The History of Pediatric and Adult Hearing Screening.

OBJECTIVES/HYPOTHESIS: To document the history of hearing seeing in children and adults. STUDY DESIGN: A literature search in all languages was carried out with the terms of hearing screening from the following sources: Pub Med, Science Direct, World Catalog, Index Medicus, Google scholar, Google Books, National Library of Medicine, Welcome historical library and The Library of Congress. METHODS: The primary sources consisting of books, scientific reports, public documents, governmental reports, and other written material were analyzed to document the history of hearing screening. RESULTS: The concept of screening for medical conditions that, when found, could influence some form of the outcome of the malady came about during the end of 19th century. The first applications of screening were to circumscribe populations, schoolchildren, military personnel, and railroad employees. During the first half of the 20th century, screening programs were extended to similar populations and were able to be expanded on the basis of the improved technology of hearing testing. The concept of universal screening was first applied to the inborn errors of metabolism of newborn infants and particularly the assessment of phenylketonuria in 1963 by Guthrie and Susi. A limited use of this technique has been the detection of genes resulting in hearing loss. The use of a form of hearing testing either observational or physiological as a screen for all newborns was first articulated by Larry Fisch in 1957 and by the end of the 20th century newborn infant screening for hearing loss became the standard almost every nation worldwide. CONCLUSIONS: Hearing screening for newborn infants is utilized worldwide, schoolchildren less so and for adults many industrial workers and military service undergo hearing screening, but this is not a general practice for screening the elderly. LEVEL OF EVIDENCE: NA Laryngoscope, 131:S1-S25, 2021.

Phyllis M. Tookey Kerridge and the science of audiometric standardization in Britain.

The provision of standardized hearing aids is now considered to be a crucial part of the UK National Health Service. Yet this is only explicable through reference to the career of a woman who has, until now, been entirely forgotten. Dr Phyllis Margaret Tookey Kerridge (1901-1940) was an authoritative figure in a variety of fields: medicine, physiology, otology and the construction of scientific apparatus. The astounding breadth of her professional qualifications allowed her to combine features of these fields and, later in her career, to position herself as a specialist to shape the discipline of audiometry. Rather than framing Kerridge in the classic 'heroic-woman' narrative, in this article we draw out the complexities of her career by focusing on her pursuit of standardization of hearing tests. Collaboration afforded her the necessary networks to explore the intricacies of accuracy in the measurement of hearing acuity, but her influence was enhanced by her ownership of Britain's first Western Electric (pure-tone) audiometer, which she placed in a specially designed and unique 'silence room'. The room became the centre of Kerridge's hearing aid clinic that, for the first time, allowed people to access free and impartial advice on hearing aid prescription. In becoming the guardian expert and advocate of the audiometer, Kerridge achieved an objectively quantified approach to hearing loss that eventually made the latter an object of technocratic intervention.

Wideband acoustic immittance measurements of the middle ear: introduction and some historical antecedents.

This supplement focuses on some of the most recent acoustic measurements within the occluded, human external auditory meatus (EAM). The goal of this introduction is to provide an overview of basic and clinical EAM measurements that evolved in the 20th century and some relations between these measurements and wideband acoustic absorbance. The authors review some of the major efforts that have been used to evaluate the condition of the human, adult middle ear transmission system, the middle ear cavity, and the function of the Eustachian tube. They have grouped most of this work under the rubric of "acoustic immittance." A historical perspective helps one appreciate that the measurement of wideband acoustic absorbance is not a totally new procedure. Rather, it is the latest enhancement to aural acoustic-immittance measurements. An enhancement that can expand one's ability to characterize middle ear function and effects of ear disease on that function. It also allows clinicians evaluate middle ear function for frequencies whose wavelength is shorter than the length of the EAM.

Why the audiogram is upside-down.

Two quite sensible ways of recording audiometric threshold data emerged in the early 1920s. They were advanced by Edmund Prince Fowler, an otologist, and by Harvey Fletcher, a physicist. Either would probably have been better than the present system, and would have preserved scientific tradition relative to the orientation of the ordinates of graphs.

A historical vignette (21). A tribute to noise.

A tribute to noise. Noise is not only the harmful waste of the world of sounds. Some noises have contributed, or continue to contribute, an added value in three fields at least: Internal Medicine, Audiology and Music. Moreover, they are perceived naturally by the ear (Figure 1).

Speech signals used to evaluate functional status of the auditory system.

This review presents a brief history of the evolution of speech audiometry from the 1800s to present day. The two-component aspect of hearing loss (audibility and distortion), which was formalized into a framework in past literature, is presented in the context of speech recognition. The differences between speech recognition in quiet and in background noise are discussed as they relate to listeners with normal hearing and listeners with hearing loss. A discussion of the use of sentence materials versus word materials for clinical use is included as is a discussion of the effects of presentation level on recognition performance in quiet and noise. Finally, the effects of age and hearing loss on speech recognition are considered.

The history of neuro-otology. A personal perspective.

I realize I practiced otology and neuro-otology during a golden era, but I have to admit that I didn't appreciate how important it was until I sat down to outline this article. How fortunate I was to have lived and practiced during these developing years of neuro-otology. How fortunate to have worked with the likes of Howard and William House, James Sheehy, James Crabtree, David Austin, and John Shea. How fortunate to have had the opportunity to teach residents and fellows in association with my private practice. So I envy the young otologist-neuro-otologist and the future you have. You stand on the brink of great discoveries. And like my generation, you stand on the shoulders of giants. Good luck.

The Mel Scale's disqualifying bias and a consistency of pitch-difference equisections in 1956 with equal cochlear distances and equal frequency ratios.

In 1956, Stevens 'commissioned' an experiment to equisect a pitch difference between two tones. Results appear to reveal a methodological flaw that would invalidate the Mel Scale (Stevens and Volkmann, 1940). Stevens sought to distinguish sensory continua, e.g., loudness and pitch, on various criteria. He expected that the pitch continuum would not exhibit 'hysteresis'; i.e., that subjects dividing a pitch difference (delta f) into equal-appearing parts would not set dividing frequencies higher when listening to notes in ascending order than in descending order. Seven subjects equisected a pitch difference, between tones of 400 and 7000 Hz, into equal-seeming parts by adjusting the frequencies of three intermediate tones. All seven exhibited hysteresis, contrary to expectation. This outcome bears on other issues. Years prior, Stevens suggested that equal pitch differences might correspond to equal cochlear distances, but not to equal frequency ratios nor to equal musical intervals (Stevens and Davis, 1938; Stevens and Volkmann, 1940). In 1960 (reported now), both the 1940 Mel Scale and the equal pitch differences of 1956 were compared to equal cochlear distances, using a frequency-position function that fitted Békésy's cochlear map (Greenwood, 1961, 1990). When ascending and descending settings were combined to contra-pose biases, equal pitch differences did coincide with equal distances--which the Mel Scale did not. Further, the biased ascending-order data coincided with the Mel Scale, suggesting the Mel Scale was similarly biased. Thus, the combined-order equal pitch differences of 1956--but not the Mel Scale--are consistent with equal cochlear distances. However, since the map between 400 and 7000 Hz is nearly logarithmic, equal frequency ratios also approximate equal distances. Ironically, above 400 Hz, Békésy's map and Stevens' equal-distance hypothesis jointly imply that musical intervals will nearly agree with equal pitch differences, which Stevens thought he had disconfirmed. However, given Békésy's map, only near the cochlear apex will equal distances not approximate equal frequency ratios; and Pratt's (Pratt, 1928) bisections of delta fs greater than an octave indicated that equal pitch differences, on average, did agree with equal distances. However, they did so for only two of four subjects and coincided instead with equal frequency ratios for one musical subject. Historical distinctions suggest that between the parts of equisected delta fs subjective equivalence may be of two kinds--one linked to musical intervals, leading to equal frequency ratios; a second linked to 'tone-height' and 'distance', leading to deviations from equal frequency ratios near the apex, though not appreciably if equisected delta fs are less than an octave (or if perhaps subjects are musicians). Data of other kinds suggest that, if pure-tone pitch height were a function of place, the place could be the apical excitation-pattern edge, in any case not a maximum, which in neural data shifts and disappears with tone level.

Tuning fork tests: forgotten art.

Four examples are cited in which tuning fork tests helped in proper selection of patients for surgery, after audiometric air and bone tests were equivocal or gave the wrong diagnostic and prognostic indication.

Development of the audiometer and audiometry.

The authors consider the reasons why the induction coil audiometer was not widely adopted in clinical practise. The conclusion is that they offered little relevance to the management of hearing-impaired patients at that time, bearing in mind the state of therapeutics, surgery and contemporary aids to hearing.