High-frequency thresholds: circumaural earphone versus insert earphone

Benefits of high-frequency audiometry in monitoring hearing sensitivity of patients administered ototoxic medications are well established. High-frequency thresholds have been reported to be variable, due in part to small differences in the placement of the earphone diaphragm over the opening of the ear canal. Reliability may be improved by using insert earphones (ER-2) when obtaining high-frequency thresholds. The purposes of this study were to determine high-frequency threshold test-retest reliability using Koss HV/1A+ and ER-2 earphones and to determine if significant differences are present between high-frequency thresholds obtained using these two earphones. Results obtained on 40 ears of 20 normal hearing adults revealed that differences between the test and retest thresholds for each earphone were not significant. Intrasubject threshold differences between the test and retest thresholds for each earphone were, for the most part, within +/- 10 dB at all test frequencies. Further, significantly greater intensity was required to measure threshold when using the ER-2 earphone when compared to the Koss HV/1A+ at all test frequencies.