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Auteur Daniel B. Putterman
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Automated Adaptive Wideband Acoustic Reflex Threshold Estimation in Normal-hearing Adults / Kim Schairer in Ear and hearing, Vol.43, n°2 (Mars-avril 2022)
Titre : Automated Adaptive Wideband Acoustic Reflex Threshold Estimation in Normal-hearing Adults Type de document : Article Auteurs : Kim Schairer ; Daniel B. Putterman ; Douglas H. Keefe ; Dennis F. Fitzpatrick ; Angela C. Garinis ; Elizabeth R. Kolberg ; M. Patrick Feeney Année de publication : 2022 Article en page(s) : p. 370-378 Langues : Anglais (eng) Descripteurs : HE Vinci
Immitance acoustique ; Reflexe de l'oreille moyenne ; Reflexion a large bande
Résumé : Objectives: Acoustic stapedius reflex threshold (ART) tests are included in a standard clinical acoustic immittance test battery as an objective cross-check with behavioral results and to help identify site of lesion. In traditional clinical test batteries, middle-ear admittance of a 226 Hz probe is estimated using ear-canal measurements in the presence of a reflex-activating stimulus. In the wideband (WB) acoustic immittance ART test used in this study, the pure-tone probe is replaced by a WB probe stimulus and changes in absorbed power are estimated using ear-canal measurements in the presence of the activator. The ART is defined as the lowest level at which a criterion change in admittance (clinical) or absorbed power (WB) is observed in the presence of the activator. In the present study, ARTs were obtained in adults with normal hearing using the clinical, manual method and with a new WB automated adaptive threshold detection method. It was hypothesized that the WB test would result in lower ARTs than the clinical test because reflex-related changes in power absorbance could be observed across multiple frequency bands in the WB test compared with a single frequency in the traditional test.
Design: Data were collected in a prospective research design. ARTs were obtained in ipsilateral and contralateral conditions using 500, 1000, 2000 Hz, and broadband noise (BBN) activators on a clinical system and on an experimental WB system. The bandwidth of the BBN activator was 125 to 4000 Hz on the clinical system and 200 to 8000 Hz on the wideband system. ARTs were estimated at both tympanometric peak pressure (TPP) and ambient pressure on the WB system. Data were collected in both ears of 39 adults (21 males) of mean age 47.7 years (range 23-72 years). Differences in ARTs among the three threshold estimation methods (clinical, WB at TPP, WB at ambient) were examined using the general linear model repeated measures test in SPSS. Post-hoc pairwise comparisons were completed with Bonferroni correction for multiple comparisons. Statistical significance was defined as p
Results: ARTs obtained on the WB system at TPP and ambient pressure were significantly lower than obtained on the clinical system. ARTs obtained on the WB system at TPP were significantly higher than at ambient pressure in the 500 and 2000 Hz ipsilateral conditions.
Conclusions: WB automated adaptive ARTs in normal-hearing adults were lower than for clinical methods when measured at TPP and ambient pressure. Lower presentation levels required to estimate ART in the WB test may be more tolerable to patients. Patients with ARTs that are not present at the maximum level of a traditional reflex test may have present ARTs with a WB ART test, which may reduce the need to refer for additional testing for possible retrocochlear involvement. Automation of the test may allow clinicians more time to attend to the other requisite tasks of a hearing evaluation and make the system useful for telehealth applications.
DOI : 10.1097/AUD.0000000000001102|1 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=292896
in Ear and hearing > Vol.43, n°2 (Mars-avril 2022) . - p. 370-378[article]Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power / M. Patrick Feeney in Ear and hearing, Vol. 42, n°3 (Mai- Juin 2021)
Titre : Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power Type de document : Article Auteurs : M. Patrick Feeney ; Douglas H. Keefe ; Lisa L. Hunter ; Dennis F. Fitzpatrick ; Daniel B. Putterman ; Angela C. Garinis Année de publication : 2021 Article en page(s) : p. 547-557 Langues : Anglais (eng) Descripteurs : Autres descripteurs
Otosclerose ; Reflectance acoustique
Absorbance acoustique ; Oreille moyenne ; Tympanométrie ; Wideband absorbance (WBA)
Résumé : Objective: Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate preoperative and postoperative test results.
Design: Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare preoperative and postoperative results at 3 and 6 months.
Results: There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance at 226 Hz was near chance performance, which is consistent with previous findings. There were significant mean differences between preoperative and postoperative tests for absorbance and absorbed power.
Conclusions: Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than static acoustic admittance at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.
DOI : 10.1097/AUD.0000000000000968|1 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=273194
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 547-557[article]Wideband Acoustic Reflex Measurement / M. Patrick Feeney ; Kim S. Schairer ; Daniel B. Putterman in Seminars in hearing, Vol. 44, n°1 (February 2023)
Titre : Wideband Acoustic Reflex Measurement Type de document : Article Auteurs : M. Patrick Feeney, Auteur ; Kim S. Schairer, Auteur ; Daniel B. Putterman, Auteur Année de publication : 2023 Article en page(s) : p. 84-92 Note générale : DOI: 10.1055/s-0043-1763296 Langues : Anglais (eng) Descripteurs : Autres descripteurs
Absorbance acoustique ; Réflexe acoustique ; synaptopathie cochléaire
Mots-clés : Synaptophatie induite par le bruit Résumé : Acoustic reflex thresholds (ART) obtained using pure-tone probe stimuli as part of a traditional immittance test battery can be used to evaluate site of lesion and provide a cross-check with behavioral results. ARTs obtained as part of a wideband acoustic immittance (WAI) test battery using a click as the probe stimulus can be used in the same way with the added benefit that they may provide lower ARTs than those obtained using a pure-tone probe. Another benefit of the WAI ART test is that it can be completed without requiring a hermetic seal or pressurizing the ear canal. A new adaptive method of obtaining ARTs using WAI techniques may cut test time in half, thus making this an attractive option for future clinical use. More advanced uses of WAI ART tests include the measurement of AR growth functions. These may be used to investigate the possible effects of synaptopathy related to high levels of noise exposure and possible auditory deficits related to ototoxicity. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://medone-comsci.thieme.com/ejourn [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=305931
in Seminars in hearing > Vol. 44, n°1 (February 2023) . - p. 84-92[article]