Measurement of variability in sound field audiometry due to subject movement

Sound field audiometry is used primarily for hearing assessment in young children and for functional hearing aid evaluation. It is important that measurements are accurate and reliable as they affect the management of patients. Most clinics use a substitution method for calibration and, as a result, if the subject moves from the calibrated test point, the sound pressure level (SPL) at the ears will vary as the sound field is very rarely uniform. This variation can result in inaccurate threshold estimation and increased test-retest variability. A commonly used method for evaluating the potential errors due to subject movement involves measuring the variation in SPL, with respect to the test point, at six points around the test point. This method makes assumptions about the sound field which may not be valid and could lead to an underestimation of the variation present. The aim of this investigation was to assess the accuracy of this method. Measurements of variation were taken with a microphone and repeated with a head and torso simulator (HATS) which was used to represent a test subject. The total degree of variation indicated by these two methods was compared. The microphone measurements indicated less variation than the HATS measurements. The differences were statistically significant but small in clinical terms. Assuming that the HATS is properly representative of the normal population, then this result indicates that simple microphone measurements are acceptable for normal clinical practice but that higher quality measurements are desirable for critical work.