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Svistushkin M, Kotova S, Zolotova A, Fayzullin A, Antoshin A, Serejnikova N, Shekhter A, Voloshin S, Giliazova A, Istranova E, Nikiforova G, Khlytina A, Shevchik E, Nikiforova A, Selezneva L, Shpichka A, Timashev PS. Collagen Matrix to Restore the Tympanic Membrane: Developing a Novel Platform to Treat Perforations. Polymers (Basel) 2024; 16:248. [PMID: 38257047 PMCID: PMC10820519 DOI: 10.3390/polym16020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Modern otology faces challenges in treating tympanic membrane (TM) perforations. Instead of surgical intervention, alternative treatments using biomaterials are emerging. Recently, we developed a robust collagen membrane using semipermeable barrier-assisted electrophoretic deposition (SBA-EPD). In this study, a collagen graft shaped like a sponge through SBA-EPD was used to treat acute and chronic TM perforations in a chinchilla model. A total of 24 ears from 12 adult male chinchillas were used in the study. They were organized into four groups. The first two groups had acute TM perforations and the last two had chronic TM perforations. We used the first and third groups as controls, meaning they did not receive the implant treatment. The second and fourth groups, however, were treated with the collagen graft implant. Otoscopic assessments were conducted on days 14 and 35, with histological evaluations and TM vibrational studies performed on day 35. The groups treated with the collagen graft showed fewer inflammatory changes, improved structural recovery, and nearly normal TM vibrational properties compared to the controls. The porous collagen scaffold successfully enhanced TM regeneration, showing high biocompatibility and biodegradation potential. These findings could pave the way for clinical trials and present a new approach for treating TM perforations.
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Affiliation(s)
- Mikhail Svistushkin
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Svetlana Kotova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Anna Zolotova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Alexey Fayzullin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Artem Antoshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Natalia Serejnikova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Anatoly Shekhter
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Sergei Voloshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Aliia Giliazova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Elena Istranova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Galina Nikiforova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Arina Khlytina
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Elena Shevchik
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Anna Nikiforova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Liliya Selezneva
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Anastasia Shpichka
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Peter S. Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
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Grinn SK, Trevino M, Lobarinas E. Noise-Induced Hearing Threshold Shift Correlated with Body Weight and External-Ear Amplification in Chinchilla: a Preliminary Analysis. J Assoc Res Otolaryngol 2023; 24:563-574. [PMID: 38010580 PMCID: PMC10752858 DOI: 10.1007/s10162-023-00913-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/11/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND External-ear amplification (EEA) has been shown to vary from 5-19 dB-A in large datasets of pediatric, adolescent, and adult human participants. However, variable EEA is an overlooked characteristic that likely plays a role in individual noise-induced hearing loss (NIHL) susceptibility. A noise exposure varying 5-19 dB-A translates to high-EEA individuals theoretically experiencing 3-4 times greater NIHL risk than low-EEA individuals. OBJECTIVE The purpose of this preliminary analysis was to test the hypothesis that higher EEA is correlated with increased noise-induced threshold shift susceptibility. DESIGN Nine chinchillas were exposed to 4-kHz octave-band noise at 89 dB-SPL for 24 h. Auditory brainstem response thresholds were obtained pre-exposure, 24-h post-exposure, and 4-week post-exposure. Relationships between EEA and threshold shift were analyzed. RESULTS Open-ear EEA ranged 11-19 dB-SPL, and occluded-ear EEA ranged 10-21 dB-SPL. Higher occluded-ear EEA was correlated with increased NIHL susceptibility (p = 0.04), as was lower body weight (p = 0.01). Male animals exhibited more threshold shift than female animals (p = 0.02), lower body weight than female animals (p = 0.02), and higher occluded-ear EEA (male mean = 18 dB; female mean = 15 dB). CONCLUSIONS Taken together, increased threshold shift susceptibility was observed in the smallest animals, animals with the highest occluded-ear EEA, and in male animals (which tended to have higher occluded-ear EEA). Given the established relationship between smaller body size and higher occluded-ear EEA, these preliminary results suggest that body size (and occluded-ear EEA; a function of body size) could be a potential, underlying driver of NIHL susceptibility differences, rather than true sex differences.
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Affiliation(s)
- Sarah K Grinn
- College of Health Professions, Central Michigan University, Mount Pleasant, MI, USA.
| | - Monica Trevino
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Edward Lobarinas
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
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McCreery RW, Grindle A, Merchant GR, Crukley J, Walker EA. Predicting wideband real-ear-to-coupler differences in children using wideband acoustic immittance. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:991-1002. [PMID: 37581511 PMCID: PMC10431946 DOI: 10.1121/10.0020660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
Individual differences in ear-canal acoustics introduce variability into hearing aid output that can affect speech audibility. Measuring ear-canal acoustics in young children can be challenging, and relying on normative real-ear-to-coupler difference (RECD) transforms can lead to large fitting errors. Acoustic immittance measures characterize the impedance of the ear and are more easily measured than RECD. Using 226 Hz tympanometry to predict the RECD is more accurate than using age-based average RECD values. The current study sought to determine whether wideband acoustic immittance measurements could improve predictions of wideband real-ear-to-coupler difference (wRECD). 150 children ages 2-10 years with intact tympanic membranes underwent wRECD and wideband acoustic immittance measures in each ear. Three models were constructed to predict each child's measured wRECD: the age-based average wRECD, 226 Hz admittance wRECD, and wideband absorbance wRECD. The average age-based wRECD model predicted the child's measured wRECD within 3 dB in 62% of cases, but both the 226 Hz admittance and wideband absorbance wRECD were within 3 dB in 90% of cases. Using individual 226 Hz or wideband absorbance to predict wRECD improved the accuracy and precision of transforms used for pediatric hearing aid fitting.
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Affiliation(s)
- Ryan W McCreery
- Audibility, Perception, and Cognition Laboratory, Boys Town National Research Hospital, Omaha, Nebraska 68131, USA
| | - Anastasia Grindle
- Pediatric Audiology, UW Health American Family Children's Hospital, Madison, Wisconsin 53792, USA
| | - Gabrielle R Merchant
- Translational Auditory Physiology and Perception Laboratory, Boys Town National Research Hospital, Omaha, Nebraska 68131, USA
| | - Jeffery Crukley
- Faculty of Medicine, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario M5G 1V7, Canada
| | - Elizabeth A Walker
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa 52242, USA
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McCreery RW, Crukley J, Grindle A, Merchant GR, Walker E. Predicting children's real-ear-to-coupler differences based on tympanometric data. Int J Audiol 2023; 62:462-471. [PMID: 36752672 PMCID: PMC10159987 DOI: 10.1080/14992027.2023.2169200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Paediatric hearing-aid verification relies on measures of output obtained from the ear canal or in a coupler with the child's real-ear-to-coupler difference (RECD). Measured RECD cannot always be completed in children, leading to fitting inaccuracies. Audiologists often have tympanometry data that characterises the child's ear-canal acoustics. The goal of this study was to determine if tympanometry can be used to improve predictions of measured RECD. DESIGN A retrospective analysis of RECD and admittance, tympanometric peak pressure, and equivalent ear-canal volume from 226 Hz tympanometry collected as part of a longitudinal study of children with hearing loss were modelled with Bayesian hierarchical regression. STUDY SAMPLE Two-hundred sixty-six children with mild-to-severe hearing loss contributed data. RESULTS Age-based average RECD models were within 3 dB of measured RECD values in 54% of cases with normal middle ear status and 50.6% of cases with abnormal middle ear status. Immittance-predicted RECD were within 3 dB in 69.6% of cases with normal middle ear status and 74.4% of cases with abnormal middle ear status. CONCLUSION Immittance-predicted RECD was more accurate than age-based average RECD, particularly in children with abnormal middle ear status. The findings suggest that 226 Hz tympanometry could be used clinically to improve predictions of measured RECD when it cannot be measured.
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Affiliation(s)
- Ryan W. McCreery
- Audibility, Perception, and Cognition Laboratory at Boys Town National Research Hospital, Omaha, NE, United States of America
| | - Jeffery Crukley
- Faculty of Medicine, Department of Speech-Language Pathology, University of Toronto, Canada
| | - Anastasia Grindle
- Pediatric Audiology, UW Health American Family Children’s Hospital, Madison, WI, United States of America
| | - Gabrielle R. Merchant
- Translational Auditory Physiology and Perception Laboratory at Boys Town National Research Hospital, Omaha, NE, United States of America
| | - Elizabeth Walker
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, United States of America
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Jorgensen L, Barrett R, Jedlicka D, Messersmith J, Pratt S. Real-Ear-to-Coupler Difference: Physical and Perceptual Differences. Am J Audiol 2022; 31:1088-1097. [PMID: 36037483 DOI: 10.1044/2022_aja-21-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The real-ear-to-coupler difference (RECD) is a recommended measure for accurate hearing aid fittings, especially for pediatric populations. However, for adults, many clinicians question whether it is necessary. METHOD Hearing aids were fit on two groups of 85 older adults seen at a Veterans Administration audiology clinic. One group was fit using RECD measurements, whereas the second group was fit with population-based average RECD values. The two groups had similar pure-tone hearing thresholds. RESULTS Like previous studies, there was little difference between the measured RECD for the right and left ears among the participants. Although the majority of the measured RECDs were within 1 SD of the mean, approximately 20% of those measured were outside of the normal range. It also was found that all participants produced lower (improved) Hearing Handicap Inventory for Elderly-Screening (HHIE-S) scores from pre- to postfitting, thus suggesting a reduction in self-perceived hearing handicap. CONCLUSIONS Despite having similar prefitting HHIE-S scores, those participants who had their hearing aids fit using measured RECD values had lower postfitting scores than the group that was fit with average RECD values. Furthermore, there was a significant difference between the groups on several questions of the International Outcome Inventory-Hearing Aids, suggesting that there was higher satisfaction with the fittings based on the custom RECD rather than the fittings based on the average RECD. This study demonstrated that, in addition to performing verification using real-ear measurements, accurate conversion of dB HL to dB SPL using personalized RECD likely improved hearing aid satisfaction.
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Affiliation(s)
- Lindsey Jorgensen
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion.,VA Sioux Falls Healthcare System, SD.,VA Pittsburgh Healthcare System, PA
| | - Rachel Barrett
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion
| | - David Jedlicka
- VA Pittsburgh Healthcare System, PA.,Department of Communication Sciences and Disorders, University of Pittsburgh, PA
| | - Jessica Messersmith
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion
| | - Sheila Pratt
- VA Pittsburgh Healthcare System, PA.,Department of Communication Sciences and Disorders, University of Pittsburgh, PA
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The accuracy of standard audiometric hearing level thresholds in pediatric patients. Int J Pediatr Otorhinolaryngol 2020; 138:110381. [PMID: 33152972 DOI: 10.1016/j.ijporl.2020.110381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Standard audiograms provide decibels Hearing Level (dB HL) thresholds, which are referenced to normative values specified in decibels Sound Pressure Level in an acoustic coupler. Due to variability in external ear acoustics, the actual sound levels reaching the eardrum can vary across individuals. The real-ear to coupler difference (RECD) is a frequency-specific measurement of the difference between sound levels measured at the eardrum and in a coupler. Here, we compare the standard audiogram dB HL levels to RECD corrected hearing thresholds (dB RECHL) in children. METHODS Children who underwent standard audiometric and RECD testing were included. The dB RECHL was established and the differences between dB HL and dB RECHL (threshold error) was calculated. A threshold error >5 dB was considered significant. RESULTS A total of 166 children were included (mean age 12 years). Overall, 14% had normal hearing, 52% had conductive hearing loss and 27% had sensorineural hearing loss. Hearing threshold levels were overestimated by the standard audiogram compared to dB RECHL, at all frequencies (250-6000 Hz). In the lower frequencies and at 6000 Hz, 33-59% of patients were overestimated, with a threshold error up to 25 dB. In the mid frequencies, 33% were overestimated with a similar threshold error. CONCLUSION Standard audiogram thresholds overestimated hearing levels in children which may have clinical implications. This problem can be addressed by correcting thresholds with RECD. More studies are needed to assess the effect of correcting thresholds on hearing outcomes in children.
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Konukseven O, Kaya S, Oguzturk S, Gezgin B. External and middle ear resonance frequency of fourty patients with tympanoplasty and mastoidectomy. Clin Otolaryngol 2020; 45:622-625. [PMID: 32277862 DOI: 10.1111/coa.13546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/10/2020] [Accepted: 03/29/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Ozlem Konukseven
- Audiology Department, Faculty of Health Sciences, Istanbul Aydın University, Istanbul, Turkey
| | - Sule Kaya
- Audiology Department, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Saadet Oguzturk
- Audiology Department, Faculty of Health Sciences, KTO Karatay University, Ankara, Turkey
| | - Bahri Gezgin
- ENT Department, Faculty of Medicine, Medicana Konya Hospital, KTO Karatay University, Konya, Turkey
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Ibekwe TS, Nwaorgu OG, Adeosun AA, Kokong DD, Lawal HO, Okundia PO, Onakoya PA. Assessments of the Size of Tympanic Membrane Perforations: A Comparison of Clinical Estimations with Video-Otoscopic Calculations. EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808701009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a study to determine how accurate various ENT specialists were in estimating the size of 100 tympanic membrane (TM) perforations with standard otoscopy. The specialists included, in descending order of rank, 2 Consultant Surgeons, 2 Senior Registrars, and 2 Registrars, all of whom had confirmed good vision. We compared their estimates, which were made independently and expressed as a percentage of the total area of the TM, with exact measurements calculated with computer-based video-otoscopy. We found that the video-otoscopic calculations were far superior to the estimates of the specialists, even the most experienced Consultants (p < 0.01). We recommend that video-otoscopy he used whenever possible.
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Affiliation(s)
- Titus S. Ibekwe
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
| | | | - Aderemi A. Adeosun
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
| | - Daniel D. Kokong
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
| | - Hakeem O. Lawal
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
| | - Patrick O. Okundia
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
| | - Paul A. Onakoya
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
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Munro KJ, Buttfield LM. Comparison of real-ear to coupler difference values in the right and left ear of adults using three earmold configurations. Ear Hear 2005; 26:290-8. [PMID: 15937410 DOI: 10.1097/00003446-200506000-00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of the study was to compare real-ear to coupler difference (RECD) values in the right and left ear of adults using three earmold configurations. DESIGN The RECD was obtained from both ears of 18 normal hearing adults by subtracting the HA2 2-cc coupler response from the real-ear response using an ER-3A insert earphone and a swept pure tone on the Audioscan RM500 probe-tube microphone system. The measurements were made with a personal earmold, foam eartip, and oto-admittance tip. RESULTS The mean difference between the right and left RECD was close to 0 dB for all earmold configurations and was not statistically significant on a repeated-measures analysis of variance (p > 0.05). In 90% of participants, the difference between ears was generally less than 3 dB at 0.5 to 4 kHz. CONCLUSIONS Cooperative participants with non-occluding wax and normal middle ear function (on tympanometry) show small differences in RECD between the right and left ear, irrespective of the earmold configuration. The study has yet to be extended to the clinical setting where subject cooperation and earmold fit may differ from the present study. In the meantime, the findings from the present study indicate that where an RECD can be obtained from only one ear of a participant, it is probably best to use this to derive real-ear SPL of both ears instead of relying on average age appropriate corrections.
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Affiliation(s)
- Kevin J Munro
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
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