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Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range

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Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range. / Stone, Michael; Perugia, Emanuele; Bakay, Warren et al.
In: Ear and Hearing, Vol. 43, No. 4, 31.07.2022, p. 1208-1221.

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Stone M, Perugia E, Bakay W, Lough M, Whiston H, Plack C. Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range. Ear and Hearing. 2022 Jul 31;43(4):1208-1221. Epub 2022 Mar 11. doi: 10.1097/AUD.0000000000001175

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Stone, Michael ; Perugia, Emanuele ; Bakay, Warren et al. / Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range. In: Ear and Hearing. 2022 ; Vol. 43, No. 4. pp. 1208-1221.

Bibtex

@article{c5121dfb77674aafb2a3bf97bd26b2f8,
title = "Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the {"}Normal{"} Audiogram Range",
abstract = "Objectives: The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear “dead regions” (i.e., regions of loss of inner hair cell [IHC] connectivity), using a “pass/fail” criterion based on the degree of elevation of a masked threshold in a tone-detection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a “fail” diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells. Design: One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their pure-tone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience. Results: Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of “normal” hearing (absolute thresholds ≤15 dB HL). Conclusions: Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically “normal” hearing. Results from the TEN test residing between “pass” and “fail” are dominated by processes not related to IHCs. The TEN test for IHC-related function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.",
keywords = "NESI, Noise-induced hearing loss, Subclinical hearing loss, TEN test",
author = "Michael Stone and Emanuele Perugia and Warren Bakay and Melanie Lough and Helen Whiston and Christopher Plack",
note = "Copyright {\textcopyright} 2015 The American Auditory Society",
year = "2022",
month = jul,
day = "31",
doi = "10.1097/AUD.0000000000001175",
language = "English",
volume = "43",
pages = "1208--1221",
journal = "Ear and Hearing",
issn = "0196-0202",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

RIS

TY - JOUR

T1 - Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range

AU - Stone, Michael

AU - Perugia, Emanuele

AU - Bakay, Warren

AU - Lough, Melanie

AU - Whiston, Helen

AU - Plack, Christopher

N1 - Copyright © 2015 The American Auditory Society

PY - 2022/7/31

Y1 - 2022/7/31

N2 - Objectives: The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear “dead regions” (i.e., regions of loss of inner hair cell [IHC] connectivity), using a “pass/fail” criterion based on the degree of elevation of a masked threshold in a tone-detection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a “fail” diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells. Design: One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their pure-tone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience. Results: Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of “normal” hearing (absolute thresholds ≤15 dB HL). Conclusions: Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically “normal” hearing. Results from the TEN test residing between “pass” and “fail” are dominated by processes not related to IHCs. The TEN test for IHC-related function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.

AB - Objectives: The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear “dead regions” (i.e., regions of loss of inner hair cell [IHC] connectivity), using a “pass/fail” criterion based on the degree of elevation of a masked threshold in a tone-detection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a “fail” diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells. Design: One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their pure-tone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience. Results: Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of “normal” hearing (absolute thresholds ≤15 dB HL). Conclusions: Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically “normal” hearing. Results from the TEN test residing between “pass” and “fail” are dominated by processes not related to IHCs. The TEN test for IHC-related function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.

KW - NESI

KW - Noise-induced hearing loss

KW - Subclinical hearing loss

KW - TEN test

U2 - 10.1097/AUD.0000000000001175

DO - 10.1097/AUD.0000000000001175

M3 - Journal article

C2 - 35276701

VL - 43

SP - 1208

EP - 1221

JO - Ear and Hearing

JF - Ear and Hearing

SN - 0196-0202

IS - 4

ER -