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Abstract (summary

The purpose of the present study was to determine the feasibility of reducing intersubject
variability of highf-requency hearing thresholds by using insert earphones and frequencymodulated (warble) tones. Forty listeners with normal hearing in the conventional
audiometric range (125-8000 Hz) participated in the study. Hearing thresholds were
measured at 10, 12, 14, 16, and 18 kHz with circumaural (HD-250) and insert (ER1)earphones using pure tones and 2% and 5% frequency-modulated FM (warble) tones.
Obtained results demonstrated significantly smaller intersubject variability of hearing
thresholds measured with insert earphones and 5% FM tones in comparison to all other test

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The purpose of the present study was to determine the feasibility of reducing intersubject
variability of highf-requency hearing thresholds by using insert earphones and frequencymodulated (warble) tones. Forty listeners with normal hearing in the conventional
audiometric range (125-8000 Hz) participated in the study. Hearing thresholds were
measured at 10, 12, 14, 16, and 18 kHz with circumaural (HD-250) and insert (ER1)earphones using pure tones and 2% and 5% frequency-modulated FM (warble) tones.
Obtained results demonstrated significantly smaller intersubject variability of hearing
thresholds measured with insert earphones and 5% FM tones in comparison to all other test
Audiometry, hearing threshold, high frequency
1. Introduction
High-frequency audiometry (HFA) refers to the hearing threshold measurements at
frequencies above 8 kHz. It complements conventional audiometric measurements
extending from low frequencies up to 8 kHz. Since frequencies in the order of 4-8 kHz are
considered the high frequency region of conventional audiometric measurements, the

There are also studies indicating the importance of high-frequency hearing for speech perception and for proper selection of aural rehabilitation strategies [1][2]. [3]). The HFA is typically . Therefore. and the dimensions of the ear canal. In this paper we refer to frequencies beyond 8 kHz as the HFA range. This variability results from large changes in high frequency hearing due to age. The main factor making the development of general normative data a very difficult task is the large intersubject variability of high frequency thresholds. In addition. spatial orientation. The medical community has limited interest of in developing the HFA norms for the general population since medical use of HFA is limited to serial measurements of the threshold of hearing in individual patients. Since high frequency hearing is important for human auditory awareness of the environment and general well-being it is important to determine normative values of high frequency hearing thresholds for the general population. the normative HFA data that can be used across large populations are very difficult to establish despite the fact that there are several documents and reports proposing normative high frequency thresholds for specific testing conditions and specific applications (e. Such values are needed in order to determine whether specific changes in high frequency sounds can be perceived by most of the population or to determine what a change in high frequency signal needs to be made by a signal designer in order to be detected and recognized under specific environmental conditions. Human factors interest in HFA stems also from the fact that the first symptoms of noise-induced hearing loss (NIHL) frequently develop in the high frequency range before it spreads down toward lower frequencies. and music perception. However. In both cases an early detection of a high-frequency hearing loss is important for prevention of more severe hearing loss affecting speech communication and perception of acoustic warnings as well as for identification of populations at risk. many nonNIHL hearing losses are progressive sensorineural high-frequency losses caused by various pathological agents.g.. the HFA range is of great interest to human factors engineering. In addition.audiometry above 8 kHz is also frequently referred to as extended high frequency audiometry (EHFA). Such signals emphasize rather than deemphasize differences in people and require careful calibration of equipment. exposure and susceptibility to noise. the proposed thresholds have been developed for pure tone signals under rigorous and time-consuming procedures using calibration equipment that is not easily available outside medical clinics and research laboratories. The HFA range lies beyond the basic range of speech communication frequencies but this range is important for acoustic signature recognition of many natural and military sources. which greatly affect the behavior of high frequency acoustic waves.

However. medications. and human factors applications it is important to first develop a procedure that is easily repeatable. 2. Good intrasubject reliability reported in these studies also indicates that the random errors related to calibration procedures and earphones fitting in HFA can be kept relatively small especially when the threshold of hearing is determined by measuring sound pressure in the ear canal using a probe tube microphone. this is a clinical and laboratory technique that is time consuming and requires medically trained personnel. In addition. can be used in various environments. Thus. Thus. and provides some averaging of the threshold values to provide more robust estimates of the HFA thresholds. In these applications patients serve as their own baselines. This paper presents a description and an initial validation of a new HFA procedure that results in relatively small intersubject variability and could be used across both medical and nonmedical applications of HFA. audio. for all the above reasons. they are inappropriate signals for human factors and audio applications where more general information about the hearing threshold is needed. Method . the existing HFA normative data and test procedures are not well suited for human factor applications. In order to compare a person's hearing to established norms. and noise levels affect the threshold of hearing over time. The probe microphone technique is an excellent method for determining the normative HFA values and for general HFA measurements. The signals proposed in this procedure are frequencymodulated tones that have never been reported before to be used for hearing threshold in high frequency range (HFA). There are several studies reporting very good intrasubject variability of the HFA data that is comparable to that of conventional audiometry.used to monitor to what extent specific pathologies. while pure tones are important frequency-specific test signals for medical assessment of hearing. research. in order to establish the normative HFA thresholds that can be used across wide ranges of medical. the procedure and instrumentation used for testing must be compatible with the procedure and instrumentation that was used to determine the norms. For that reason most of the efforts to develop appropriate methods to calibrate HFA equipment and to determine related normative hearing threshold values for the medical community was concerned with minimizing the intrasubject variability than intersubject variability of the data.

The test signals were high frequency pure tones and 2% and 5% FM tones at 10. The Sennheiser HD-250 circumaural earphones were calibrated with a flat-plate configuration of the IEC 318-2 (1998) [7] artificial ear (B&K 4153). SD = 2. and 18 kHz were actually modulated in both frequency (FM) and amplitude (AM).25-1989 [6] occluded ear simulator (Knowles DB-100 Zwislocki Coupler) with the nipple of the ER-1 sound tube attached to the coupler through ER1-08 adapter.1 Listeners Forty listeners.3 Procedures . Both earphonesused in this study had gradual frequency response roll-offs above 15 kHz and steep roll-offs above 17 kHz.5 s with a 25 ms rise/fall time.6 years) participated in this study. no history of recent otologic pathology. 2. The ER-1 insert earphone is a shoulder-mounted transducer coupled to the ear via plastic tubing ending with a foam eartip surrounding the internal plastic tube.2 Instrumentation All hearing screening and subsequent experimental testing were conducted in an audiometric test booth (Suttle.25 to 8 kHz frequency range (ANSI S3. Each participant had bilateral air conduction hearing thresholds less than 20 dB HL at all audiometric frequencies within the 0. All signals were presented for 1. 20 males and 20 females. 16 and 18 kHz produced by a Beltone 2000 audiometer. the additional amplitude modulation of FM signals might have influenced threshold data reported in the study. The test stimuli were delivered to the subject's ears monaurally through either an insert earphone (Etymotic Research ER-1.6-1989 [4]). 10 ohms) or circumaural earphone (Sennheiser HD-250.2. 14. 2. however. is common for reproduction of FM signals by the transducers with non-ideal frequency responses and was not accounted for in this study. ranging in age from 20 to 30 years (mean = 26. This situation. A custom-built impedance matching device was inserted between the 50 ohms Beltone 2000 output and the ER-1 10 ohms insert earphone during both calibration and testing. normal bilateral tympanograms.2 years. SEB1) complying with ANSI S3. Therefore. The audiometer calibration was verified before and after the collection of the data. Each ER-1 insert earphone was calibrated using an ANSI S3. Consequently. and no history of any prolonged noise exposure.1-1991 [5] noise requirements for open ear testing. The FM tones were obtained by linear (triangular) frequency modulation with a 5 Hz modulation rate. the high-frequency FM tones at 16. 12. 50 ohms).

These fitting procedures are common in HFA testing [8]. In each test block. the level was decreased in 10 dB steps until no response occurred and then increased in 2 dB steps until the subject responded again. The eartip was checked for insertion depth and reinserted if necessary. experimental sessions: test session (Session 1) and retest session (Session 2). 1. The order of test blocks as well as ears tested were counterbalanced in Session 1 and reversed in Session 2. After the earphones had been placed. the foam eartips were inserted by an experimenter into the listener's ear canal. Instructions for responding at threshold were identical to those routinely given for conventional audiometry. There was a minimum interval of two and a maximum of seven days between the test and the retest session for each listener.Each listener participated in two. the subject was not allowed to touch or reposition theearphones. In each test block. Then the headband assembly was tightened.5-hour long. The listener's task was to press the response button every time the signal was heard even if the signal was very faint. Results and Discussion . This was done by compressing the foam eartip and inserting it into the ear canal so that the outer edge of the earplug was flush with the floor of the subject's concha (12 mm insertion depth). 3. . Threshold was defined as the mean of the six ascending thresholds [9]. In the case of the ER-1 insert earphones. all test stimuli were initially demonstrated at suprathreshold level to familiarize the listener with the type of stimuli used in this block. (4) circumaural earphones with pure tone stimuli. the stimulus was initially presented at a subtreshold level and increased gradually in 2 dB steps until the listener responded. Once an initial response occurred. This procedure (10 dB down and 2 dB up) was continued until six ascending thresholds were obtained. each listener was seated comfortably and provided with a response button. both ears were tested and the test signals were always presented in the 10 to 18 kHz sequence. The HD-250 circumaural earphones were fitted on each listener by an experimenter to ensure that eachearphone diaphragm was centered over the opening of the ear canal. During the experiment. Each session included six test conditions presented as the test blocks: (1) insert earphones with pure tone stimuli. and (6) circumaural earphones with 5% FM tone stimuli. (3) insert earphones with 5% FM tone stimuli. The eartip was then held in place for 30 seconds to allow it to expand. (2) insert earphones with 2% FM tone stimuli. (5) circumaural earphones with 2% FM tone stimuli. During testing.

002 level or better.2 High Frequency Hearing Thresholds All listeners (n = 40) responded to all the stimuli at each frequency in each ear. ten three-factor repeated measures ANOVAs on SESSION (test. for the same signal and at the same signal frequency.4 dB for the pure tone at 10 kHz. The differences between the RETSPLs of both earphones. and all test signals were all very small. both ears. The mean hearing threshold data combined across all listeners are shown in Table 1. Since there were no statistically significant effects of either test session or test ear on collected data. The test-retest differences observed for the ER-1 earphones were slightly smaller than those reported for the HD-250earphones. further data analysis was limited to the right ear data collected during the test session.1 Intrasubject Reliability Intrasubject reliability was assessed by comparing test and retest data at all experimental conditions. The ANOVA results did not reveal any significant effects at p<0. These values are similar to those reported by Frank [9] for HD-250 data measured across four test sessions and agree with the data reported by Frank and Dreisbach [10]. 5% FM tone) were conducted for individual frequencies (5) and earphone types (2). These findings agree with number of other studies reporting good intrasubject variability of HFA thresholds measured with careful fitting of the transducers. The mean highfrequency thresholds reported in Table 1 increase with frequency regardless of the differences in the transducer or stimulus. EAR (left. Average left-right ear differences were below 3 dB for all conditions tested and both earphones.05 for either SESSION or EAR factors across both earphones and all test frequencies.3.1 dB for the 5% FM tone at 16 kHz to 1. The threshold curves measured with ER-1 and HD250 earphones are both relatively flat in the frequency range of 10 to 12 kHz and rise steeply beyond 12 kHz. To assess statistical significance of the observed differences. Mean test-retest differences observed for both types of earphones. retest). 3. Since . are due to both the differences in ear coupling and the differences in frequency response of the couplers used for calibration of theearphones. the mean threshold values are the largest for pure tones and the smallest fort 5% FM tones. For both earphones. right). 2% FM tone. The STIMULUS factor was always significant at p<0. and STIMULUS (pure tone. For the HD-250 earphones they were in the range from 0. The threshold SPL values presented in Table 1 are the reference-equivalent threshold SPLs (RETSPLs) measured in an IEC flat plate coupler (ER-250) and DB-100 Zwislocki coupler (ER-1).

For both tested earphones. Table 2 presents mean values of high-frequency pure-tone threshold levels obtained in the present study and other studies using the same earphones. Normalized hearing threshold data [3] for HDA-200 and ER-2earphones commonly used for medical purposes are also included for comparison together with calibration coupler information. no absolute comparison of the threshold SPLs for both earphones was made in this study and only differences across signals and frequencies are compared. our thresholds are generally higher than those reported in previous studies. The different findings of this study can be accounted for by the differences in the shape of the threshold curves in conventional audiometry and HFA ranges. the slope of the threshold results in additional amplitude modulation of the signal that increases the audibility of the stimulus. was not the object of this study. the greater the difference. the FM signals resulted in lower threshold values than those obtained with pure-tone signals. The direct comparison between both earphonescould be made if the SPLs were measured in the ear canal of the listener during testing (e.the acoustic loads provided by both couplers in the measured frequency range are not equivalent. Presented data indicate that though all the thresholds curves are similar in shape. Hearing threshold at high frequencies rises abruptly with frequency whereas it has a much flatter contour within most of the conventional audiometry range. Apart from the age differences. the measured threshold is defined by the lowest value of the hearing threshold within the modulation bandwidth rather than by the center frequency of the band. larger frequency deviation resulted in a less steep slope of the threshold. highfrequency hearing thresholds obtained with FM tones should be naturally lower than those obtained with pure tones if the hearing threshold monotonically and steeply rises with frequency. The difference should also increase with the increase in the frequency deviation of the FM-tone signal. Therefore. however. These results are different from the results of studies utilizing FM tones in conventional audiometry. The mean age of subjects in our study was greater by almost five years than the mean age of subjects participating in the Frank's [9] and Tang and Letowski's [15] studies.. the experimental conditions and the listeners' characteristics reported in these . Such comparison. Several studies [12-14] reported no significant differences between thresholds obtained for FM and pure tone signals in the conventional audiometric range. In addition. In addition. The higher the frequency. [11]).g. This difference is most likely related to age differences between subjects participating in the studies. When FM tones sweep through the frequency range where the hearing threshold raises quite steeply.

05) with the exception of ER-1 at 16 and 18 kHz. As expected.9 to 5. the smaller the variability of the threshold data for a given test frequency.1 to 7. the larger the frequency deviation of the signal.51). by using the ER-1 insert earphones in place of the HD.studies were very similar. reached a maximum value at 16 kHz and decreased markedly at 18 kHz for both transducers and all signals except for 5% FM tones.05. Thus. These data are consistent with our previous report [15].01 level to maintain the experiment-wide error rate at 0. The results of Morgan t-test indicated that all SDs obtained with HD-250 were significantly higher than respective SDs obtained with ER1 earphones at 0. the SDs increased as a function of frequency.7 dB from 10 to 16 kHz. The combined effect of the insert earphone and 5% FM signal reduced variability (SD) of hearing thresholds in the 10 to 16 kHz range by as much as 4. the Bonferroni-corrected significance level for any single comparison was set to 0.3 Threshold Variability Standard deviations (SDs) of high frequency hearing thresholds obtained under each test condition are shown in Table 1. the intersubject threshold variability for pure tone signals can be reduced by 2. In general. When the comparisons were made for the stimulus factor within the same earphone all the differences between PT and 5% FM were significant (p<0. The use of a 5% FM tone in place of a pure-tone stimulus reduced the threshold SDs obtained with circumaural earphones by an additional 1. Lower variability of hearing threshold at very high frequencies conforms to other reports [9] [17] and may be caused by the signal reaching the threshold of feeling at this frequency.250 circumaural earphones.6÷8.05 level (t>2. data presented in Table 1 demonstrate that insert earphones yielded smaller SDs than circumauralearphones for all the test frequencies except 18 kHz. the Morgan t-test [15] for related measures was performed Due to multiple comparisons assessed by Morgan test. [16] as the basis for high-frequency threshold normalization.7 dB depending on test frequency. In general. In order to examine whether the differences between SDs obtained under various test conditions were statistically significant. The actual SDs reported in this study for frequency range up to 14 kHz (SD=5. 3.8 dB in comparison to HD250 earphones used with pure-tone signals.0 to 3.7 dB) are not much greater than those observed . This observation seems to lend support to the five-year steps postulated by Schechter et al.

The results of the present study indicate that intersubject variability of threshold of hearing in the high frequency range can be reduced substantially by using insert earphones and FM (warble) signals. "Superior Ultraaudiometric Hearing: A New Type of Hearing Loss which Correlates Highly with Unusually Good Speech in the "Profoundly Deaf".. H. M. 347-361." American National Standards Institute (ANSI). the specification of normative high frequency threshold levels also requires acceptable intersubject variability. 4. and Berlin. J. "Specifications for Audiometers. ISO 389-5." International Organization of Standardization (ISO).J.Reference Zero for the Calibration of Audiometric Equipment . Cullen. 3. 111-118. 2006. K. "Maximum Permissible Ambient Noise Levels for Audiometric Test Rooms.K.." Otolaryngology. and Smith. Halperin. 86(1). C.I. S. New York. Geneva. "Acoustics ." Audiology.1 dB at 16 kHz and 15. . The research needs to be also extended on other types of insert earphones to determine the normative thresholds needs to be earphone specific. 20.6 dB at 18 kHz. Berlin.. References References 1. 2.for pure tone signals in conventional audiometric range (4 to 6 dB) [8].R.F.. Collins.Jr.. However. 1978. New York. Intersubject variability was 16. Wexler. C. "Auditory Signal Processing in a Hearing-impaired Subject with Residual Ultra-audiometric Hearing. J.I. 1981. 5." American National Standards Institute (ANSI). ANSI S3.Part 5: Reference Equivalent Threshold Sound Pressure Levels for Pure Tones in the Frequency Range 8 kHz to 16 kHz. Jerger. Resulting variability can be acceptable low for both human factor and medical applications without a need to control sound pressure level in the ear canal with a probe microphone.1-1999 (R2003). the determination of normative threshold data and standardized variability for the proposed variant of HFA requires validation of present findings on a much larger population. Conclusions Even though the high frequency threshold levels have good intrasubject variability.F. 4. ANSI S3.6-1989...

" Journal of Speech and Hearing Disorders.L. 14. "High Frequency Hearing Threshold Levels Using a Beltone 2000 Audiometer and Sennheiser HD 250 Earphones. 11. E. New York. T. D. 11. D. H.B.. 1978. D. 12.Z.H. T. Orchik.Part 2: An Interim Acoustic Coupler for the Calibration of Audiometric Earphones in the Extended Hugh Frequency Range. M. W. 16. 1979. 214-220. Journal of the American Auditory Society.. 1988. 13. 9. 79 (3).6. and Martin." Ear and Hearing. "High Frequency Threshold Measurements Using Insert Earphones. 105-112. Morgan. 37-54. 1998." Ear and Hearing. G. Dirks.. ." International Electrotechnical Commission (IEC). 1986. G. "Electroacoustics . "Warble Tone as an Audiometric Stimulus. Warble Tone and Narrow Band Noise Thresholds of Young Normal-hearing Children. "Age Categorization of Highfrequency Audiometry Thresholds Data.K. L. IEC 60318-2.. B. Han.. ANSI S3.. 8. 44.. S. 294-295. "The Frequency Response of the ER. 1195-1198. Frank." Journal of the Acoustical Society of America. Dockum. I. 101(2). Fausti. and Dreisbach. and Robinson. 3(5)... "Comparison of Pure Tone. D. Frank. 7." Ear and Hearing.A. D.. 1992. and Rintelmann..A. D. Whitehead.Simulator of Human Head and Ear .A. 450-454. Stagner.. R.2 Speaker in the Eardrum. Rappaport. and Fret. 1975. and Poulsen." American National Standards Institute (ANSI). 1990.25-1989 (2003). R. F. J.. 1991. Schechter. 767-771. M." Journal of the Acoustical Society of America. "Repeatability of High Frequency Thresholds. 351-356.. "Occluded ear simulator. 13 (5).. "Equivalent Threshold Sound Pressure Levels for Sennheiser HDA 200Earphone and Etymotic Research ER-2 Insert Earphone in the Frequency Range 125 Hz to 16 kHz. Geneva. 1997. Simons. D." Scandinavian Audiology 27. 378-379. T.. Tang. 15. and Bower. L. 12. O. 10. T. B. "Suggested Thresholds Sound Pressure Levels for Frequency-modulated (Warble) Tones in the Sound Field." Journal of Speech and Hearing Disorders" 40. and Letowski.

Army Research Laboratory.. CA 94086 Tomasz Letowski Human Research and Engineering Directorate U.S. N. 1987. Tomasz Publication title IIE Annual Conference.. 81(2). MD 21005 Word count: 3741 Copyright Institute of Industrial Engineers-Publisher 2007 Indexing (details) Cite Subject Ears & hearing.. Green. APG. and Stevens. K. Kidd. G. Jr. Sunnyvale. AuthorAffiliation Houchin Tang Camino Medical Group. "High-frequency Assessment of a Young Adult Population. Letowski.17. M. Audiology. Houchin. Proceedings Pages 1340-1345 Number of pages 6 Publication year 2007 . 485-494. Frequencies Title High-Frequency Hearing Threshold Measurements Using Insert Earphonesand Warble Signals Author Tang. D." Journal of the Acoustical Society of America.

Publication date 2007 Year 2007 Section Proceedings of the 2007 Industrial Engineering Research Conference Publisher Institute of Industrial Engineers-Publisher Place of publication Norcross Country of publication United States Publication subject Engineering--Industrial Engineering Source type Scholarly Journals Language of publication English Document type Feature ProQuest document ID 192450617 Document URL Copyright Copyright Institute of Industrial Engineers-Publisher 2007 Last updated 2011-06-03 Database ABI/INFORM Complete .