TIP-300插入式耳机与TDH-50P耳罩式耳机的耳间衰减比较

目的 比较TIP-300插入式耳机耳间衰减(insert earphone interaural attenuation,IEIA)与TDH-50P耳罩式耳机耳间衰减(supra-aural earphone interaural attenuation,SELA)的差异，为TIP-300插入式耳机的临床应用提供参考依据。方法 利用GSI61临床听力计、TIP-300插入式耳机和TDH-50P耳罩式耳机，对一组单耳全聋而另一耳听力正常者35人(男13人，女22人)进行纯音气导的耳间衰减测试。结果 TIP-300插入式耳机与TDH-50P耳罩式耳机组间耳间衰减有显著性差异；其中TIP-300插入式耳机组内的某些频率之间耳间衰减也有显著性差异。结论 在低中频测听范围，TIP-300插入式耳机的耳间衰减比TDH-50P耳罩式耳机大。     

Three studies comparing performance of the ER-3A tubephone with the TDH-50P earphone

Three studies compared the performance of the ER-3A Tubephone insert earphone and the TDH-50P-MX41/AR supra-aural earphone. The three factors addressed were: threshold differences in children 7 to 10 yr old compared to adults, differences in real ear attenuation, and threshold differences in the presence of high background noise levels. The influence of insertion depth of the ER-3A Tubephone was also investigated. Findings showed no significant threshold differences between children and adults, significantly better real ear attenuation for the ER-3A Tubephone, and significantly better thresholds for the ER-3A in the presence of high background noise levels. Most critically, there was a significant change in attenuation characteristics of the ER-3A Tubephone, which was dependent on the insertion depth of the ear-tip.     

Interaural attenuation for tubephone insert earphones

Interaural attenuation of pure tone and speech signals was evaluated for a new audiometric insert earphone, the ER-3A tubephone, and a conventional TDH-49P supra-aural earphone in seven unilaterally deaf adult subjects. These results validate and extend the interaural attenuation data reported by the manufacturer of the ER-3A and his associates. At frequencies of 0.5 to 1 kHz, mean interaural attenuation for the deeply inserted ER-3A decreased from 94+ dB to 81 dB, with the lowest value for any subject, 75 dB. Interaural attenuation for speech approximated that of the 1 to 2 kHz frequency range. The ER-3A tubephone provides significantly greater acoustic isolation between the two ears in the low-mid frequency audiometric range than the conventional supra-aural earphone.     

How does the sound pressure generated by circumaural, supra-aural, and insert earphones differ for adult and infant ears?

OBJECTIVE: To determine how the ear canal sound pressure levels generated by circumaural, supra-aural, and insert earphones differ when coupled to the normal adult and infant ear. DESIGN: The ratio between the sound pressure generated in an adult ear and an infant ear was calculated for three types of earphones: a circumaural earphone (Natus Medical, ALGO with Flexicoupler), a supra-aural earphone (Telephonics, TDH-49 with MXAR cushion), and an insert earphone placed in the ear canal (Etymoup and down arrow tic Research, ER-3A). The calculations are based on (1) previously published measurements of ear canal impedances in adult and infant (ages 1, 3, 6, 12, and 24 months) ears (Keefe et al., 1993, Acoustic Society of America, 94:2617-2638), (2) measurements of the Thévenin equivalent for each earphone configuration, and (3) acoustic models of the ear canal and external ear. RESULTS: Sound-pressure levels depend on the ear canal location at which they are measured. For pressures at the earphone: (1) Circumaural and supra-aural earphones produce changes between infant and adult ears that are less than 3 dB at all frequencies, and (2) insert earphones produce infant pressures that are up to 15 dB greater than adult pressures. For pressures at the tympanic membrane: (1) Circumaural and supra-aural earphones produce infant pressures that are within 2 dB of adult ears at frequencies below 2000 Hz and that are 5 to 7 dB smaller in infant ears than adult ears above 2000 Hz, and (2) insert earphones produce pressures that are 5 to 8 dB larger in infant ears than adult ears across all audiometric frequencies. CONCLUSIONS: Sound pressures generated by all earphone types (circumaural, supra-aural, and insert) depend on the dimensions of the ear canal and on the impedance of the ear at the tympanic membrane (e.g., infant versus adult). Specific conclusions depend on the location along the ear canal at which the changes between adult and infant ears are referenced (i.e., the earphone output location or the tympanic membrane). With circumaural and supra-aural earphones, the relatively large volume of air within the cuff of the earphone dominates the acoustic load that these earphones must drive, and differences in sound pressure generated in infant and adult ears are generally smaller than those with the insert earphone in which the changes in ear canal dimensions and impedance at the tympanic membrane have a bigger effect on the load the earphone must drive.     

A comparison of the variability in thresholds measured with insert and conventional supra-aural earphones

The purpose of this study was to evaluate the reliability and comparability of the commercially available insert earphone Etymotic Research ER-3A and the commonly available supra-aural TDH earphone. Thirteen subjects were tested five times with the ER-3A and five times with TDH-49P with MX-41/AR cushions. Threshold determinations were obtained utilizing a sweep-frequency audiometer in the range 0.25-8 kHz. The results showed that the reliability of the ER-3A earphone as measured by intra-individual variation, was comparable to that obtained with the TDH earphone. No evidence was found indicating an increased variability due to the positioning of the insert earphone's coupling device in the ear canal. Comparison of thresholds obtained with both devices indicated that the manufacturer's suggested correction values were appropriate.     

Attenuation values for a supra-aural earphone for children and insert earphone for children and adults.

Earphone attenuation values were determined for 17 children (6-14 years old) using supra-aural (TDH-49P/Model 51 cushion) and insert earphones (E-A-Rtone 3A) terminated by an E-A-Rlink 3A (for normal size ear canals) or E-A-Rlink 3B (for small size ear canals) foam eartips, and for 10 adults having small ear canals using insert earphones and E-A-Rlink 3B foam eartips. The test signals were 1/3-octave bands of noise presented in a diffuse sound field (re: ANSI S12.6-1984). The supra-aural earphone attenuation values for the children were slightly higher (more attenuation) or similar to reported adult values, and always lower (less attenuation) compared with insert earphone/E-A-Rlink 3A (IE/3A) or 3B (IE/3B) values for both children and adults. The IE/3B attenuation values were similar between the children and adults and provided slightly more attenuation than the IE/3A. Overall, the results indicated that the ANSI S3.1-1991 maximum permissible ambient noise levels allowed in a test room for ears covered testing with a supra-aural earphone, which were determined using adult values, are appropriate for testing children. Future revisions of ANSI S3.1-1991 may include maximum permissible ambient noise levels for testing with insert earphones. The IE/3A and IE/3B attenuation values could be used for that purpose. In the meantime, because more attenuation was provided by the IE/3A and IE/3B, they can be used for testing both children and adults in higher ambient noise levels than specified in ANSI S3.1-1991.     

Middle ear pathology can affect the ear-canal sound pressure generated by audiologic earphones

OBJECTIVE: To determine how the ear-canal sound pressures generated by earphones differ between normal and pathologic middle ears. DESIGN: Measurements of ear-canal sound pressures generated by the Etymtic Research ER-3A insert earphone in normal ears (N = 12) were compared with the pressures generated in abnormal ears with mastoidectomy bowls (N = 15), tympanostomy tubes (N = 5), and tympanic-membrane perforations (N = 5). Similar measurements were made with the Telephonics TDH-49 supra-aural earphone in normal ears (N = 10) and abnormal ears with mastoidectomy bowls (N = 10), tympanostomy tubes (N = 4), and tympanic-membrane perforations (N = 5). RESULTS: With the insert earphone, the sound pressures generated in the mastoid-bowl ears were all smaller than the pressures generated in normal ears; from 250 to 1000 Hz the difference in pressure level was nearly frequency independent and ranged from -3 to -15 dB; from 1000 to 4000 Hz the reduction in level increased with frequency and ranged from -5 dB to -35 dB. In the ears with tympanostomy tubes and perforations the sound pressures were always smaller than in normal ears at frequencies below 1000 Hz; the largest differences occurred below 500 Hz and ranged from -5 to -25 dB. With the supra-aural earphone, the sound pressures in ears with the three pathologic conditions were more variable than those with the insert earphone. Generally, sound pressures in the ears with mastoid bowls were lower than those in normal ears for frequencies below about 500 Hz; above about 500 Hz the pressures showed sharp minima and maxima that were not seen in the normal ears. The ears with tympanostomy tubes and tympanic-membrane perforations also showed reduced ear-canal pressures at the lower frequencies, but at higher frequencies these ear-canal pressures were generally similar to the pressures measured in the normal ears. CONCLUSIONS: When the middle ear is not normal, ear-canal sound pressures can differ by up to 35 dB from the normal-ear value. Because the pressure level generally is decreased in the pathologic conditions that were studied, the measured hearing loss would exaggerate substantially the actual loss in ear sensitivity. The variations depend on the earphone, the middle ear pathology, and frequency. Uncontrolled variations in ear-canal pressure, whether caused by a poor earphone-to-ear connection or by abnormal middle ear impedance, could be corrected with audiometers that measure sound pressures during hearing tests.     

Inter-aural attenuation with insert earphones

Abstract

The aim of the present study was to determine inter-aural attenuation (IA) values for pure tones and a broadband click obtained using an ER-3A insert earphone with a foam plug and with a customized hard acrylic earmould. Participants were 15 adults with a longstanding unilateral dead ear. IA was operationally defined as the difference between the good-ear and poorer-ear not-masked air conduction threshold. Minimum IA values for the foam earplug were 50 dB and 55 dB for pure tones and broadband click, respectively. Minimum IA values for the hard acrylic earmould were 45 dB and 50 dB for pure tones and broadband click, respectively.

Sumario

El objetivo de este estudio fue determinar los valores de IA para tonos puros y para un clic de banda ancha utilizando los audífonos de inserción ER-3A con oclusión de esponja y con un molde de acrílico duro a la medida. Participaron 15 adultos con un oído muerto unilateral de larga evolución. Desde el punto de vista operacional se definió IA como la diferencia de umbral por conducción aérea sin enmascarar, entre el oído sano y el dañado. Los valores mínimos de IA con el tapón de esponja fue de 50dB y 55dB para los tonos puros y para el clic de banda ancha respectivamente. Los valores IA mínimos con el molde de acrílico duro fueron de 45dB y 50dB para tonos y clic de banda ancha respectivamente.     

Test-retest variability in audiometric threshold with supraaural and insert earphones among children and adults

The effect of age and earphone condition on test-retest intrasubject variability in audiometric threshold was investigated. Ten subjects in each of the following age groups were investigated: 6-9 years, 10-13 years and young adults. Test-retest audiometric thresholds were collected at six frequencies (250, 500, 1,000, 2,000, 4,000 and 8,000 Hz) under three earphone conditions (Telephonics TDH-50P supraaural and Etymotic Research ER-3A insert earphone coupled to an immittance probe cuff or a foam insert). No statistically significant differences were found in variability of test-retest differences as a function of age, earphone condition or test frequency (p greater than 0.05). The clinical application of the insert earphone is recommended with children and adults as it affords no greater test-retest variability and at the same time provides a solution to a number of limitations incurred with the use of the supraaural earphone.     

Attenuation provided by four different audiometric earphone systems

The attenuation provided by TDH earphones in MX-41/AR and P/N 51 cushions, Audiocup earphone enclosures and ER-3A insert earphones with ER3-14 foam earplugs was determined for 30 normally hearing subjects using a real-ear attenuation at threshold paradigm. The MX-41/AR and P/N 51 cushions provided about the same amount of attenuation which was less than the attenuation provided by the Audiocup enclosures. The ER-3A/ER3-14 provided the highest amount of attenuation. The MX-41/AR and ER-3A/ER3-14 attenuation values were in agreement with other studies using similar methodology. However, the attenuation provided by the Audiocup enclosures was considerably less, in the lower frequencies, than reported in two other studies. ANSI S3.1-1977 supra-aural earphone cushion attenuation values, which were determined using pure-tones presented in a free-field, should be replaced by earphone cushion attenuation values determined with 1/3 octave bands of noise presented in a diffuse sound field.     

Compensated active noise cancellation earphone for audiometric screening tests in noisy environments

Abstract

Objective: This study investigated hearing screening tests by using a custom-designed compensated hybrid active noise cancellation (ANC) earphone and compared it with TDH39 and Audiocups audiometric earphones under conditions of quiet, 45?dB HL masking narrowband, wideband speech-shaped, and white noise.

Design: The hearing screening tests were conducted to characterise the shifts of screening results under noisy conditions, and real-ear attenuations at thresholds were assessed to quantify real-ear noise reduction performance.

Study sample: Twenty-four normal-hearing adults, aged 20–25?years, participated in this study.

Results: The ANC earphone exhibited significantly lower/better mean screening results than those of the TDH39 earphone at 250 and 500?Hz and those of the Audiocups earphone at 250?Hz under conditions of narrowband, speech-shaped, and white noise. Compared with the TDH39 earphone at 250 and 500?Hz, applying a hybrid ANC earphone reduced the shifts in screening results by 14.2 and 12.3?dB, respectively, under the narrowband noise condition.

Conclusion: This study demonstrated that the compensated hybrid ANC earphone provided lower shifts of screening results than the TDH39 and Audiocups earphones and that it was capable of screening at 250 and 500?Hz from 20?dB HL under 45?dB HL masking narrowband and wideband noise.     

Reference equivalent threshold sound pressure levels for insert earphones

Insert earphones, coupled to the ear canal by means of a long plastic tube and soft ear plug (Etymotic Research ER-3A Tubephone) are being used for a number of audiometric applications as an alternative to supra-aural earphones. This report presents the results of hearing threshold level measurements in 36 ears of young, otologically normal listeners. The results are expressed as mean sound pressure levels measured on a 2 cm3 coupler according to IEC 126 as well as on an ear simulator according to IEC 711.     

Interaural attenuation using etymotic ER-3A insert earphones in auditory brain stem response testing

Click interaural attenuation (IA) was measured behaviorally and with the auditory brain stem response (ABR) in two unilaterally deaf adults with Etymotic ER-3A insert earphones, and TDH-39P and TDH-49P supraaural earphones. Stimulus crossover for each set of earphones was also determined with pure-tone audiometry. Pure-tone results agreed with previous research, showing that the ER-3A provided substantially greater IA than the supraaural earphones, particularly for low frequencies. For click stimuli, behavioral and ABR results revealed only modest, if any, improvement in IA with the ER-3A relative to the supraaural earphones. The results of this study suggest that while the ER-3A earphones provide a clear IA advantage for behavioral pure-tone audiometry, they do not eliminate the need for contralateral masking of click stimuli in ABR testing.     

A New Masking Transducer with Low Contralateral Transmission

A new making transducer is presented which uses a large moving coil driving unit acoustically shielded in a plastic shell. Sound waves are conveyed to the ear by means of a flexible plastic tube and an insert nipple. In tests made under normal clinical situations, it has been found ot provide an interaural isolation from 20-50 dB better than the conventional supra-aural audio-metric earphone and 16-34 dB better than the common hearing-aid type of insert erphone, while being more rugged and more reliable than the latter. It is therefore proposed as a supplementary tool to the clinician, for masking in all cases where other types of transducers are inadequate     

Interaural attenuation for Sennheiser HDA 200 circumaural earphones

Abstract

Interaural attenuation (IA) was evaluated for pure tones (frequency range 125 to 16000 Hz) using Sennheiser HDA 200 circumaural earphones and Telephonics TDH-39P earphones in nine unilaterally deaf subjects. Audiometry was conducted in 1-dB steps using the manual ascending technique in accordance with ISO 8253-1. For all subjects and for all tested frequencies, the lowest IA value for HDA 200 was 42 dB. The present IA values for TDH-39P earphones closely resemble previously reported data. The findings show that the HDA 200 earphones provide more IA than the TDH-39P, especially at lower frequencies (≤500 Hz). It is concluded that contralateral masking should be applied during pure-tone audiometry with the HDA 200 earphones when the level at the test ear is more than 40 dB above the threshold of the non-test ear.

Sumario

Se evaluó la atenuación interaural (AI) con tonos puros (rango de frecuencia 125-16000 Hz) usando auriculares circumaurales Sennheiser HAD 200 y auriculares Telephonics TDH-39P, en nueve sordos unilaterales. La audiometría se practicó en pasos de 1-dB usando la técnica manual ascendente de acuerdo con ISO 8253-1. En todos los sujetos y en todas las frecuencias el valor de AI más bajo para HDA 200 fue de 42 dB. Los valores actuales de AI para los auriculares TDH-39P se asemejan mucho a los datos previamente reportados. Los hallazgos muestran que los auriculares HDA 200 proporcionan mayor AI que los TDH-39P, especialmente en las frecuencias bajas (≤ 500Hz). Se concluye que el enmascaramiento contralateral debe aplicarse en la audiometría tonal con auriculares HDA 200, cuando el nivel en el oído evaluado sea mayor a 40 dB sobre el umbral del oído no evaluado.     

A model of the occlusion effect with bone-conducted stimulation

An acoustical model using simplified ear anatomy was designed to predict the ear-canal sound pressure occlusion effect in humans. These predictions were compared perceptually as well as with ear-canal sound pressure occlusion effect measurements using a foam earplug with shallow insertion, a foam earplug with deep insertion into the bony part of the ear canal, and a circumaural earmuff. There was good resemblance between model predictions and ear-canal sound pressure measurements. It was also found that all occlusion positions, even deep ear-canal occlusion, produced noticeable occlusion effects. With the bone-conduction transducer at the forehead, the perceived occlusion effect was close to that obtained from ear-canal sound pressure data in the 0.3 to 2 kHz frequency range; when the stimulation was at the mastoid the difference between the perceived and measured ear-canal sound pressure occlusion effect was around 10 dB at frequencies below 1 kHz. Further, the occlusion effect was obtained in two clinical settings: with supra-aural earphones (TDH39), and insert earphones (CIR22). Although both transducers produced occlusion effects, insert earphones produced a greater effect than surpa-aural earphones at the low frequencies.     

Solving audiometric masking dilemmas with an insert masker

For some bilateral hearing losses, standard audiometric techniques cannot provide sufficient data for correct otologic diagnosis. These hearing losses are termed "masking dilemmas" because sound attenuation across the head is inadequate to prevent unwanted masking of the test cochlea. In most cases, the masking dilemma can be eliminated by presenting masking through an insert phone in the ear canal, rather than through a standard earphone and cushion. Insert earphones are not standard on most audiometers, but the minimal necessary equipment and alterations are inexpensive, readily available, and require little time to implement. Test time is not increased significantly. Some masking dilemmas will not be solved by the insert masker, but, when properly constructed and used, an insert masker will provide an accurate measurement of cochlear reserve not otherwise obtainable for most cases.     

Binaural hearing, atresia, and the masking dilemma

A masking dilemma occurs when energy from a non-test ear crosses over the head to a test ear. In cases of bilateral atresia, obtaining thresholds on the poorer ear is problematic. Near threshold, however, sufficient ear-bone isolation exists to test with validity but not so much above threshold, even for the ultra-high (> 10 kHz) frequencies. This aspect of the bone audiogram should not be overlooked. We suggest two uses of binaural bone conduction hearing to help resolve the dilemma--one an auditory brainstem response variation, the other a high-frequency lateralization procedure. Both are also applicable in unilateral atresia with and without a sensorineural component. The use of an insert earphone for masking in the unobstructed ear will provide adequate interaural attenuation to resolve most but not all dilemmas. That is to say, the maximum isolation of an insert earplug is on the order of 100 dB, so it has a limit. The dilemma extends through the ultra-high frequencies (> 10 kHz) because the intra-aural attenuation is no more than 10 dB. In the cited case of unilateral congenital atresia of the external ear, the intra-aural threshold differences in the high frequencies plus the resolution of the masking dilemma in the low frequencies (without the need for more masking) leads us to conclude that the unmasked thresholds are valid. Masking can be extended above 10 kHz, but this is not generally within the capacity of commercial audiometers, a feature that should be included.     

Audiometric earphone discomfort level and hearing aid saturation sound pressure level for a 90 decibel input signal (SSPL90) as measured in the human ear canal

The acoustical problems involved in matching the saturation sound pressure level for a 90 dB input signal (SSPL90) of a hearing aid to individual discomfort level were investigated. The real ear SPL (RE/SSPL90) produced by a supra-aural earphone used when measuring uncomfortable loudness (UCL), and RE/SSPL90 produced by three different hearing aids at 90 dB SPL input, were measured for nine subjects, using a miniature microphone technique, and compared to the corresponding coupler levels used when matching hearing aid maximum output to UCL. It was found that a hearing aid often gives about 5 dB, and sometimes 10 dB, higher RE/SPLs than the earphone, if the hearing aid output levels, as measured in a 2-cc coupler (IEC126), are equal to the earphone output levels as measured in a 6-cc coupler (NBS9A). It is recommended that a safety margin of at least 5 dB be used in the preliminary fitting when matching hearing aid SSPL90 to the patient's UCL, converted to dB SPL.     

Measuring the real-ear to coupler difference transfer function with an insert earphone and a hearing instrument: are they the same?

OBJECTIVE: The purpose of the study was to compare the real-ear to coupler difference (RECD) measured with an insert earphone and two models of hearing instrument. DESIGN: The RECD was obtained from one ear of 18 normal-hearing subjects by subtracting the 2-cc coupler (HA1 and HA2) response from a real-ear aided response, using a conventional probe-tube microphone system. The measurements were made with a conventional ER-3A earphone and two models of behind-the-ear hearing instrument (Unitron US80, Unitron, Kitchener, Canada; and Widex Diva, Widex, Vaerloese, Denmark). RESULTS: The procedures were very reliable, with mean differences on retest of less than 1 dB. There were statistically significant differences between the mean RECDs obtained using an insert earphone compared with those obtained with each hearing instrument (p < 0.05). The differences were greatest when using the HA2 2-cc coupler. For example, the maximum difference in mean RECD between the insert earphone and the Widex Diva was 6 dB and 11 dB when using the HA1 and the HA2 2-cc coupler, respectively. CONCLUSIONS: The RECD is dependent on the acoustic impedance of the sound source, the coupling system, and the coupler and ear. The acoustic impedance may be different for an insert earphone and a given hearing instrument. Therefore, the RECD measured with an insert earphone may not always accurately represent the difference in performance of a hearing instrument measured in the real ear and the 2-cc coupler.