Sensitivity to Envelope Interaural Time Differences at High Modulation Rates

Sensitivity to interaural time differences (ITDs) conveyed in the temporal fine structure of low-frequency tones and the modulated envelopes of high-frequency sounds are considered comparable, particularly for envelopes shaped to transmit similar fidelity of temporal information normally present for low-frequency sounds. Nevertheless, discrimination performance for envelope modulation rates above a few hundred Hertz is reported to be poor-to the point of discrimination thresholds being unattainable-compared with the much higher (>1,000 Hz) limit for low-frequency ITD sensitivity, suggesting the presence of a low-pass filter in the envelope domain. Further, performance for identical modulation rates appears to decline with increasing carrier frequency, supporting the view that the low-pass characteristics observed for envelope ITD processing is carrier-frequency dependent. Here, we assessed listeners' sensitivity to ITDs conveyed in pure tones and in the modulated envelopes of high-frequency tones. ITD discrimination for the modulated high-frequency tones was measured as a function of both modulation rate and carrier frequency. Some well-trained listeners appear able to discriminate ITDs extremely well, even at modulation rates well beyond 500 Hz, for 4-kHz carriers. For one listener, thresholds were even obtained for a modulation rate of 800 Hz. The highest modulation rate for which thresholds could be obtained declined with increasing carrier frequency for all listeners. At 10 kHz, the highest modulation rate at which thresholds could be obtained was 600 Hz. The upper limit of sensitivity to ITDs conveyed in the envelope of high-frequency modulated sounds appears to be higher than previously considered.

Using individual differences to test the role of temporal and place cues in coding frequency modulation

The question of how frequency is coded in the peripheral auditory system remains unresolved. Previous research has suggested that slow rates of frequency modulation (FM) of a low carrier frequency may be coded via phase-locked temporal information in the auditory nerve, whereas FM at higher rates and/or high carrier frequencies may be coded via a rate-place (tonotopic) code. This hypothesis was tested in a cohort of 100 young normal-hearing listeners by comparing individual sensitivity to slow-rate (1-Hz) and fast-rate (20-Hz) FM at a carrier frequency of 500 Hz with independent measures of phase-locking (using dynamic interaural time difference, ITD, discrimination), level coding (using amplitude modulation, AM, detection), and frequency selectivity (using forward-masking patterns). All FM and AM thresholds were highly correlated with each other. However, no evidence was obtained for stronger correlations between measures thought to reflect phase-locking (e.g., slow-rate FM and ITD sensitivity), or between measures thought to reflect tonotopic coding (fast-rate FM and forward-masking patterns). The results suggest that either psychoacoustic performance in young normal-hearing listeners is not limited by peripheral coding, or that similar peripheral mechanisms limit both high- and low-rate FM coding.

Aging effect on Mandarin Chinese vowel and tone identification

Mandarin Chinese speech sounds (vowels × tones) were presented to younger and older Chinese-native speakers with normal hearing. For the identification of vowel-plus-tone, vowel-only, and tone-only, younger listeners significantly outperformed older listeners. The tone 3 identification scores correlated significantly with the age of older listeners. Moreover, for older listeners, the identification rate of vowel-plus-tone was significantly lower than that of vowel-only and tone-only, whereas for younger listeners, there was no difference among the three identification scores. Therefore, aging negatively affected Mandarin vowel and tone perception, especially when listeners needed to process both phonemic and tonal information.

The perception of complex pitch in cochlear implants: A comparison of monopolar and tripolar stimulation

Cochlear implant listeners typically perform poorly in tasks of complex pitch perception (e.g., musical pitch and voice pitch). One explanation is that wide current spread during implant activation creates channel interactions that may interfere with perception of temporal fundamental frequency information contained in the amplitude modulations within channels. Current focusing using a tripolar mode of stimulation has been proposed as a way of reducing channel interactions, minimising spread of excitation and potentially improving place and temporal pitch cues. The present study evaluated the effect of mode in a group of cochlear implant listeners on a pitch ranking task using male and female singing voices separated by either a half or a quarter octave. Results were variable across participants, but on average, pitch ranking was at chance level when the pitches were a quarter octave apart and improved when the difference was a half octave. No advantage was observed for tripolar over monopolar mode at either pitch interval, suggesting that previously published psychophysical advantages for focused modes may not translate into improvements in complex pitch ranking. Evaluation of the spectral centroid of the stimulation pattern, plus a lack of significant difference between male and female voices, suggested that participants may have had difficulty in accessing temporal pitch cues in either mode.

Effects of Presentation Rate and Attention on Auditory Discrimination: A Comparison of Long-Latency Auditory Evoked Potentials in School-Aged Children and Adults

Decoding human speech requires both perception and integration of brief, successive auditory stimuli that enter the central nervous system as well as the allocation of attention to language-relevant signals. This study assesses the role of attention on processing rapid transient stimuli in adults and children. Cortical responses (EEG/ERPs), specifically mismatch negativity (MMN) responses, to paired tones (standard 100-100 Hz; deviant 100-300 Hz) separated by a 300, 70 or 10 ms silent gap (ISI) were recorded under Ignore and Attend conditions in 21 adults and 23 children (6-11 years old). In adults, an attention-related enhancement was found for all rate conditions and laterality effects (L>R) were observed. In children, 2 auditory discrimination-related peaks were identified from the difference wave (deviant-standard): an early peak (eMMN) at about 100-300 ms indexing sensory processing, and a later peak (LDN), at about 400-600 ms, thought to reflect reorientation to the deviant stimuli or "second-look" processing. Results revealed differing patterns of activation and attention modulation for the eMMN in children as compared to the MMN in adults: The eMMN had a more frontal topography as compared to adults and attention played a significantly greater role in childrens' rate processing. The pattern of findings for the LDN was consistent with hypothesized mechanisms related to further processing of complex stimuli. The differences between eMMN and LDN observed here support the premise that separate cognitive processes and mechanisms underlie these ERP peaks. These findings are the first to show that the eMMN and LDN differ under different temporal and attentional conditions, and that a more complete understanding of children's responses to rapid successive auditory stimulation requires an examination of both peaks.

Fundamental-frequency discrimination using noise-band-vocoded harmonic complexes in older listeners with normal hearing

Voice-pitch cues provide detailed information about a talker that help a listener to understand speech in complex environments. Temporal-envelope based voice-pitch coding is important for listeners with hearing impairment, especially listeners with cochlear implants, as spectral resolution is not sufficient to provide a spectrally based voice-pitch cue. The effect of aging on the ability to glean voice-pitch information using temporal envelope cues is not completely understood. The current study measured fundamental frequency (f0) discrimination limens in normal-hearing younger and older adults while listening to noise-band vocoded harmonic complexes with varying numbers of spectral channels. Age-related disparities in performance were apparent across all conditions, independent of spectral degradation and/or fundamental frequency. The findings have important implications for older listeners with normal hearing and hearing loss, who may be inherently limited in their ability to perceive f0 cues due to senescent decline in auditory function.

Higher-level linguistic categories dominate lower-level acoustics in lexical tone processing

Native tonal-language speakers exhibit reduced sensitivity to lexical tone differences within, compared to across, categories (higher-level linguistic category influence). Yet, sensitivity is enhanced among musically trained, non-tonal-language-speaking individuals (lower-level acoustics processing influence). The current study investigated the relative contribution of higher- and lower-level influences when both are present. Seventeen Mandarin musicians completed music pitch and lexical tone discrimination tasks. Similar to English musicians [Zhao and Kuhl (2015). J. Acoust. Soc. Am. 137(3), 1452-1463], Mandarin musicians' overall sensitivity to lexical tone differences was associated with music pitch score, suggesting lower-level contributions. However, the musician's sensitivities to lexical tone pairs along a continuum were similar to Mandarin non-musicians, reflecting dominant higher-level influences.

Spectrum pattern resolution after noise exposure in a beluga whale, Delphinapterus leucas: Evoked potential study

Temporary threshold shift (TTS) and the discrimination of spectrum patterns after fatiguing noise exposure (170 dB re 1 μPa, 10 min duration) was investigated in a beluga whale, Delphinapterus leucas, using the evoked potential technique. Thresholds were measured using rhythmic (1000/s) pip trains of varying levels and recording the rhythmic evoked responses. Discrimination of spectrum patterns was investigated using rippled-spectrum test stimuli of various levels and ripple densities, recording the rhythmic evoked responses to ripple phase reversals. Before noise exposure, the greatest responses to rippled-spectrum probes were evoked by stimuli with a low ripple density with a decrease in the response magnitude occurring with an increasing ripple density. After noise exposure, both a TTS and a reduction of the responses to rippled-spectrum probes appeared and recovered in parallel. The reduction of the responses to rippled-spectrum probes was maximal for high-magnitude responses at low ripple densities and was negligible for low-magnitude responses at high ripple densities. It is hypothesized that the impacts of fatiguing sounds are not limited by increased thresholds and decreased sensitivity results in reduced ability to discriminate fine spectral content with the greatest impact on the discrimination of spectrum content that may carry the most obvious information about stimulus properties.

Just-noticeable difference of tone pitch contour change for Mandarin congenital amusics

Congenital amusia is a neuro-developmental disorder that may affect the processing of both music pitch and lexical tone. In the present study, the just-noticeable differences (JNDs) of tone pitch contour change were examined for three groups of Mandarin-native listeners: amusics with (tone agnosics) and without lexical tone difficulties (pure amusics), and matched controls. Tone agnosics showed significantly larger JNDs than normal controls, while pure amusics performed comparably with the controls. These results suggest that only those amusics with behavioral lexical tone deficits might be psychophysically impaired in pitch contour discrimination.

[Neurotology and cochlear implants]

In this review we analyse cochlear implantation in terms of the fundamental aspects of the functioning of the auditory system. Concepts concerning neuronal plasticity applied to electrical stimulation in perinatal and adult deep hypoacusis are reviewed, and the latest scientific bases that justify early implantation following screening for congenital deafness are discussed. Finally, this review aims to serve as an example of the importance of fostering the sub-specialty of neurotology in our milieu, with the aim of bridging some of the gaps between specialties and thus improving both the knowledge in the field of research on auditory pathologies and in the screening of patients. The objectives of this review, targeted above all towards specialists in the field of otorhinolaryngology, are to analyse some significant neurological foundations in order to reach a better understanding of the clinical events that condition the indications and the rehabilitation of patients with cochlear implants, as well as to use this means to foster the growth of the sub-specialty of neurotology.

Relationship between tinnitus pitch and edge of hearing loss in individuals with a narrow tinnitus bandwidth

OBJECTIVE

Psychoacoustic measures of tinnitus, in particular dominant tinnitus pitch and its relationship to the shape of the audiogram, are important in determining and verifying pathophysiological mechanisms of the condition. Our previous study postulated that this relationship might vary between different groups of people with tinnitus. For a small subset of participants with narrow tinnitus bandwidth, pitch was associated with the audiometric edge, consistent with the tonotopic reorganization theory. The current study objective was to establish this relationship in an independent sample.

DESIGN

This was a retrospective design using data from five studies conducted between 2008 and 2013.

STUDY SAMPLE

From a cohort of 380 participants, a subgroup group of 129 with narrow tinnitus bandwidth were selected.

RESULTS

Tinnitus pitch generally fell within the area of hearing loss. There was a statistically significant correlation between dominant tinnitus pitch and edge frequency; higher edge frequency being associated with higher dominant tinnitus pitch. However, similar to our previous study, for the majority of participants pitch was more than an octave above the edge frequency.

CONCLUSIONS

The findings did not support our prediction and are therefore not consistent with the reorganization theory postulating tinnitus pitch to correspond to the audiometric edge.

Representation of pitch chroma by multi-peak spectral tuning in human auditory cortex

Musical notes played at octave intervals (i.e., having the same pitch chroma) are perceived as similar. This well-known perceptual phenomenon lays at the foundation of melody recognition and music perception, yet its neural underpinnings remain largely unknown to date. Using fMRI with high sensitivity and spatial resolution, we examined the contribution of multi-peak spectral tuning to the neural representation of pitch chroma in human auditory cortex in two experiments. In experiment 1, our estimation of population spectral tuning curves from the responses to natural sounds confirmed--with new data--our recent results on the existence of cortical ensemble responses finely tuned to multiple frequencies at one octave distance (Moerel et al., 2013). In experiment 2, we fitted a mathematical model consisting of a pitch chroma and height component to explain the measured fMRI responses to piano notes. This analysis revealed that the octave-tuned populations-but not other cortical populations-harbored a neural representation of musical notes according to their pitch chroma. These results indicate that responses of auditory cortical populations selectively tuned to multiple frequencies at one octave distance predict well the perceptual similarity of musical notes with the same chroma, beyond the physical (frequency) distance of notes.

Relationship between listeners' nonnative speech recognition and categorization abilities

Enhancement of the perceptual encoding of talker characteristics (indexical information) in speech can facilitate listeners' recognition of linguistic content. The present study explored this indexical-linguistic relationship in nonnative speech processing by examining listeners' performance on two tasks: nonnative accent categorization and nonnative speech-in-noise recognition. Results indicated substantial variability across listeners in their performance on both the accent categorization and nonnative speech recognition tasks. Moreover, listeners' accent categorization performance correlated with their nonnative speech-in-noise recognition performance. These results suggest that having more robust indexical representations for nonnative accents may allow listeners to more accurately recognize the linguistic content of nonnative speech.

Effect of stimulus bandwidth and duration on monaural envelope correlation perception

Monaural envelope correlation perception is the ability to discriminate between stimuli composed of two or more bands of noise based on envelope correlation. Sensitivity decreases as stimulus bandwidth is reduced below 100 Hz. The present study manipulated stimulus bandwidth (25-100 Hz) and duration (25-800 ms) to evaluate whether performance of highly trained listeners is limited by the number of inherent modulation periods in each presentation. Stimuli were two bands of noise, separated by a 500-Hz gap centered on 2250 Hz. Performance improved reliably with increasing numbers of envelope modulation periods, although there were substantial individual differences.

Sensitivity to interaural envelope correlation changes in bilateral cochlear-implant users

Provision of bilateral cochlear implants (CIs) to people who are deaf is partially justified by improved abilities to understand speech in noise when comparing bilateral vs unilateral listening conditions. However, bilateral CI listeners generally show only monaural head shadow with little improvement in speech understanding due to binaural unmasking. Sensitivity to change in interaural envelope correlation, which is related to binaural speech unmasking, was investigated. Bilateral CI users were tested with bilaterally synchronized processors at single, pitch-matched electrode pairs. First, binaural masking level differences (BMLDs) were measured using 1000 pulse-per-second (pps) carriers, yielding BMLDs of 11.1 ± 6.5 and 8.5 ± 4.2 dB for 10- and 50-Hz bandwidth masking noises, respectively. Second, envelope correlation change just-noticeable differences (JNDs) were measured. Stimuli presented at 1000 pps yielded lower JNDs than those presented at 100 pps. Furthermore, perfectly correlated reference stimuli produced lower JNDs than uncorrelated references, and uncorrelated references generally produced immeasurable JNDs. About 25% of JNDs measured in the CI listeners were in the range of JNDs observed in normal-hearing listeners presented CI simulations. In conclusion, CI listeners can perceive changes in interaural envelope correlation, but the poor performance may be a major limiting factor in binaural unmasking tested to date in realistic listening environments.

Musicians and non-musicians are equally adept at perceiving masked speech

There is much interest in the idea that musicians perform better than non-musicians in understanding speech in background noise. Research in this area has often used energetic maskers, which have their effects primarily at the auditory periphery. However, masking interference can also occur at more central auditory levels, known as informational masking. This experiment extends existing research by using multiple maskers that vary in their informational content and similarity to speech, in order to examine differences in perception of masked speech between trained musicians (n = 25) and non-musicians (n = 25). Although musicians outperformed non-musicians on a measure of frequency discrimination, they showed no advantage in perceiving masked speech. Further analysis revealed that non-verbal IQ, rather than musicianship, significantly predicted speech reception thresholds in noise. The results strongly suggest that the contribution of general cognitive abilities needs to be taken into account in any investigations of individual variability for perceiving speech in noise.

Age effects in discrimination of intervals within rhythmic tone sequences

This study measured listener sensitivity to increments of a target inter-onset interval (IOI) embedded within tone sequences that featured different rhythmic patterns. The sequences consisted of six 50-ms 1000-Hz tone bursts separated by silent intervals that were adjusted to create different timing patterns. Control sequences were isochronous, with all tonal IOIs fixed at either 200 or 400 ms, while other patterns featured combinations of the two IOIs arranged to create different sequential tonal groupings. Duration difference limens in milliseconds for increments of a single sequence IOI were measured adaptively by adjusting the duration of an inter-tone silent interval. Specific target IOIs within sequences differed across discrimination conditions. Listeners included younger normal-hearing adults and groups of older adults with and without hearing loss. Discrimination performance measured for each of the older groups of listeners was observed to be equivalent, with each group exhibiting significantly poorer discrimination performance than the younger listeners in each sequence condition. Additionally, the specific influence of variable rhythmic grouping on temporal sensitivity was found to be greatest among older listeners.

Decoding time for the identification of musical key

This study examines the decoding times at which the brain processes structural information in music and compares them to timescales implicated in recent work on speech. Combining an experimental paradigm based on Ghitza and Greenberg (Phonetica, 66(1-2), 113-126, 2009) for speech with the approach of Farbood et al. (Journal of Experimental Psychology: Human Perception and Performance, 39(4), 911-918, 2013) for musical key-finding, listeners were asked to judge the key of short melodic sequences that were presented at a highly a compressed rate with varying durations of silence inserted in a periodic manner in the audio signal. The distorted audio signals comprised signal-silence alternations showing error rate curves that identify peak performance centered around an event rate of 5-7 Hz (143-200 ms interonset interval; 300-420 beats/min), where event rate is defined as the average rate of pitch change. The data support the hypothesis that the perceptual analysis of music entails the processes of parsing the signal into chunks of the appropriate temporal granularity and decoding the signal for recognition. The music-speech comparison points to similarities in how auditory processing builds on the specific temporal structure of the input, and how that structure interacts with the internal temporal dynamics of the neural mechanisms underpinning perception.

Pitch ranking, electrode discrimination, and physiological spread of excitation using current steering in cochlear implants

The first objective of this study was to determine whether adaptive pitch-ranking and electrode-discrimination tasks with cochlear-implant (CI) recipients produce similar results for perceiving intermediate "virtual-channel" pitch percepts using current steering. Previous studies have not examined both behavioral tasks in the same subjects with current steering. A second objective was to determine whether a physiological metric of spatial separation using the electrically evoked compound action potential spread-of-excitation (ECAP SOE) function could predict performance in the behavioral tasks. The metric was the separation index (Σ), defined as the difference in normalized amplitudes between two adjacent ECAP SOE functions, summed across all masker electrodes. Eleven CII or 90 K Advanced Bionics (Valencia, CA) recipients were tested using pairs of electrodes from the basal, middle, and apical portions of the electrode array. The behavioral results, expressed as d', showed no significant differences across tasks. There was also no significant effect of electrode region for either task. ECAP Σ was not significantly correlated with pitch ranking or electrode discrimination for any of the electrode regions. Therefore, the ECAP separation index is not sensitive enough to predict perceptual resolution of virtual channels.

Re-examining the upper limit of temporal pitch

Five normally hearing listeners pitch-ranked harmonic complexes of different fundamental frequencies (F0s) filtered in three different frequency regions. Harmonics were summed either in sine, alternating sine-cosine (ALT), or pulse-spreading (PSHC) phase. The envelopes of ALT and PSHC complexes repeated at rates of 2F0 and 4F0. Pitch corresponded to those rates at low F0s, but, as F0 increased, there was a range of F0s over which pitch remained constant or dropped. Gammatone-filterbank simulations showed that, as F0 increased and the number of harmonics interacting in a filter dropped, the output of that filter switched from repeating at 2F0 or 4F0 to repeating at F0. A model incorporating this phenomenon accounted well for the data, except for complexes filtered into the highest frequency region (7800-10 800 Hz). To account for the data in that region it was necessary to assume either that auditory filters at very high frequencies are sharper than traditionally believed, and/or that the auditory system applies smaller weights to filters whose outputs repeat at high rates. The results also provide evidence on the highest pitch that can be derived from purely temporal cues, and corroborate recent reports that a complex pitch can be derived from very-high-frequency resolved harmonics.

Effects of language experience and expectations on attention to consonants and tones in English and Mandarin Chinese

Both long-term native language experience and immediate linguistic expectations can affect listeners' use of acoustic information when making a phonetic decision. In this study, a Garner selective attention task was used to investigate differences in attention to consonants and tones by American English-speaking listeners (N = 20) and Mandarin Chinese-speaking listeners hearing speech in either American English (N = 17) or Mandarin Chinese (N = 20). To minimize the effects of lexical differences and differences in the linguistic status of pitch across the two languages, stimuli and response conditions were selected such that all tokens constitute legitimate words in both languages and all responses required listeners to make decisions that were linguistically meaningful in their native language. Results showed that regardless of ambient language, Chinese listeners processed consonant and tone in a combined manner, consistent with previous research. In contrast, English listeners treated tones and consonants as perceptually separable. Results are discussed in terms of the role of sub-phonemic differences in acoustic cues across language, and the linguistic status of consonants and pitch contours in the two languages.

[High-resolution distortion-product otoacoustic emissions: method and clinical applications]

Unlike pure tone thresholds that assess both peripheral and central sound processing, distortion-product otoacoustic emissions (DPOAEs) selectively mirror the functioning of the cochlear amplifier. High resolution DPOAEs are missing in the toolbox of routine audiometry due to the fact that high resolution DPOAE measurements are more time-consuming when compared to normal clinical DP grams with rough frequency resolution. Measurements of high resolution DPOAEs allow an early assessment of beginning sensory cell damage due to sound overexposure or administration of ototoxic drugs. When using a rough grid, sensory cell damage would be overlooked as in the early state damage only appears at some distinct cochlear sites. A review is given on the method and application of high resolution DPOAEs.

Factors affecting sensitivity to frequency change in school-age children and adults

PURPOSE

The factors affecting frequency discrimination in school-age children are poorly understood. The goal of the present study was to evaluate developmental effects related to memory for pitch and the utilization of temporal fine structure.

METHOD

Listeners were 5.1- to 13.6-year-olds and adults, all with normal hearing. A subgroup of children had musical training. The task was a 3-alternative forced choice in which listeners identified the interval with the higher frequency tone or the tone characterized by frequency modulation (FM). The standard was 500 or 5000 Hz, and the FM rate was either 2 or 20 Hz.

RESULTS

Thresholds tended to be higher for younger children than for older children and adults for all conditions, although this age effect was smaller for FM detection than for pure-tone frequency discrimination. Neither standard frequency nor modulation rate affected the child/adult difference FM thresholds. Children with musical training performed better than their peers on pure-tone frequency discrimination at 500 Hz.

CONCLUSIONS

Testing frequency discrimination using a low-rate FM detection task may minimize effects related to cognitive factors like memory for pitch or training effects. Maturation of frequency discrimination does not appear to differ across conditions in which listeners are hypothesized to rely on temporal cues and place cues.

Perception of a sung vowel as a function of frequency-modulation rate and excursion in listeners with normal hearing and hearing impairment

PURPOSE

Frequency fluctuations in human voices can usually be described as coherent frequency modulation (FM). As listeners with hearing impairment (HI listeners) are typically less sensitive to FM than listeners with normal hearing (NH listeners), this study investigated whether hearing loss affects the perception of a sung vowel based on FM cues.

METHOD

Vibrato maps were obtained in 14 NH and 12 HI listeners with different degrees of musical experience. The FM rate and FM excursion of a synthesized vowel, to which coherent FM was applied, were adjusted until a singing voice emerged.

RESULTS

In NH listeners, adding FM to the steady vowel components produced perception of a singing voice for FM rates between 4.1 and 7.5 Hz and FM excursions between 17 and 83 cents on average. In contrast, HI listeners showed substantially broader vibrato maps. Individual differences in map boundaries were, overall, not correlated with audibility or frequency selectivity at the vowel fundamental frequency, with no clear effect of musical experience.

CONCLUSION

Overall, it was shown that hearing loss affects the perception of a sung vowel based on FM-rate and FM-excursion cues, possibly due to deficits in FM detection or discrimination or to a degraded ability to follow the rate of frequency changes.

Effects of consecutive wideband tympanometry trials on energy absorbance measures of the middle ear

PURPOSE

Wideband acoustic immittance (WAI) is a new technique for assessing middle ear transfer function. It includes energy absorbance (EA) measures and can be acquired with the ear canal pressure varied, known as wideband tympanometry (WBTymp). The authors of this study aimed to investigate effects of consecutive WBTymp testing on EA.

METHOD

Data were collected in 29 young adults with normal hearing and middle ear status. Before and after 8 successive WBTymp runs, EA was also measured at ambient pressure. Subsequently, two 226-Hz tympanometry tests were performed.

RESULTS

EA systematically changed over the WBTymp trials in a frequency-specific manner: increase for low frequencies (below 1.5 kHz) and decrease for high frequencies (around 2 kHz and 5 to 6 kHz). The changes, although small, were significant. Much larger EA changes were measured at ambient pressure. The test-retest difference of 226-Hz tympanogram measures was much smaller than previously reported.

CONCLUSION

Consecutive tympanometry testing alters EA measures of the middle ear. This phenomenon could be mainly attributed to change in stiffness at the eardrum, called tympanometric preconditioning. This also has effects on baseline WBTymp outcomes. This effect should be taken into account as a procedural variable in both research and clinical applications of WAI measurements.