scale; pure-tone audiometry, speech audiometry, tympanometry, and acoustic reflexes; and distortion product otoacoustic emissions (DPOAEs) and contralateral suppression of DPOAEs. SPSS Version 25 was used for statistical analyses, and values of p < .05 were considered statistically significant. Results There were no statistically significant differences in the pure-tone audiometry thresholds and DPOAE responses between the individuals with PD and their normal-hearing peers ( p = .732). However, statistically significant differences were found between the groups in suppression levels of DPOAEs and hearing quality ( p < .05). In addition, a statistically significant and positive correlation was found between the amount of suppression at some frequencies and the Speech, Spatial and Qualities of Hearing Scale scores. Conclusions This study indicates that medial olivocochlear efferent system function and the hearing quality of individuals with PD were affected adversely due to the results of PD pathophysiology on the hearing system. For optimal intervention and follow-up, tasks related to hearing quality in daily life can also be added to therapies for PD.

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