Extended high frequency audiometry thresholds in healthy school children
Dagny Hemmingsen1, Niels Christian Stenklev2, Claus Klingenberg3
1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of North Norway, 9038 Tromsø, Norway; Paediatric Research Group, Faculty of Health Sciences, University of Tromsø-Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway.
Insights
Extended high frequency (EHF) audiometry is crucial for monitoring hearing loss in children. This study reveals that hearing sensitivity in the EHF range may decline before age 10, necessitating age-specific reference standards.
Area of Science:
- Pediatric Audiology
- Ototoxicity Monitoring
- Hearing Science
Background:
- Extended high frequency (EHF) audiometry is the gold standard for detecting ototoxic hearing loss in pediatric populations.
- Establishing normative audiological data for the EHF range in healthy children is essential for accurate monitoring.
- Clinical trial registration: NCT03253614.
Purpose of the Study:
- To establish high-quality reference audiological data for the extended high frequency (EHF) range in healthy children aged 6-14 years.
- To provide a baseline for identifying early signs of hearing loss in children undergoing potentially ototoxic treatments.
- To investigate age-related differences in EHF hearing thresholds.
Main Methods:
- 126 healthy schoolchildren aged 6-14 years participated in the study.
- Participants were screened for normal birth history and absence of middle ear disease.
- Extended high frequency (EHF) audiometry was performed to measure hearing thresholds from 9 kHz to 16 kHz.
Main Results:
- The average hearing threshold across the EHF range (9-16 kHz) was -0.4 (6.0) dB HL.
- The lowest mean hearing thresholds were observed at 14 kHz (-4.2 dB HL) and 16 kHz (-6.4 dB HL).
- Significantly lower thresholds were found in younger children (6-9 years) at 16 kHz compared to older children (10-14 years) (p=0.042), with increased variability at higher frequencies.
Conclusions:
- Hearing sensitivity in the EHF range may decrease around or before the age of 10 years in children.
- Establishing international reference standards for EHF hearing levels in children under 18 is recommended for ototoxicity monitoring.
- Age-specific reference data are crucial due to the gradual deterioration of hearing in the EHF range from an early age.
Objectives:
Extended high frequency (EHF) audiometry is the recommended method for monitoring oxotoxic hearing loss in children. This study aims to provide high quality reference audiological data for the EHF range in healthy children.
Methods:
Participants were 126 healthy schoolchildren between 6 and 14 years of age. All participants were term born with normal birthweight, had not suffered severe neonatal illness and had no history of middle ear disease.
Results:
The averaged mean (SD) hearing threshold for the EHF 9, 10, 11.2, 12.5, 14 and 16 kHz was -0.4 (6.0) dB HL. The lowest mean hearing thresholds were observed at 14 kHz with -4.2 (8.7) dB and at 16 kHz with -6.4 (12.1) dB HL. We found significantly lower thresholds at 16 kHz for children aged 6-9 years (-8.7 dB HL) compared to age 10-14 years (-3.9 db HL), p 0.042. For both age groups the inter-subject variability increased in the highest frequencies. We found no significant differences in mean hearing thresholds between right and left ears at any frequency, and no gender differences in the EHF range.
Conclusion:
Our findings support that decreased hearing sensitivity in the EHF's may start around or even before the age of 10 years. In order to use EHF audiometry for ototoxic monitoring in children, we suggest to establish an international reference standard for hearing levels in children under the age of 18. Specific references for different age groups are needed as hearing in the EHF range appears to gradually deteriorate from an early age.
Clinical Trial Registration:
NCT03253614.
