Pure-tone audiometry without bone-conduction thresholds: using the digits-in-noise test to detect conductive hearing loss

Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment–related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual’s risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71–0.88) and its specificity was 0.84 (95% CI = 0.76–0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53–0.75) and its specificity was 0.71 (95% CI = 0.62–0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.

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Monitoring of conductive hearing loss due to because of eustachian tube dysfunction preservative treated with the Otovent pneumotherapy method.

Journal of Medical Science ◽

10.20883/jms.2018.302 ◽

2018 ◽

Vol 87 (3) ◽

pp. 133-137

Author(s):

Małgorzata Nowak ◽

Beata Wolnowska ◽

Alicja Sekula

Keyword(s):

Hearing Loss ◽

Eustachian Tube ◽

Research Group ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Control Group ◽

Tube Obstruction ◽

Before And After ◽

Conductive Hearing

INTRODUCTION. A conductive hearing loss is a very common problem in childhood. It is possible to indicate many reasons for the problem, but most of the times it is caused by the infectious process, as well as the typical adenoid hypertrophy in children. Very often this disease is associated with obstruction of the eustachian tube.OBJECTIVE. In this study, the authors present the results of the hearing tests of patients who underwent the treatment of the eustachian tube obstruction by pneumotherapy with otovent. The aim of the work was to monitor the effectiveness of this method of OME treatment.RESEARCH GROUP AND METHODOLOGY. The research group consisted of 54 children aged 4 to 15 years, including 23 girls and 31 boys. The control group consisted of 16 children. Pure tone audiometry and impedance audiometry were performed before and after the therapy, for all of the participants.RESULTS. Obtained results of the study showed improvement in hearing in children correctly using the Otovent set. Hearing improvement was recorded both in the results of pure tone audiometry and impedance audiometry.CONCLUSIONS. The obtained results showed the effectiveness of the pneumotherapy method. In the case of the research group, 81.4% of children achieved the auditory norm (44 people). In the case of the control group, after a fixed period of application of the Otovent set, this value was 0%. The intergroup comparative analysis clearly shows that the research group obtained significantly better results within all of the parameters assessed, than the control group.

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Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215106003343 ◽

2006 ◽

Vol 121 (3) ◽

pp. 219-221 ◽

Cited By ~ 11

Author(s):

H Yasan

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Middle Ear ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Stapes Footplate ◽

Predictive Role ◽

Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

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Tympanoscopy to increase the accuracy of diagnosis in conductive hearing loss

The Journal of Laryngology & Otology ◽

10.1017/s0022215100140174 ◽

1998 ◽

Vol 112 (2) ◽

pp. 154-157 ◽

Cited By ~ 9

Author(s):

Tapio S. Karhuketo ◽

Heikki J. Puhakka ◽

Pekka J. Laippala

Keyword(s):

Decision Making ◽

Hearing Loss ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Bone Conduction ◽

Speech Discrimination ◽

Bone Conduction Threshold ◽

Pure Tone Average ◽

Stapedial Reflex ◽

Conductive Hearing

AbstractThe diagnosis of conductive hearing loss is usually based on audiological methods and radiology. The aim of our study was to show that there is a useful additive method to clarify the findings of diseases with conductive hearing loss.Patients (151 ears) with conductive hearing loss were examined using several methods: otomicroscopy, air- and bone-conduction threshold, pure tone average, speech threshold, speech discrimination, tympanometry and stapedial reflex and tympanoscopy.The management of the patients changed in 17 per cent of cases due to tympanoscopy. In a group with normal tympanic membrane the movement of the stapes during endoscopy was compared to stapedial reflex. Stiff stapes were found more often than an abnormal stapedial reflex.Middle ear endoscopy can increase the accuracy of diagnosis of conductive hearing loss thus enhancing decision making in the case of the patient.

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Bone Conduction Implants: Transcutaneous vs. Percutaneous

Otolaryngology ◽

10.1177/019459989210600130 ◽

1992 ◽

Vol 106 (1) ◽

pp. 68-74 ◽

Cited By ~ 15

Author(s):

Phillip S. Wade ◽

Jerry J. Halik ◽

Marshall Chasin

Keyword(s):

Clinical Trial ◽

Hearing Loss ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Bone Conduction ◽

Mixed Hearing Loss ◽

Hearing Devices ◽

Bone Anchored Hearing Aid ◽

Bone Conduction Hearing ◽

Conductive Hearing

Clinical experience with transcutaneous bone conduction implants has demonstrated that they are most beneficial for patients with purely conductive hearing loss in at least one ear. Percutaneous bone conduction implants, however, have been reported to provide adequate benefit for patients with mixed hearing loss with bone conduction pure-tone averages up to 45 db hl (Tjellstrom, 1989). The results of 24 Xomed Audiant osseointegrated bone conduction hearing devices (including a clinical trial on two patients using a new, larger magnet [Neodynium Iron Boron]), plus the results of eleven patients implanted and fitted with the percutaneous bone-anchored hearing aid are reported. Aided results with these devices will be presented. In addition, general comparisons of benefit obtained with the two devices will be made for patients who exhibit similar hearing losses. Finally, a direct comparison will be made on two patients who have undergone both implant procedures.

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Ear Findings and Hearing analysis in cleft palate patients in Nepal

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i2.22762 ◽

2019 ◽

Vol 10 (2) ◽

pp. 52-57

Author(s):

Sanjeev Thakur ◽

Baleshwar Yadav ◽

Manish Agrawal ◽

Kailash Khaki Shrestha ◽

Raj Kumar Bedajit

Keyword(s):

Hearing Loss ◽

Cleft Palate ◽

Tympanic Membrane ◽

Pure Tone ◽

Cleft Lip ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

P Value ◽

Age Group ◽

Conductive Hearing

Background: The orofacial cleft is the most common birth anomaly with a prevalence rate ranging from 1/1000 to 2.69/ 1000. The middle ear diseases are known to be associated with cleft palate, however, the prevalence and the magnitude of the condition is usually underestimated. Aims and Objectives: The purpose of this study was to find out the various exisiting ear abnormalities, to assess the middle ear function and hearing status in patients with cleft palate and confirm the existence of these manifestations and their significance. Materials and Methods: All the patients with cleft palate with or without cleft lip over a one-year duration from January to December 2018 at the teaching hospital were include after informed consent. The patients with only cleft lip were excluded. General ENT examination and Otoscopy was performed. Tympanometry and Pure tone Audiometry was done (in those above 5 years). The degree of hearing loss was categorized using the WHO guidelines. Results: Out of a total of 56 patients, there were 30(53.6%) male and 26(46.4%) female. The age range was from 2years to 31 years. The mean age was 12.8 years. Maximum number of patients were in the 10-20 years age group 29(51.8%) followed by 22 (39.3%) in the less than 10 years age group. 53 (47.3%) of 112 ears examined had dull tympanic membrane, followed by retraction of tympanic membrane in 42 (37.5%) ears. Other findings were central perforation in 5 (4.5%), bulging tympanic membrane in 2 (1.8%) and atticoantral disease in 1 (0.9%) ear. 8 (7.1%) ears had normal findings. There was one case with right ear atresia (0.9%). In Tympanometry findings, the maximum number of ears, 51 (48.1%) had type B curve, followed by 33 (31.2%) ears with type As curve. 16 (15%) of ears had type C curve. 6 (5.7%) ears had type A curve. B type curve was found more common in less than 10 years age group. A chi Square test was performed and the findings had statistically significant association. (P value: 0.03 for Right ear tympanometry ; P value: 0.043 for left ear tympanometry). In Pure tone audiometry findings of 105 ears, 72 (68.6%) ears had mild conductive hearing loss. 10 (9.5%) ears had moderate conductive hearing loss, while 1 (1%) ear had mixed hearing loss. 22 (20.9%) ears had normal hearing level. Conclusion: This study assessed the common ear problems prevalent in cleft patients, along with the hearing loss. Since, ear disease were quite common in these patients, these patients should be evaluated regularly by an otolaryngologist to detect, treat and prevent such problems in these patients so that long term morbidity could be avoided.

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Promontory osteoma mimicking otosclerosis: case report

The Journal of Laryngology & Otology ◽

10.1017/s0022215119002007 ◽

2019 ◽

Vol 133 (12) ◽

pp. 1107-1109

Author(s):

S Gülşen

Keyword(s):

Hearing Loss ◽

Case Report ◽

Middle Ear ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Additional Treatment ◽

Recent Onset ◽

History Of ◽

Conductive Hearing

AbstractObjectiveThis case report presents a middle-ear osteoma mimicking otosclerosis that was located at the promontory. The osteoma was successfully excised using an endoscopic transcanal approach without any complication.Case reportA 21-year-old man presented with a 4-year history of progressive conductive hearing loss (47 dB with a 30-dB air–bone gap) with intermittent tinnitus of recent onset in his right ear. Endoscopic transcanal middle-ear exploration showed that an osteoma located on the promontory was restricting the mobility of the stapes by affecting the anterior crus of the stapes. After transcanal resection of the osteoma, pure tone audiometry improved to 23 dB with a 5-dB air–bone gap. Tinnitus resolved spontaneously without any additional treatment.ConclusionPromontory osteomas, a rare and usually asymptomatic clinical entity, should be taken into consideration in the differential diagnosis in patients with progressive conductive hearing loss and tinnitus with intact stapedial reflexes and normal otoscopic findings.

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A Controlled Comparison of Auditory Steady-State Responses and Pure-Tone Audiometry in Patients with Hearing Loss

Ear Nose & Throat Journal ◽

10.1177/0145561317096010-1109 ◽

2017 ◽

Vol 96 (10-11) ◽

pp. E47-E52

Author(s):

Raman Wadhera ◽

Sharad Hernot ◽

Sat Paul Gulati ◽

Vijay Kalra

Keyword(s):

Hearing Loss ◽

Steady State ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Normal Hearing ◽

Sensorineural Hearing ◽

Hearing Thresholds ◽

Conductive Hearing

We performed a prospective interventional study to evaluate correlations between hearing thresholds determined by pure-tone audiometry (PTA) and auditory steady-state response (ASSR) testing in two types of patients with hearing loss and a control group of persons with normal hearing. The study was conducted on 240 ears—80 ears with conductive hearing loss, 80 ears with sensorineural hearing loss, and 80 normal-hearing ears. We found that mean threshold differences between PTA results and ASSR testing at different frequencies did not exceed 15 dB in any group. Using Pearson correlation coefficient calculations, we determined that the two responses correlated better in patients with sensorineural hearing loss than in those with conductive hearing loss. We conclude that measuring ASSRs can be an excellent complement to other diagnostic methods in determining hearing thresholds.

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