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15 protocols using gsi tympstar

1

Measurement of Behavioral Hearing Thresholds

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Behavioral AC and BC pure-tone thresholds were measured at 125, 250, 500, 750, 1,000, 1,500, and 2,000 Hz using a stimulus duration of 200 ms and a step size of 2 dB using equipment described above. For each test frequency, thresholds were assessed using an ascending and descending track. The initial stimulus level for the ascending track was below the subject's audible threshold, whereas the initial stimulus level for the descending track was above the subject's behavioral threshold. The final threshold was defined as the average of the ascending and descending values. Masking was used for estimating bone conduction thresholds. Any response reported as vibrotactile or questionably vibrotactile was considered as no response.
Tympanometry was used to understand the condition of middle ear and to rule out conductive hearing loss (GSI Tympstar, Grason-Stadler Inc, Eden Prairie, MN 55344).
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2

Comprehensive Audiometric Assessment

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Pure-tone air conduction thresholds (0.25, 0.5, 1, 2, 3, 4, and 8 kHz) were obtained for each ear and pure-tone bone conduction thresholds as required (0.5, 1, and 2 kHz), following the procedure recommended by the British Society of Audiology (BSA 2004 ), using a Siemens (Crawley, West Sussex, UK) Unity PC audiometer, Sennheiser (Hanover, Germany) HDA-200 headphones, and B71 Radioear (New Eagle, PA) transducer in a sound-attenuating booth. Otoscopy was performed and middle ear function was assessed by standard clinical tympanometry by using a GSI Tympstar (Grason-Stadler, Eden Prairie, MN).
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3

Comprehensive Hearing Evaluation Protocol

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A detailed case history was taken to ensure that the client meets the eligibility criteria. The eligible candidates were made to undergo pure tone audiometry by modified HughsonWestlake procedure [23 ] and speech audiometry to establish hearing thresholds. The evaluation was carried out using a dually calibrated diagnostic audiometer (Madsen Astera: ANSI S3.43-1996, GN Otometrics, Natus, Denmark). Middle ear analysis was carried out using a GSI Tympstar (Grason Stadler, Eden prairie, MN, USA), with 226 Hz probe tone which was delivered using an airtight probe tip (JBL T450BLU, Harman International Industries, China).
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4

Measuring Ear Canal Volume and Stimulus Linearity

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Probe microphone peSPL measurements were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess the linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively.
Equivalent ear canal volume and peSPLs were measured from one ear selected at random for each of the participants yielding data from 6 left ears and 4 right ears for the child participants and 7 left ears and 3 right ears for the adult participants. Equivalent ear canal volumes were measured during tympanometry using a 226 Hz probe tone (Otoflex, Otometrics, Schaumberg, IL or GSI Tympstar, Grason-Stadler, Eden Prairie, MN). The term equivalent ear canal volume is used because the ear canal volume is not measured directly during tympanometry. Only an estimate of the volume of air between the probe tip and the tympanic membrane” is measured, which can overestimate ear canal volume (Wiley et al, 2002 ).
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5

Acoustic Reflex Assessment Protocol

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Immittance evaluation for 226 Hz probe tone was carried out with a middle ear analyzer (GSI Tympstar, Grason Stadler). Ipsilateral and contralateral acoustic reflexes were recorded at 500, 1,000, and 2,000 Hz. Participants were instructed not to move or swallow during the procedure.
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6

Audiometric Assessment for Hearing Evaluation

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Patients and controls underwent pure tone audiometry (PTA) testing (GSI 61 clinical audiometer, Grason-Stadler, Eden Prairie, USA). Subjective auditory thresholds for 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz were included in the statistical analysis to ensure that there was no difference in hearing level between the groups. Impedance audiometry (GSI Tympstar, Grason-Stadler, United States) was performed, both to rule out asymptomatic chronic otitis media and to assess the cocleostapedial reflex threshold [or middle ear muscle reflex (MEMR)] for the aforementioned frequencies. The utility of measuring the MEMR threshold is to avoid stimulating such reflex while performing contralateral suppression of OAEs with broadband noise.[16 (link)]
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7

Audiometric Assessment of Hearing

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Outer and middle ear functions were checked by otoscopy and standard clinical tympanometry using a GSI Tympstar (Grason-Stadler, Eden Prairie, MN, USA). Pure-tone air conduction thresholds (0.25, 0.5, 1, 2, 3, 4, 8 kHz) were obtained for each ear, following the procedure recommended by the British Society of Audiology (British Society of Audiology, 2011 ), using a Siemens (Crawley, West Sussex, UK) Unity PC audiometer, Sennheiser (Hannover, Germany) HDA-200 headphones, and a B71 Radioear (New Eagle, PA, USA) transducer in a sound-attenuating booth. The better-ear-average (BEA) across octave frequencies 0.5–4 kHz was derived and is reported here.
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8

Tympanometry and Acoustic Reflex Testing

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Tympanograms and ARTs were recorded in both ears with GSI Tympstar (Grason-Stadler, Eden Prairie, MN, USA) to primarily study the middle ear system and the function of the reflex arc. The ART was elicited ipsilaterally at tympanic peak pressure and at the stimulus frequency of 1000 Hz, using an ascending method in steps of 5 dB with a maximum of 105 dB HL (as recorded in a 2-cc coupler). The criterion for a reflex response was a repeatable compliance change corresponding to 0.02 mL or greater, supported with an impedance growth at a higher stimulus level.
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9

Hearing Screening and Otoacoustic Emissions Assessment

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All children had hearing thresholds of 20 dB HL or better at octave intervals
between 0.25 and 8 kHz (GSI-61, Grason-Stadler Inc., MN) and normal middle ear
function as determined by clinical tympanometry: type-A tympanogram, middle ear
pressure between ±50 daPa, and static compliance between 0.3 and 1.5 mmho
(GSI-TympStar, Grason-Stadler Inc., MN). All children also had contralateral
acoustic reflex thresholds >70 dB HL for steady-state broadband noise.
Children also underwent a screening DPOAE measurement (Integrity v-500,
Vivosonic Inc., ON) to confirm the presence of OAEs. Screening OAEs were
performed with primary tones (f1/f2) presented at 65/55 dB sound pressure level
(SPL) between 0.75 to 6 kHz in half-octave intervals.
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10

Comprehensive Hearing Assessment Protocol

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The hearing sensitivity was assessed using a GSI 61 (Grason-Stadler Inc., Eden Prairie, MN, USA) two-channel diagnostic audiometer. The immittance analysis was performed using the GSI Tympstar (Grason-Stadler Inc., Eden Prairie, MN, USA) Middle Ear Analyzer, version 2. The external ear canal and the tympanic membrane were visualized using an Otoscope (Welch Allyn, Skaneateles Falls, NY, USA). A computer based DPOAE analyzer (Grason-Stadler Inc., Eden Prairie, MN, USA) (GSI AUDERA) was used to record the DPOAEs. The Affinity 440 (Interacoustics, Middelfart, Denmark) HIT module was used to measure the output sound pressure level of the PMS used by the participants.
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