Psychoacoustic evaluation of internal combustion engine noises

When buying a car, the acoustic impression of quality of a vehicle drive train is becoming more and more relevant. The perceived sound quality of the engine unit plays a key role here. Due to the nature of individual background noises, that sound quality is negatively influenced. These noise components, which are perceived as unpleasant, need to be further reduced in the course of vehicle development with the identification and evaluation of disruptive noise components in the overall engine noise being a prerequisite for effective acoustics optimization. In particular, the pulsed ticker noise is classified as particularly annoying in Otto DI engines, which is why this article aims to analyze and evaluate the ticking noise components from the overall noise. For this purpose, an empirical formula was developed which can classify the ticking noise components in terms of their intensity. This is purely perception-based and consists of the impulsiveness, the loudness and the sharpness of the overall engine noise. As with other psychoacoustic evaluation scales, the rating was made from 1 (very ticking) to 10 (not ticking). The ticker noise evaluation formula was then verified on the basis of hearing tests with the help of a jury of experts. According to this, it can be predicted precisely in which engine map areas the ticker noise undermines the pleasantness of the overall engine noise.

Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

Introduction During surgery in patients with labyrinthine fistula the mandatory complete removal of the cholesteatoma while preserving inner ear and vestibular function is a challenge. Options so far have been either the complete removal of the cholesteatoma or leaving the matrix on the fistula. We evaluated an alternative “under water” surgical technique for complete cholesteatoma resection, in terms of preservation of postoperative inner ear and vestibular function. Methods From 2013 to 2019, 20 patients with labyrinthine fistula due to cholesteatoma were operated. We used the canal wall down approach and removal of matrix on the fistula was done as the last step during surgery using the “under water technique”. The pre and postoperative hearing tests and the vestibular function were retrospectively examined. Results There was no significant difference between pre and post-operative bone conduction thresholds; 20% experienced an improvement of more than 10 dB, with none experiencing a postoperative worsening of sensorineural hearing loss. Among seven patients who presented with vertigo, two had transient vertigo postoperatively but eventually recovered. Conclusion Our data show that the “under water technique” for cholesteatoma removal at the labyrinthine fistula is a viable option in the preservation of inner ear function and facilitating complete cholesteatoma removal.

Audit of the Aetiological Investigations Performed in Children with Sensorineural Hearing Loss At Salford

Objective: This project aims to look at the Audiovestibular Physician’s practice at Salford and how closely it aligns with the gold standard guidelines set in the protocol lately published by the British Association of Audiological Physicians. Method: An audit was done retrospectively on 20 patients suffering from sensorineural hearing loss. As such, patient notes were utilised to ascertain which aetiological investigations have been completed and which were not. Any inadequacy in the aetiological work up has been dissected to help know the underlying reasons. Results: All patients had a thorough history taken and were comprehensively physically examined. 95% of patients underwent imaging in the form of MRI/CT. 80% received CMV testing. 75% underwent ECG testing. 60% received family hearing tests. Only 35% had ophthalmology examinations and 25% underwent urine and genetic testing. Conclusion: In some cases, the low compliance rates were due to the Audiovestibular Physician not ordering the investigation as part of the aetiological work up. This could be improved with the use of a dedicated checklist to act as an aid to the physician. Moreover, genetic counselling has been proposed to attempt to boost the compliance rates with genetic testing and similarly, leaflets briefing patients’ families about the importance of undergoing hearing tests themselves is another promising proposition to help improve the adherence

Hearing and Exposure to Music in Adolescents From Four Schools of Córdoba, Argentina

Purposes The aims of this study are (a) to characterize the hearing of adolescents from four schools of Córdoba, Argentina, through the analysis of conventional and extended high-frequency audiometric thresholds and otoacoustic emissions (OAEs) and (b) to analyze the association between the mentioned hearing tests and exposure to music. Method It was a cross-sectional correlational descriptive study. Hearing thresholds (250–16000 Hz), transient evoked OAEs, and distortion product OAEs were evaluated in 225 adolescents (450 ears) aged 14 and 15 years. The ears were split into two groups: Group 1 had thresholds ≤ 21 dB HL in all frequencies, and Group 2 had thresholds > 21 dB HL in at least one. Exposure to music was evaluated through a questionnaire. Results Statistically significant differences were found in both ears between Groups 1 and 2. A notch at 3000–6000 Hz was noted in both groups. Group 2 showed a progressive threshold increase from 9000 Hz. Amplitude decrease, negative values, absent distortion product OAEs, and transient evoked OAEs were noted even in Group 1. A statistically significant association between Groups 1 and 2 and the presence/absence of OAEs was observed in most frequencies. Ears with moderate or high exposure to music had greater hearing thresholds compared to ears with low exposure at most frequencies; this was more evident in Group 1. Regarding exposure to music and OAEs, no significant differences were found between the exposure categories. Conclusions The findings highlight the value of implementing hearing conservation programs in Argentina, analyzing hearing tests correlated with questionnaires about recreational noise exposure in order to detect vulnerable ears early.

Audiometric Tests without Booths

Audiometric booths are used to reduce background noise levels at testing locations to below values specified in the standards. As such, they are considered inherent parts of the audiometric testing equipment. This paper presents the results from a literature search of solutions that could ensure that background noise levels are acceptable outside booths. The technology used is especially valuable for survey tests and for locations where booths are unavailable or cannot be used for different reasons. However, its use is recommendable for only screening hearing tests but not for clinical or research applications.

Harmadikablak-szindróma – osztályozás, diagnózis, terápia

Összefoglaló. Halláspanasszal számos beteg fordul orvoshoz. A rutinszerűen elvégzett súgottbeszéd-, hangvilla- és tisztahangküszöb-audiometriai vizsgálat alapján vezetéses, sensorineuralis, illetve a kettő együttes fennállása esetén kevert típusú halláscsökkenést különböztetünk meg. Vezetéses halláscsökkenés létrejöhet mind a külső, mind a közép- vagy a belső fül veleszületett vagy szerzett rendellenességei esetén. Amennyiben a stapediusreflex kiváltható, ugyanakkor a betegnél nincs jelen a külső fület, valamint a középfület érintő kórfolyamat, felmerül a harmadikablak-szindróma lehetősége. A kórkép okaként egy, a belső fül csontos tokján „harmadik ablakként” funkcionáló laesio van jelen, amely az ovális ablakon keresztül beérkező hangenergia egy részét elvezeti, mielőtt az a kerek ablakon át kivezetődik a középfülbe. A diagnózis felállítása gyakran nehéz feladat elé állítja a klinikust, melyhez a megfelelő audiológiai, illetve képalkotó vizsgálatok elvégzése elengedhetetlen. Tekintettel arra, hogy a panaszok megszüntetésére számos műtéti módszer került leírásra, közleményünkben átfogó képet adunk a kórkép etiológiájáról, diagnosztikájáról, terápiájáról, valamint bemutatjuk saját kezdeti tapasztalatainkat is 2 eset prezentálásával. Orv Hetil. 2020; 161(46): 1944–1952. Summary. Patients frequently present to the physician with hearing loss. Routine hearing tests include speech field (whisper test), tuning forks and pure tone threshold audiometry, which can identify the presence of sensorineural hearing loss, conductive hearing loss or a combination of both (mixed type). Conductive hearing loss can be a symptom of many different conditions. These include congenital or acquired malformations of the outer, middle and inner ear. If a conductive hearing loss with intact stapedial reflexes are recorded and in the absence of outer or middle ear pathology, then the third window syndrome should be considered. The cause is a bony defect on the otic capsule that acts as a ’third window’, dissipating the incoming sound energy. Without the appropriate audiological and imaging tests, the diagnosis of the condition is challenging in clinical setting. Several surgical techniques have been described to treat the condition. The authors give a comprehensive review of the etiology, diagnosis and treatment of the disease presenting their initial experiences with 2 cases. Orv Hetil. 2020; 161(46): 1944–1952.

Barriers and facilitators to implementation of serial point-of-care hearing tests using a novel iPad-based audiometry in platinum chemotherapy-treated cancer patients (pts).

223 Background: Platinum-based chemotherapy agents cause significant hearing loss in 40-80% of treated cancer pts. Lack of follow-up serial testing has created gaps in knowledge regarding hearing loss onset, progression, and possible recovery between treatment cycles. This study aims to determine barriers and facilitators to implementation of a tablet-based point-of-care hearing test, as a serial screening tool to address these knowledge gaps. Methods: From Jul 2019 to Mar 2020, 53 pts receiving high dose platinum agents were recruited from three clinics (Thoracic, head and neck, and testicular cancer) at a comprehensive cancer centre, to undergo serial audiometry testing. Baseline hearing tests, mid cycles (3,6, and 9 weeks), and post treatment tests (3,6,9,12, 19 and 24 months) were completed during the pts’ clinic appointments. Clinical research coordinators (CRCs) collected feedback from physicians, nurses, and pts to identify barriers and facilitators of implementing serial point-of-care hearing tests in these clinics. An inductive and iterative approach was used to identify themes. Implementation was tailored and mapped to the CIHR Knowledge to Action Framework (KTA). Results: Barriers: Logistical barriers included: locating quiet and accessible rooms to administer the test; pts being distracted or interrupted while completing the test; presence of family members adding to noise levels; concerns over the serial testing during treatment; length of each test; and clinic staff burden. Facilitators: User-friendly self-administered tests; increasing healthcare staff education and pt management. Adapting to the local context: Logistical barriers were resolved by CRCs designating quiet spaces for the study to occur, and meeting pts upon arrival to utilize their wait time. A ‘hearing test in progress’ sign put on exam room doors prevented interruptions. CRCs utilized the test’s ‘assisted mode’ feature to keep pts attentive and/or accelerate the process. Low noise level was emphasized to obtain accurate test results. Pt engagement in their test results facilitated retention in the study. Test length may be shortened in the future by omitting low frequency testing. Conclusions: Participants and stakeholders expressed support for in-clinic hearing tests and identified personal and systemic barriers to implementation. These findings suggest that implementation should focus on addressing concerns related to accessible rooms, pt time investment and overall clinic flow.

Comparison of Pure Tone, Dichotic Digit Test and Speech in Noise in Persian Language Using a Mobile-Based Approach (Shenava® application) with the Audiometer Device: Protocol of the Randomized Controlled Trial

Introduction: The global prevalence of hearing loss is around 5 percent in low to middle-income countries. The main purpose of this study is validating a mobile-based Pure Tone Audiometry (PTA), Dichotic Digit Test (DDT) and Speech in Noise (SIN) hearing tests for hearing loss screening purposes in Persian people comparing with routine audiometry exam results.Material and Methods: This is a single blind randomized controlled trial for comparing a mobile application for hearing screening exams. We designed and standardized PTA, DDT and SIN tests for Persian people and settled them into a specific developed mobile application called “Shenava®”. In the audiology clinic, we will recruit at least 100 healthy adult participants, 50 for the case and 50 for the control group. The first group will pass “Shenava®” and standard test respectively and the other group will pass the tests vice versa to prevent order bias.Results: The results of the tests performed by “Shenava®” and audiometry exam will be analyzed to ensure the accuracy and validity of the” Shenava®” in comparison with standard audiometric exam results.Conclution: Hearing tests are costly even for time and money and need a lot of efforts for audiologists and the patients. By designing a mobile app for hearing tests, we hope to be able to make diagnostic screening easier for hearing loss, and relying on the diagnostic value of this tool, it may encourage the patients to have a better follow up and effective treatment plan.