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Audiometry
Audiometry () is a branch of audiology and the science of measuring hearing acuity for variations in sound intensity and pitch and for tonal purity, involving thresholds and differing frequencies. Typically, audiometric tests determine a subject's hearing levels with the help of an audiometer, but may also measure ability to discriminate between different sound intensities, recognize pitch, or distinguish speech from background noise. Acoustic reflex and otoacoustic emissions may also be measured. Results of audiometric tests are used to diagnose hearing loss or diseases of the ear, and often make use of an audiogram. History The basic requirements of the field were to be able to produce a repeating sound, some way to attenuate the amplitude, a way to transmit the sound to the subject, and a means to record and interpret the subject's responses to the test. Mechanical "acuity meters" and tuning forks For many years there was desultory use of various devices capable o ...
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Pure Tone Audiometry
Pure-tone audiometry is the main hearing test used to identify hearing threshold levels of an individual, enabling determination of the degree, type and configuration of a hearing loss and thus providing a basis for diagnosis and management. Pure-tone audiometry is a subjective, behavioural measurement of a hearing threshold, as it relies on patient responses to '' pure tone'' stimuli. Therefore, pure-tone audiometry is only used on adults and children old enough to cooperate with the test procedure. As with most clinical tests, standardized calibration of the test environment, the equipment and the stimuli is needed before testing proceeds (in reference to ISO, ANSI, or other standardization body). Pure-tone audiometry only measures audibility thresholds, rather than other aspects of hearing such as sound localization and speech recognition. However, there are benefits to using pure-tone audiometry over other forms of hearing test, such as click auditory brainstem response (ABR ...
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Audiogram
An audiogram is a graph that shows the audible threshold for standardized frequencies as measured by an audiometer. The Y axis represents intensity measured in decibels and the X axis represents frequency measured in hertz. The threshold of hearing is plotted relative to a standardised curve that represents 'normal' hearing, in dB(HL). They are not the same as equal-loudness contours, which are a set of curves representing equal loudness at different levels, as well as at the threshold of hearing, in absolute terms measured in dB SPL (sound pressure level). Audiograms are set out with frequency in hertz (Hz) on the horizontal axis, most commonly on a logarithmic scale, and a linear dBHL scale on the vertical axis. For humans, normal hearing is between −10 dB(HL) and 15 dB(HL), although 0 dB from 250 Hz to 8 kHz is deemed to be 'average' normal hearing. Hearing thresholds of humans and other mammals can be found with behavioural hearing tests or phy ...
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Conditioned Play Audiometry
Conditioned play audiometry (CPA) is a type of audiometry done in children from ages 2 to 5 years old, in developmental age. It is the test that directly follows visual reinforcement audiometry when the child becomes able to focus on a task. It is a type of behavioral hearing test, of which there are many. Conditioned play audiometry uses toys to direct the child's attention on the listening task and turns it into a game. Instead of raising one's hand in response to the sound, as an adult would, the child might drop a toy into a bucket every time he or she hears a sound. This keeps the child interested in the listening task for longer. Common games include dropping balls in buckets, placing rings on a stick, feeding coins in a play pig, among many others. The first part of CPA involves conditioning the child. The audiologist presents a loud sound that the child can comfortably hear, while encouraging the child to "drop the ball in the bucket every time you hear the sound," or which ...
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Auditory Brainstem Response
The auditory brainstem response (ABR), also called brainstem evoked response audiometry (BERA), is an auditory evoked potential extracted from ongoing electrical activity in the brain and recorded via electrodes placed on the scalp. The measured recording is a series of six to seven vertex positive waves of which I through V are evaluated. These waves, labeled with Roman numerals in ''Jewett'' and ''Williston'' convention, occur in the first 10 milliseconds after onset of an auditory stimulus. The ABR is considered an ''exogenous response'' because it is dependent upon external factors. The auditory structures that generate the auditory brainstem response are believed to be as follows: *Wave I through III – generated by the auditory branch of cranial nerve VIII and lower *Wave IV and V – generated by the upper brainstem *More in depth location – wave I and II originates from the distal and proximal auditory nerve fibers, wave III from the cochlear nucleus, IV showing act ...
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Audiometer
An audiometer is a machine used for evaluating hearing acuity. They usually consist of an embedded hardware unit connected to a pair of headphones and a test subject feedback button, sometimes controlled by a standard PC. Such systems can also be used with bone vibrators, to test conductive hearing mechanisms. Audiometers are standard equipment at ENT (ear, nose, throat) clinics and in audiology centers. An alternative to hardware audiometers are software audiometers, which are available in many different configurations. Screening PC-based audiometers use a standard computer. Clinical PC-based audiometers are generally more expensive than software audiometers, but are much more accurate and efficient. They are most commonly used in hospitals, audiology centers and research communities. These audiometers are also used to conduct industrial audiometric testing. Some audiometers even provide a software developer's kit that provides researchers with the capability to create their ...
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Otoacoustic Emission
An otoacoustic emission (OAE) is a sound that is generated from within the inner ear. Having been predicted by Austrian astrophysicist Thomas Gold in 1948, its existence was first demonstrated experimentally by British physicist David Kemp in 1978, and otoacoustic emissions have since been shown to arise through a number of different cellular and mechanical causes within the inner ear. Studies have shown that OAEs disappear after the inner ear has been damaged, so OAEs are often used in the laboratory and the clinic as a measure of inner ear health. Broadly speaking, there are two types of otoacoustic emissions: spontaneous otoacoustic emissions (SOAEs), which occur without external stimulation, and evoked otoacoustic emissions (EOAEs), which require an evoking stimulus. Mechanism of occurrence OAEs are considered to be related to the amplification function of the cochlea. In the absence of external stimulation, the activity of the cochlear amplifier increases, leading to the pr ...
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Intelligibility (communication)
In speech communication, intelligibility is a measure of how comprehensible speech is in given conditions. Intelligibility is affected by the level (loud but not too loud) and quality of the speech signal, the type and level of background noise, reverberation (some reflections but not too many), and, for speech over communication devices, the properties of the communication system. A common standard measurement for the quality of the intelligibility of speech is the Speech Transmission Index (STI). The concept of speech intelligibility is relevant to several fields, including phonetics, human factors, acoustical engineering, and audiometry. Important Influences Speech is considered to be the major method of communication between humans. Humans alter the way they speak and hear according to many factors, like the age, gender, native language and social relationship between talker and listener. Speech intelligibility may also be affected by pathologies such as speech and hearing ...
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Equal-loudness Contour
An equal-loudness contour is a measure of sound pressure level, over the frequency spectrum, for which a listener perceives a constant loudness when presented with pure steady tones. The unit of measurement for loudness levels is the phon and is arrived at by reference to equal-loudness contours. By definition, two sine waves of differing frequencies are said to have equal-loudness level measured in phons if they are perceived as equally loud by the average young person without significant hearing impairment. The Fletcher–Munson curves are one of many sets of equal-loudness contours for the human ear, determined experimentally by Harvey Fletcher and Wilden A. Munson, and reported in a 1933 paper entitled "Loudness, its definition, measurement and calculation" in the ''Journal of the Acoustical Society of America''. Fletcher–Munson curves have been superseded and incorporated into newer standards. The definitive curves are those defined in ISO 226 from the International Orga ...
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Psychoacoustic
Psychoacoustics is the branch of psychophysics involving the scientific study of sound perception and audiology—how humans perceive various sounds. More specifically, it is the branch of science studying the psychological responses associated with sound (including noise, speech, and music). Psychoacoustics is an interdisciplinary field of many areas, including psychology, acoustics, electronic engineering, physics, biology, physiology, and computer science. Background Hearing is not a purely mechanical phenomenon of wave propagation, but is also a sensory and perceptual event; in other words, when a person hears something, that something arrives at the ear as a mechanical sound wave traveling through the air, but within the ear it is transformed into neural action potentials. The outer hair cells (OHC) of a mammalian cochlea give rise to enhanced sensitivity and better frequency resolution of the mechanical response of the cochlear partition. These nerve pulses then travel to t ...
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