Tone-in-notched-noise testing for screening high-frequency sensorineural hearing loss

Area of Science:

• Audiology
• Hearing Science
• Medical Diagnostics

Background:

• High-frequency sensorineural hearing loss (HF-SNHL) is permanent and progressive, necessitating early detection.
• Current screening methods may require improvement for accuracy and reliability.

Purpose of the Study:

• To evaluate masked tone thresholds in narrowband noise (TNB), notched noise (TNN), and their derived difference (TFS) for HF-SNHL screening.
• To assess the reliability and diagnostic accuracy of TNN for detecting HF-SNHL at 4 and 8 kHz.

Main Methods:

• Eighty-eight participants (18-79 years) with normal hearing or HF-SNHL underwent testing using a self-administered Frequency Selectivity Screener app.
• Evaluated within-session test-retest reliability, Bland-Altman limits of agreement, and associations with pure-tone audiometry.
• Assessed diagnostic accuracy using receiver operating characteristic curves.

Main Results:

• Notched noise (TNN) demonstrated superior or equivalent test-retest reliability compared to TNB and TFS.
• TNN showed strong correlations with pure-tone audiometric thresholds (Spearman's ρ = 0.84-0.87).
• TNN exhibited excellent diagnostic accuracy (AUC > 0.90), outperforming TNB and matching TFS performance.

Conclusions:

• Notched noise (TNN) testing is a reliable, frequency-specific screening tool for high-frequency sensorineural hearing loss (HF-SNHL).
• TNN testing can effectively complement conventional audiological assessments for early detection.
• Further research is needed to validate TNN across diverse populations and for longitudinal monitoring.