Marriage Josephine, Moore Brian C J, Ogg Vivian, Stone Michael A
Department of Experimental Psychology, University of Cambridge, Cambridge, UK.
Ear Hear. 2008 Jun;29(3):392-400. doi: 10.1097/AUD.0b013e3181690701.
To compare results for the original version of the threshold equalizing noise [TEN(HL)] test for diagnosis of dead regions (DRs) in the cochlea, using stimuli presented via headphones, with results for an aided version of the test, the ATEN test, in which subjects listened to stimuli presented in free field using their own hearing aids.
The test tones were warble tones for both the TEN(HL) and the ATEN test. Twenty-five subjects (12 males and 13 females), aged between 12 and 19 yr, with severe or profound sensorineural hearing loss were tested. For each test, two levels of the TEN were used, chosen to fall within the comfortable range of levels for the individual subject. A DR was considered to be present when the TEN(HL) produced at least 10 dB of masking and when the masked threshold was at least 10 dB above the nominal TEN(HL) level. Measurements of the outputs of the hearing aids in response to the TEN(HL) plus the test tones were obtained using a KEMAR acoustic manikin to assess the extent to which distortion or compression might have influenced the outcomes.
For the TEN(HL) test, the results were often inconclusive, because the TEN(HL) could not be made sufficiently intense to give at least 10 dB of masking. The incidence of these inconclusive cases was markedly reduced for the ATEN test. There were more positive diagnoses of DRs for the ATEN test than for the TEN(HL) test. The KEMAR measurements indicated that distortion, compression, and/or feedback cancellation probably influenced the outcomes in some cases, leading to a moderate incidence of false positives for the ATEN test, and also some "missed" cases.
The ATEN test leads to a lower incidence of inconclusive results than the TEN(HL) test in the diagnosis of DRs in people with severe to profound hearing loss. However, for some hearing aids the gain changed rapidly as a function of frequency, which undermined the validity of the ATEN test. Also, some hearing aids introduced distortion that probably affected the outcome of the test and gave misleading results. Hence, the ATEN test cannot be recommended for use in the clinic.
比较使用耳机呈现刺激的耳蜗死区（DRs）诊断阈值均衡噪声原版本测试 [TEN(HL)] 的结果，与该测试的辅助版本ATEN测试的结果，在ATEN测试中，受试者使用自己的助听器聆听自由声场中呈现的刺激。
TEN(HL) 测试和ATEN测试的测试音均为啭音。对25名年龄在12至19岁之间、患有重度或极重度感音神经性听力损失的受试者（12名男性和13名女性）进行了测试。对于每项测试，使用两个TEN水平，选择使其落在个体受试者的舒适水平范围内。当TEN(HL) 产生至少10 dB的掩蔽且掩蔽阈值比标称TEN(HL) 水平至少高10 dB时，认为存在DR。使用KEMAR声学模型获得助听器对TEN(HL) 加测试音的输出测量值，以评估失真或压缩可能影响结果的程度。
对于TEN(HL) 测试，结果往往不确定，因为TEN(HL) 无法产生足够强的强度以提供至少10 dB的掩蔽。ATEN测试中这些不确定情况的发生率明显降低。ATEN测试对DR的阳性诊断比TEN(HL) 测试更多。KEMAR测量表明，失真、压缩和/或反馈消除可能在某些情况下影响了结果，导致ATEN测试出现中度假阳性发生率，也出现了一些“漏诊”情况。
在重度至极重度听力损失患者的DR诊断中，ATEN测试导致不确定结果的发生率低于TEN(HL) 测试。然而，对于一些助听器，增益随频率快速变化，这削弱了ATEN测试的有效性。此外，一些助听器引入了失真，这可能影响测试结果并给出误导性结果。因此，不建议在临床中使用ATEN测试。
