Objectives: To develop a new method of screening audiometry that reduces the adverse effects of low frequency background noise by using active noise reduction (ANR) headphone technology.
Design: Prospective testing within an anechoic chamber evaluated the physical properties of ANR headphones. A prospective clinical crossover study compared standard audiometry with ANR headphone audiometry.
Methods: Bose Aviation X circum-aural ANR headphones were tested for both active and passive attenuation properties in a hemi-anechoic chamber using a head and torso simulator. Thirty-seven otology clinic patients then underwent standard audiometry and ANR audiometry, which was performed in a 30- and/or 40-dB sound field.
Results: Objective ANR headphone attenuation levels of up to 12 dB were achieved at frequencies below 2,000 Hz. In standard audiometric testing, 40 dB of narrow-band background noise decreased patient pure tone thresholds by 24 dB at 250 Hz. The use of ANR technology provided 12 dB of additional attenuation. This resulted in a significant improvement in test results despite the 40 dB of background noise (P = <0.001). In a 30-dB sound field, standard audiometric thresholds were shifted down by an average of 12 dB. The use of ANR technology completely attenuated this effect and resulted in a significant improvement in results (P = <0.01). These results were identical to those obtained in a quiet sound booth.
Conclusions: Despite a 30-dB sound field, ANR audiometry can produce an audiogram identical to that obtained in a double-walled sound booth. ANR headphone audiometry improves the sensitivity of audiometric screening for mild low-frequency hearing loss. This technology may have important applications for screening in schools, industry, and community practices.