Presence of ipsilateral acoustic reflex artifact may result in clinical misidentification.

Objective: Upon calibration of a specific commercially available immittance device, an artifact was consistently measured in a calibration cavity when in ipsilateral acoustic reflex mode. These results were replicated in a controlled fashion, raising concerns about how clinical results might potentially be misinterpreted.

Design: Responses were measured from an Interacoustics Titan and Grason-Stadler Tympstar Pro immittance device coupled to a 0.

Binaural Interference: Quo Vadis?

The reality of the phenomenon of binaural interference with speech recognition has been debated for two decades. Research has taken one of two avenues; group studies or case reports. In group studies, a sample of the elderly population is tested on speech recognition under three conditions; binaural, monaural right and monaural left.

Auditory adaptation testing as a tool for investigating tinnitus origin: two patients with vestibular schwannoma.

Objective: To enhance the understanding of tinnitus origin by disseminating two case studies of vestibular schwannoma (VS) involving behavioural auditory adaptation testing (AAT).

Design: Retrospective case study.

Study Sample: Two adults who presented with unilateral, non-pulsatile subjective tinnitus and bilateral normal-hearing sensitivity.

Temporal integration of the contralateral acoustic reflex threshold for a 1000 hz tonal activator and its age-related changes.

Background: Previous research has noted an age effect on the temporal integration of the acoustic reflex for a noise activator.

Purpose: To determine whether the age effect earlier noted for a noise activator will be noted for a tonal activator.

Research Design: Comparison of ARTs of younger and older groups at activating stimulus durations of 12, 25, 50, 100, 200, 300, 500, and 1000 msec.

Technical report: distortion product otoacoustic emissions that are not outer hair cell emissions.

Purpose: To present a case study in order to alert clinicians to the possibility of occurrence of intermodulation distortion during otoacoustic emissions testing that arises from the cavity formed by the external auditory meatus and tympanic membrane rather than from the inner ear, compromising the reliability and validity of otoacoustic emissions testing.

Research Design: Prospective case study.

Study Sample: A young (26-year-old) female adult with a longstanding, bilateral, essentially moderate to severe sensorineural hearing loss presented with robust distortion product otoacoustic emissions.

Auditory deprivation in adults with asymmetric, sensorineural hearing impairment.

The purpose of this investigation was to prospectively examine performance on the pure-tone air-conduction threshold, speech-recognition threshold, and suprathreshold word-recognition tests over time in 21 monaurally aided (experimental group) and 28 unaided adults (control group) with asymmetric, sensorineural hearing impairment. The results revealed significant declines on the mean suprathreshold word-recognition scores over time at one and two years post-baseline for the worse ears of the control participants; no declines occurred in the worse ears of the experimental participants or in the better ears of either group. A slight, significant increase in the pure-tone average occurred for the better ears of both groups.

Temporal integration of the contralateral acoustic-reflex threshold and its age-related changes.

Although numerous studies have investigated temporal integration of the acoustic-reflex threshold (ART), research is lacking on the effect of age on temporal integration of the ART. Therefore the effect of age on temporal integration of the ART was investigated for a broad-band noise (BBN) activator. Subjects consisted of two groups of adults with normal-hearing sensitivity: one group of 20 young adults (ten males and ten females, ages 18-29 years, with a mean age of 24 years) and one group of 20 older adults (ten males and ten females, ages 59-75 years, with a mean age of 67.

Nonsurgical home treatment of middle ear effusion and associated hearing loss in children. Part II: Validation study.

In this prospective follow-up investigation, we examined the efficacy of a modified Politzer device in the home treatment of persistent middle ear effusion (MEE) and associated hearing loss in children who had previously participated in a similar clinical trial. Our study group was made up of 38 patients who had been either (1) untreated control participants in the previous study whose hearing in one or both ears had not returned to normal within 11 weeks of their initial audiologic pretest ("former control group"; n = 30), or (2) active-treatment participants in the previous study whose hearing sensitivity in at least one ear had not improved to within normal limits after treatment and who elected to undergo a continuation of treatment ("extended-treatment group"; n = 8). Treatment efficacy was determined by comparing differences in pre- and posttreatment air-conduction thresholds and otoscopic findings.

Nonsurgical home treatment of middle ear effusion and associated hearing loss in children. Part I: clinical trial.

We conducted a randomized, controlled clinical trial to investigate the efficacy of treatment of persistent middle ear effusion (MEE) and associated hearing loss with a modified Politzer device used in the home setting over a 7-week period. Efficacy was determined by comparing pre-and posttherapy air-conduction thresholds, tympanometric peak pressures, and otoscopic findings. The study group was made up of 94 children (174 ears), aged 4 to 11 years, who had at least a 2-month history of MEE and associated hearing loss.

The prediction of hearing loss in persons with cerebral palsy using contralateral acoustic reflex threshold for broad-band noise.

The utility of R. Keith's (1977) method of screening for hearing sensitivity using the contralateral acoustic-reflex threshold (ART) for broad-band noise (BBN) was tested in persons with cerebral palsy (CP). Three groups of participants were included in this prospective study.

The effects of probe-tone frequency on the acoustic-reflex growth function.

Acoustic-reflex growth functions (ARGFs) were obtained from 20 normal-hearing listeners. Contralateral acoustic reflexes (ARs) were elicited with pure tones of 2000 Hz. The magnitude of changes in static compliant susceptance (BA) and conductance (GA) were monitored with probe-tone frequencies of 226 Hz, 678 Hz and 1000 Hz.

Treatment of otitis media with effusion based on politzerization with an automated device.

This study evaluated the efficacy of politzerization with an automated, hand-held device that controls volume velocity (airflow) in the treatment of 20 children with otitis media with effusion. These patients underwent politzerization twice a week for up to 6 weeks. Another 20 children with otitis media with effusion who were not treated with politzerization served as controls.

Central auditory processing disorders and reduced motivation: three case studies.

The central auditory test results for three normal-hearing children who were initially diagnosed as having a central auditory processing disorder and learning disability are presented. They were referred to the authors for second-opinion consultations. Central auditory processing retesting was performed by the authors under the condition of no reinforcement and then the condition of reinforcement with the child's favorite food, hobby, or toy.

Efficacy of a modified politzer apparatus in management of eustachian tube dysfunction in adults.

This study evaluates the efficacy of politzeration on eustachian tube dysfunction following airplane travel using an automated, hand-held device that controls the volume velocity of air flow. Fourteen adults with eustachian tube dysfunction following airplane travel comprised the experimental group. They received politzeration over a period of 6 weeks on a twice-a-week basis.

Asymmetric suprathreshold speech recognition and the telephone ear phenomenon.

We compared interaural suprathreshold speech recognition scores in 62 adults with sensorineural hearing loss. Subjects were tested at two sites, 25 at the Baylor College of Medicine, Houston, TX and 37 at Brooklyn College, Brooklyn, NY. Ears were categorized according to telephone usage.

Report of the Eriksholm Workshop on auditory deprivation and acclimatization.

The terminology used in studies documenting changes in auditory performance following fitting of hearing aids has been diverse. Definitions for the auditory deprivation effect and auditory acclimatization are offered as a first step in rationalization. Two statements summarize current knowledge concerning auditory deprivation effects and auditory acclimatization, as well as considering the potential implications for research, field trial and clinical practice applications.

Acoustic-immittance characteristics of children with middle-ear effusion: longitudinal investigation.

The purpose of this investigation was to describe, in a longitudinal prospective study, the acoustic-immittance profile during sessions with effusion and during sessions without effusion in children with recurrent middle-ear effusion (MEE). The static-acoustic middle-ear admittance, tympanometric width (TW), tympanometric peak pressure (TPP), and ipsilateral acoustic reflex (IAR) were evaluated in 36 ears of 18 children with recurrent MEE and 24 ears of 12 children without a history of MEE. Recurrent MEE was operationally defined as MEE diagnosed by microtoscopy and/or pneumotoscopy at four or more sessions over the first year of investigation.

Binaural interference in multiple sclerosis: case study.

A case report of a young, adult male with multiple sclerosis who demonstrates binaural interference is presented. Binaural interference was demonstrated on behavioral and physiologic measures during the active stage. Binaural interference was present, although reduced, during the stage of remission.

Pure-tone assessment and screening of children with middle-ear effusion.

The purpose of this prospective investigation was to evaluate the sensitivity of pure-tone screening of children with middle-ear effusion (MEE) and to describe the short-term audiometric and otologic follow-up of children with MEE who pass versus fail a pure-tone screen. Eighty-two ears of 54 children with MEE based on pneumotoscopy/microtoscopy were investigated. A complete otolaryngologic evaluation, pure-tone screen, then complete audiologic evaluation were performed at the initial test.

Apparent auditory deprivation in children: implications of monaural versus binaural amplification.

This study investigated the effects of monaural versus binaural amplification upon the speech recognition scores (SRSs) of children with bilateral moderate sensorineural hearing loss after more than 4 years of hearing aid use. There was a significant decrease in SRSs for the unaided ears of the monaural hearing aid users, but there were no significant differences between initial and retest SRSs for their aided ears, or for both ears of those using binaural amplification. The SRS reduction was found to be large enough to be significant on an individual ear basis (by exceeding 95% confidence limits of the binomial model) in five of the ten unaided ears of the monaurally fitted children, but this did not occur for any of the initial-retest SRS differences in the aided ears of either group.

Detecting and remediating external meatal collapse during audiologic assessment.

We present a case study in which the jaw/mouth-open procedure during air-conduction testing is employed to both detect and remediate external auditory meatal collapse. A prospective investigation was also conducted to compare the efficacy of the proposed jaw/mouth-open procedure with that of the traditional insert receivers in remediating meatal collapse during audiologic assessment. Meatal collapse was present in 6 of the 136 subjects evaluated.

Case studies in binaural interference: converging evidence from behavioral and electrophysiologic measures.

We present four case reports of elderly hearing-impaired persons demonstrating a binaural interference effect. Performance measures were poorer when stimulation was binaural than when it was monaural. In the first case the effect is shown for aided speech recognition scores.

Functional components and resolved thresholds in patients with unilateral nonorganic hearing loss.

This study expanded upon previous work (Gelfand & Silman, 1985) on the relationship between functional components (the difference between the nonorganic and resolved thresholds) and the underlying organic hearing levels. The nature of nonorganic hearing loss (NOHL) was studied with respect to hearing sensitivity after resolution of the nonorganic components in 25 patients with unilateral NOHLs. Most of the subjects had an organic hearing loss underlying the functional components.

Effects of prolonged lack of amplification on speech-recognition performance: preliminary findings.

The purposes of this investigation were two-fold: 1) to prospectively investigate the effect of prolonged lack of binaural amplification in the unaided ears of adults with bilaterally symmetrical sensorineural hearing impairment (BSSHI) fitted monaurally; and, 2) to prospectively investigate the effects of amplification on speech-recognition performance in the aided ears of monaurally and binaurally fitted subjects. Subjects consisted of 19 monaurally aided adults, 28 binaurally aided adults, and 19 control adults. Both ears of the experimental subjects (binaurally and monaurally aided adults) had BSSHI.

Adult-onset auditory deprivation.

Adult-onset auditory deprivation following prolonged lack of amplification in the unaided ears of persons with bilaterally symmetrical sensorineural hearing impairment was first reported in 1984. This article on the phenomenon includes a review of the literature on adult-onset auditory deprivation in relation to etiology, pathophysiology, hearing-loss manifestations, typical audiologic profile, amplification strategies, contraindications or challenges to conventional hearing-aid fitting, and future research. A case study illustrates the phenomenon of auditory deprivation from monaural amplification with recovery following binaural amplification.