BACKGROUND AND OBJECTIVES: The agreement between pure-tone average (PTA) and speech recognition threshold (SRT) has become more important with the increasing demands for medical certification. The purpose of this study was to explore the relationships between the SRT and several variations of PTA, and to determine which PTA formula would provide the best agreement with SRT for different audiometric configurations. SUBJECTS AND METHOD: Audiological data on 783 ears were retrospectively collected. The air-conduction PTAs were calculated using five different formulas: three-frequency average (3FA), weighted three-frequency average (W3FA), four-frequency average (4FA), weighted four-frequency average (W4FA), and six-frequency average (6FA). The audiometric configuration was classified into five categories. The PTA-SRT relationships were analyzed using correlation and simple linear regression for each audiometric configuration. RESULTS: Highest correlation was observed between the SRT and W3FA for all audiometric configurations with the correlation coefficient of 0.964 as a whole. The SRT and 3FA were best-matched in the linear regression models for overall/flat/high frequency gently sloping/low frequency ascending; the SRT and W3FA were best-matched for high frequency steeply sloping (HFSS); the SRT and 4FA were best-matched for miscellaneous audiograms. CONCLUSION: The most stable PTA variations that make the best-matched pairs with SRT for any audiogram are the conventional 3FA and W3FA doubling 1 kHz threshold. The addition of frequencies higher than 2 kHz to a PTA formula seems to have impeded the PTA-SRT agreement, especially for HFSS audiograms. W3FA should be the method of choice in predicting SRT from PTA for HFSS audiograms.
Certification ; Ear ; Hearing Loss, Functional ; Linear Models ; Methods ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Sudden deafness results from, in most cases, lack an apparent cause. However viral infection, vascular occlusion, cochlear membrane rupture, and others are known to be associated with this disease. In this study, we observed incidence, etiology, audiologic, psychiatric, and clinical aspect of psychogenic sudden deafness through retrospective chart review and analysis of patients who are thought to have had sudden deafness from psychogenic causes and stressor. SUBJECTS AND METHOD: We reviewed the records of 277 patients who had been admitted to the Department of Otolaryngology, Kangbuk Samsung hospital, from January 1997 to July 2003, under the initial diagnosis of idiopathic sudden hearing loss. RESULTS: In patients' medical history, there were 9 patients who had association between sudden onset of hearing loss and psychogenic causes and stressor. And there were 4 patients who had preexisting psycho-pathologic condition. Among these patients, a joint study with psychiatrist classified 7 psychogenic sudden deafness patients (2.5%) who has been ruled out organic causes and showed discrepancy between pure tone audiometry and ABR. In distribution ratio, there were 2 males and 5 females, 4 patients were in their 10's, 1 in 20's, and 2 in 40's (24 years old in average), 3 bilaterals, and 4 unilaterals. In hearing test, there were 4 patients with severe to profound hearing loss at 71 dB or higher, 2 patients with moderately severe hearing loss ranged from 56 to 70 dB, and 1 patient with moderate hearing loss from 41 to 56 dB. Hearing ability of all these patients were partially or completely recovered by treatment including steroid injection and joint psychotherapy with psychiatrist. CONCLUSION: About 2.5% of sudden deafness patients were psychogenic sudden deafness patients, and the results showed distinctive features for each of audiologic, psychiatric, and clinical characteristics. The recovery rate and prognosis were better in patients who had cure and diagnosis under consult with department of psychiatry and accurate audiometry.
Audiometry ; Diagnosis ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Functional* ; Hearing Loss, Sudden* ; Hearing Tests ; Humans ; Incidence ; Joints ; Male ; Membranes ; Otolaryngology ; Prognosis ; Psychiatry ; Psychotherapy ; Retrospective Studies ; Rupture

Neuro-otologic symptoms such as dizziness, hearing loss, or tinnitus give rise to peripheral change-induced neuroplasticity or central pathology-induced structural or functional changes. In this regard, functional neuroimaging modalities such as positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), quantitative electroencephalography (qEEG), or functional near infrared spectroscopy have provided researchers with possibility to observe neuro-otologic disease-induced central functional changes. Among these methods, PET and fMRI are advantageous over qEEG or MEG with regard to spatial resolution, while qEEG and MEG are advantageous over PET or fMRI with regard to temporal resolution. Also, fMRI or MEG is not suitable for patients with implanted devices, whereas PET is not ideal for repetitive measures due to radiation hazard. In other words, as these modalities are complementary to one another, researchers should choose optimum imaging modality on a case by case basis. Hereinafter, representative functional neuroimaging modalities and their application to neuro-otologic research will be summarized.
Dizziness ; Electroencephalography ; Functional Neuroimaging ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Magnetoencephalography ; Neuronal Plasticity ; Neurotology ; Positron-Emission Tomography ; Spectrum Analysis ; Tinnitus