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Expanding Audiologic Evaluations with Narrowband Noise Acoustic Reflex Growth Functions

Abdelrehim, Lamiaa
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1712915578481143

Abstract Details

2024, PhD, University of Cincinnati, Allied Health Sciences: Communication Sciences and Disorders.
The acoustic reflex (AR), characterized by an involuntary contraction of the middle ear muscles in response to auditory stimuli, has been a component of routine audiological evaluations for decades. This reflex is a complex interaction of ear mechanics and the underlying neural and physiological processes (Jerger et al., 1974). The acoustic reflex growth function (ARGF) delineates the relationship between the AR response's amplitude and the intensity level of the eliciting acoustic stimulus. Such measurements gain particular significance in pathologies affecting the auditory nerve pathway. Valero et al. (2016) suggested that the ARGF may provide a valuable approach for objectively assessing peripheral auditory nerve fibers and the auditory brainstem. This study's foremost objective is to characterize ARGFs for narrowband noise (NBN) stimuli, which may be useful in assessing the peripheral auditory nerve and the associated brainstem centers in humans. Furthermore, the investigation aims to elucidate the relationship between ARGF and speech-in-noise (SIN) test outcomes among individuals with normal hearing. The study compared ARGFs and acoustic reflex thresholds (ARTs) for NBN stimuli to tonal stimuli in 34 adult participants with normal pure-tone hearing thresholds and normal SIN performance. As such, this research provides data describing a normative range for ARGFs using novel stimuli which may be helpful in the identification of peripheral auditory nerve degeneration, which is refractory to detection through conventional audiograms and some electrophysiological tests. The results indicated that, in normal hearing listeners, the' acoustic reflex thresholds (ARTs) measured by NBN activators were significantly lower than those for tonal activators, particularly at 1,2, 4, and 4 kHz frequencies. Notably, the ARGF metrics, specifically the admittance change, were higher for NBN stimuli than tonal stimuli, especially at 1, 2, 3, and 4 kHz frequencies. This suggests a broader dynamic range for NBN ARGFs than for tonal ARGFs. The ARGF slope measurements indicated that the highest ARGF was for 2 kHz NBN activators. This result was consistent across two commonly used clinical immittance measurement devices. The study also explored intersubject variability in the ARGF slope, employing the coefficient of variation (CV) as a metric. High frequencies, specifically the 2- and 3-kHz NBN activators, demonstrated more consistent responses among subjects, indicated by lower CV values. This finding highlights the potential of these frequencies in yielding more reliable ARGF measurements. The study did not find significant correlations between ARGFs and speech-in-noise test scores. However, this lack of correlation was expected given that all participants had speech-in-noise test scores clustered tightly around the normal range. This study suggests that NBN activators may be more effective for assessing the ARGF, particularly at mid-to-high frequencies. Given the reduced variability and greater dynamic range, the response to NBN activators may have more clinical potential than tonal ARGF assessments. NBN ARGFs may specifically be added to the clinical tools for the diagnosis of auditory neuropathology.
Brian Earl, Ph.D. (Committee Chair)
Nancy Creaghead, Ph.D. (Committee Member)
Peter Scheifele, Ph.D. (Committee Member)
Dalia Hassan, Ph.D. (Committee Member)
Carrie Rountrey, Ph.D. (Committee Member)
Abd-Elmateen El-latief, M.D. (Committee Member)
99 p.
Audiology
Acoustic Reflex

Recommended Citations

Citations

  • Abdelrehim, L. (2024). Expanding Audiologic Evaluations with Narrowband Noise Acoustic Reflex Growth Functions [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1712915578481143

    APA Style (7th edition)

  • Abdelrehim, Lamiaa. Expanding Audiologic Evaluations with Narrowband Noise Acoustic Reflex Growth Functions. 2024. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1712915578481143.

    MLA Style (8th edition)

  • Abdelrehim, Lamiaa. "Expanding Audiologic Evaluations with Narrowband Noise Acoustic Reflex Growth Functions." Doctoral dissertation, University of Cincinnati, 2024. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1712915578481143

    Chicago Manual of Style (17th edition)

ucin1712915578481143
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This open access ETD is published by University of Cincinnati and OhioLINK.