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      Real ear unaided gain and its relation with the equivalent volume of the external and middle ear

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          Summary

          Introduction: Old age is associated with changes in the characteristics of the middle ear transmission system and in external ear resonance, and these carry implications for the hearing aid (HA) verification process for which targets and measures of the real ear insertion gain (REIG) are used.

          Aim: To compare the real ear unaided gain (REUG) and the equivalent volumes of the external ear (VeqEE) and the middle ear (VeqME) between elderly and adult patients.

          Methods: This is a retrospective study in which the medical records of 28 elderly patients (aged between 61 and 102 years, average hearing thresholds between 38.75 and 85 dB HL) and 23 adult patients (aged 20–59, mean hearing thresholds between 31.25 and 116.25 dB HL) with bilateral sensorineural hearing loss and no history of middle ear abnormalities were analyzed. Immittance measurements (VeqEE, VeqME, and pressure of the peak of maximum compliance) and the REUG (frequency and amplitude of the primary peak) were recovered for a total of 40 ears. These data were compared between elderly and adults as well as between men and women, using Student's t test. Correlations (Pearson) between immittance and REUG data were also verified.

          Results: No statistically significant differences (p < 0.01) were found for immittance and REUG data between elderly and adults, or between men and women. A negative and weak but significant correlation was observed between the REUG primary peak and VeqEE.

          Conclusion: Hearing aid verification can be performed with target and measures of the REIG in the elderly population.

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          Most cited references11

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          Ageing and the auditory system.

          There are a number of pathophysiological processes underlying age related changes in the auditory system. The effects of hearing loss can have consequences beyond the immediate loss of hearing, and may have profound effects on the functioning of the person. While a deficit in hearing can be corrected to some degree by a hearing aid, auditory rehabilitation requires much more than simply amplifying external sound. It is important that those dealing with elderly people are aware of all the issues involved in age related hearing loss.
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            Age effects in the human middle ear: wideband acoustical measures.

            Studies that have examined age effects in the human middle ear using either admittance measures at 220 or 660 Hz or multifrequency tympanometry from 200 to 2000 Hz have had conflicting results. Several studies have suggested an increase in admittance with age, while several others have suggested a decrease in admittance with age. A third group of studies found no significant age effect. This study examined 226 Hz tympanometry and wideband energy reflectance and impedance at ambient pressure in a group of 40 young adults and a group of 30 adults with age > or = 60 years. The groups did not differ in admittance measures of the middle ear at 226 Hz. However, significant age effects were found in wideband energy reflectance and impedance. In particular, in older adults there was a comparative decrease in reflectance from 800 to 2000 Hz but an increase near 4000 Hz. The results suggest a decrease in middle-ear stiffness with age. The findings of this study hold relevance for understanding the aging process in the auditory system, for the establishment of normative data for wideband energy reflectance, for the possibility of a conductive component to presbycusis, and for the interpretation of otoacoustic emission measurements.
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              Transformation of sound-pressure level from the free field to the eardrum presented in numerical form.

              In an earlier work [E. A. G. Shaw, J. Acoust. Soc. Am. 56, 1848-1861 (1974)], self-consistent families of curves which best fitted the experimental data from 12 studies were presented to show the average sound-pressure transformation from the free field to the human eardrum in the horizontal plane. Tabulated values of azimuthal dependence at 15-deg intervals in azimuth and transformation to the eardrum at 0 degree azimuth are given at 43 selected frequencies between 0.2 and 12 kHz. These values are self-consistent within 0.1 dB.
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                Author and article information

                Journal
                Int Arch Otorhinolaryngol
                Int Arch Otorhinolaryngol
                10.1055/s-00025477
                International Archives of Otorhinolaryngology
                Thieme Publicações Ltda (Rio de Janeiro, Brazil )
                1809-9777
                1809-4864
                July 2012
                : 16
                : 3
                : 365-370
                Affiliations
                [1 ]Master in Sciencies – School of Dentistry of Bauru – University of São Paulo; Speech Pathologist and Audiologist at Hearing and Communication Institute and at Audicare.
                [2 ]PhD in Neuroscience and Behavior – Psychology Institute, USP; Professor in the Department of Speech Pathology and Audiology, School of Dentistry of Bauru, University of Sao Paulo.
                [3 ]PhD in Sciences – Communication Disorders, HRAC; Professor in the Department of Speech Pathology and Audiology, School of Dentistry of Bauru, University of Sao Paulo.
                Institution: Faculdade de Odontologia de Bauru da Universidade de São Paulo. Bauru / SP - Brazil.
                Author notes
                Address for correspondence Bárbara Guimarães Bastos Rua Maximiliano Robespierre, 52 - Vila Zezé - Jacareí - São Paulo – SP - Zip code: 12310-700 barbarabastos@ 123456gmail.com
                Article
                160311
                10.7162/S1809-97772012000300011
                4432547
                25991959
                ed713596-e26f-44dd-b892-ef498fd469ec
                © Thieme Medical Publishers
                History
                : 17 February 2012
                : 22 May 2012
                Categories
                Article

                audiology,acoustic impedance tests,ear,external,middle,aged
                audiology, acoustic impedance tests, ear, external, middle, aged

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