Test Battery System and Method for Assessment of Auditory Function

• US 20080194984A1
• Filed: 03/16/2006
• Published: 08/14/2008
• Est. Priority Date: 03/16/2005
• Status: Active Grant

• Current Assignee: Sonicom, Inc.
• Original Assignee: Sonicom, Inc.
• Inventors: Keefe, Douglas H.
• Granted Patent: US 8,241,224 B2
• Time in Patent Office: Days
• US Class Current: 600/559
• CPC Class Codes: A61B 5/121 evaluating hearing capacity
• CPC Class Codes: A61B 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system

Abstract

A test battery method and system (10, 100, 200, 225) for use in assessing auditory function (e.g., the screening or diagnosis of impairments, fitting of hearing aids, etc.) is provided which performs one or more auditory tests including, for example, an acoustic reflectance test. Such an acoustic reflectance test may be a reflectance tympanometry test that includes a feedback system to control static pressure in the ear canal. Such acoustic reflectance tests may be used alone or in combination with one or more other auditory tests. Further, for example, such a battery of tests may include middle-ear muscle reflex tests in combination with one or more other auditory or hearing tests.

Claims

1. A test system for use in assessing auditory function, the system comprising:

a probe configured to be coupled into an ear canal in a substantially leak-free state, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

a pump operatively coupled to the probe to vary the static pressure in the ear canal;

processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of a reflectance tympanometry test on the patient using the probe resulting in reflectance tympanometry data comprising at least one or more transfer functions based at least on a response to an acoustic stimulus signal and a calibrated acoustic transfer function; and

an output device to provide an output to a user based on the reflectance tympanometry data and results of one or more other auditory tests, wherein the one or more other auditory tests comprise at least one of an admittance tympanometry test, an Eustachian tube test, a middle-ear muscle reflex decay test, a middle-ear muscle reflex threshold test, an otoacoustic emission test of medial olivocochlear status, an otoacoustic emission test, an acoustic test of eardrum response based on probe response, an acoustic test of volume of air between the probe and eardrum, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal, an acoustic test of ear canal length, an auditory brain stem response test, and an audiometry test, and further wherein the output is representative of a probability of one or more auditory impairments in function of the patient'"'"'s auditory system generated using both the reflectance tympanometry data and results of the one or more other auditory tests.

2-29. -29. (canceled)

30. A system for use in assessing auditory function, the system comprising:

a probe configured to be coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of an ambient pressure acoustic reflectance test on the patient resulting in acoustic reflectance data comprising at least one or more transfer functions based at least on a response to an acoustic stimulus signal and a calibrated acoustic transfer function, wherein the ambient pressure acoustic reflectance test is controlled by the processing apparatus so as to deliver an acoustic stimulus signal into the ear canal using the at least one acoustic transmitter of the probe, wherein the acoustic stimulus signal is limited to a single amplitude level acoustic stimulus signal; and

an output device to provide an output to a user based on the acoustic reflectance data and results of one or more other auditory tests, wherein one or more other auditory tests comprise at least one of an admittance tympanometry test using a pump to vary static pressure in the ear canal, an Eustachian tube test, a middle-ear muscle reflex decay test, a middle-ear muscle reflex threshold test, an otoacoustic emission test, an otoacoustic emission test of medial olivocochlear status, an acoustic test of eardrum response based on probe response, an acoustic test of volume of air between the probe and eardrum, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal, an acoustic test of ear canal length, an auditory brain stem response test, and an audiometry test, and further wherein the output is representative of a probability of one or more auditory impairments in function of the patient'"'"'s auditory system generated using both the acoustic reflectance data and results of the one or more other auditory tests.

31. The system of claim 30, wherein the output device provides an output to the user representative of a probability that the patient has hearing loss associated with sound conduction through the middle-ear.

32. The system of claim 30, wherein the output device provides an output to the user indicating whether a normal hearing infant has a permanent hearing loss.

33. The system of claim 30, wherein the processing apparatus is further operable to initiate and control performance of one or more of the other auditory tests on the patient.

35. The system of claim 30, wherein the one or more other auditory tests comprise at least a middle-ear muscle reflex threshold test.

36. The system of claim 35, wherein the one or more other auditory tests further comprise at least a middle-ear muscle reflex decay test based at least in part on results of the middle-ear muscle reflex threshold test.

37. The system of claim 35, wherein the system further comprises means for providing an ipsilateral or contralateral sound, and wherein the processing apparatus is further operable for initiating and controlling a middle-ear muscle reflex threshold test based on a shift of a wideband response in an ambient pressure reflectance test in the presence of the ipsilateral or contralateral sound.

38. The system of claim 30, wherein the processing apparatus is further operable for initiating and controlling performance of at least one of an acoustic test of volume of air between the probe and the eardrum of the patient, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal of the patient, and an acoustic test of ear canal length of the patient between a tip of the probe and the eardrum.

42. The system of claim 30, wherein the one or more other auditory tests comprise at least an otoacoustic emission test.

45. The system of claim 30, wherein the system further comprises at least one electrode for connection to a patient'"'"'s scalp, and further wherein the one or more other auditory tests comprise at least an auditory brain stem response test using the at least one electrode.

47. The system of claim 45, wherein the one or more other auditory tests comprise at least an otoacoustic emission test.

48. The system of claim 47, wherein the output device provides an output to the user representative of a probability at least one of middle-ear dysfunction, cochlear dysfunction, sensorineural dysfunction, and auditory neuropathy.

51. The system of claim 30, wherein the one or more other auditory tests comprise at least a middle-ear muscle reflex threshold test and an otoacoustic emission test.

53. The system of claim 30, wherein the one or more other auditory tests comprise at least one audiometry test resulting in audiometry data.

55. The system of claim 30, wherein the system further includes a handheld enclosure comprising processing means within the handheld enclosure configured for at least initiating one or more tests upon receipt of input from a user;

and further wherein the probe is electrically coupled to the processing means within the handheld enclosure.

56. The system of claim 55, wherein the processing means within the handheld enclosure is further configured for communication of information to a base unit, wherein the base unit comprises base unit processing means for use in processing the information.

34. (canceled)

39-41. -41. (canceled)

43-44. -44. (canceled)

46. (canceled)

49-50. -50. (canceled)

52. (canceled)

54. (canceled)

58-88. -88. (canceled)

89. A system for use in assessing auditory function, the system comprising:

a probe configured to be coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of a middle-ear muscle reflex threshold test on the patient using the using the probe; and

an output device to provide an output to the user based on results of the middle-ear muscle reflex threshold test and results of one or more other auditory tests, wherein the one or more other auditory tests comprise at least one of an otoacoustic emission test, an acoustic reflectance test comprising at least one of an ambient pressure acoustic reflectance test and a reflectance tympanometry test using a pump to vary static pressure, an auditory brain stem response test, and an otoacoustic emission test of medial olivocochlear status, and further wherein the output is representative of a probability of one or more auditory impairments in function of the patient'"'"'s auditory system generated using both the results of the middle-ear muscle reflex threshold test and the results of the one or more other auditory tests.

57. The system of claim 89, wherein the middle-ear muscle reflex threshold test is a non-immittance type middle-ear muscle reflex threshold test.

90-120. -120. (canceled)

121. A system for use in assessing auditory function, the system comprising:

a probe configured to be coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of at least one of an acoustic test of volume of air between the probe and the eardrum of the patient, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal of the patient, and an acoustic test of ear canal length of the patient between a tip of the probe and the eardrum resulting in ear canal measurements, and wherein the processing apparatus is further operable for use in initiating and controlling performance of an acoustic reflectance test using the probe; and

an output device to provide an output to the user based on the ear canal measurements and results of the acoustic reflectance test.

122-136. -136. (canceled)

137. A system for use in fitting a hearing aid, the system comprising:

a probe configured to be coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

a pump to vary static pressure in the ear canal;

a processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of a reflectance tympanometry test resulting in reflectance tympanometry data comprising at least one or more transfer functions based at least on a response to an acoustic stimulus signal and a calibrated acoustic transfer function; and

an output device to provide an output based on at least the reflectance tympanometry data for use in adjusting one or more parameters of the hearing aid.

138-159. -159. (canceled)

160. A hearing aid system comprising:

at least one acoustic transmitter in a hearing aid to present one or more acoustic stimulus signals into the ear canal;

at least one acoustic transducer in the hearing aid to measure an acoustic response to the one or more acoustic stimulus signals; and

a processing apparatus in the hearing aid operable to initiate one or more auditory tests on a patient, wherein the processing apparatus is operable for use in initiating and controlling performance of an acoustic transfer function test resulting in acoustic transfer function data, wherein the acoustic transfer function test resulting in acoustic transfer function data is an acoustic admittance test resulting in acoustic admittance data and further wherein the processing apparatus is operable for use in adjusting one or more parameters of the hearing aid based on at least the acoustic transfer function data.

161-167. -167. (canceled)

168. A system for use in assessing auditory function, the system comprising:

a probe configured to be coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

a processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of an acoustic reflectance test resulting in acoustic reflectance data, and further wherein the processing apparatus is operable for use in initiating and controlling performance of an audiometry test resulting in audiometry data; and

an output device for use in providing an output to a user based on the acoustic reflectance data and the audiometry data.

169-177. -177. (canceled)

178. A system for use in performing reflectance tympanometry, the system comprising:

a probe configured to be coupled into an ear canal in a substantially leak-free state, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

a pump operatively coupled to the probe to vary the static pressure in the ear canal;

a processing apparatus operable to initiate one or more auditory tests on a patient upon receipt of input from a user, wherein the processing apparatus is operable for use in initiating and controlling performance of a reflectance tympanometry test on the patient using the probe resulting in reflectance tympanometry data comprising at least one or more transfer functions based at least on a response to an acoustic stimulus signal and a calibrated acoustic transfer function;

a static pressure transducer to detect static pressure in the ear canal; and

a controller for use in comparing detected actual static pressure in the ear canal to a desired static pressure, wherein the pump is controlled to maintain the desired static pressure in the ear canal based on the comparison.

179-184. -184. (canceled)

185. A method for use in assessing auditory function, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user;

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal in a substantially leak-free state, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals; and

a pump operatively coupled to the probe to vary the static pressure in the ear canal;

performing a reflectance tympanometry test on the patient using the test system, wherein performing the reflectance tympanometry test comprises;

providing a calibrated acoustic transfer function using the probe;

inserting the probe into the ear canal of the patient in a substantially leak-free state;

delivering an acoustic stimulus signal into the ear canal using the at least one acoustic transmitter of the probe;

varying the static pressure in the ear canal using the pump;

detecting a response to the acoustic stimulus signal using the at least one acoustic transducer of the probe; and

providing reflectance tympanometry data based at least on the response to the acoustic stimulus signal and the calibrated acoustic transfer function;

performing one or more other auditory tests on the patient, wherein the one or more other auditory tests comprise at least one of an admittance tympanometry test, an Eustachian tube test, a middle-ear muscle reflex decay test, a middle-ear muscle reflex threshold test, an otoacoustic emission test of medial olivocochlear status, an otoacoustic emission test, an acoustic test of eardrum response based on probe response, an acoustic test of volume of air between the probe and eardrum, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal, an acoustic test of ear canal length, an auditory brain stem response test, and an audiometry test;

analyzing the reflectance tympanometry data and results of the one or more other auditory tests; and

providing an output to the user representative of a probability of one or more auditory impairments in function of the patient'"'"'s auditory system based on both the reflectance tympanometry data and results of the one or more other auditory tests.

186-217. -217. (canceled)

218. A method for use in assessing auditory function, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user; and

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

performing an ambient pressure acoustic reflectance test on the patient using the test system, wherein performing the ambient pressure acoustic reflectance test comprises;

providing a calibrated acoustic transfer function using the probe;

inserting the probe into the ear canal of the patient;

delivering an acoustic stimulus signal into the ear canal using the at least one acoustic transmitter of the probe, wherein the acoustic stimulus signal is limited to a single amplitude level acoustic stimulus signal;

detecting a response to the acoustic stimulus signal using the at least one acoustic transducer of the probe; and

providing acoustic reflectance data based at least on the response to the acoustic stimulus signal and the calibrated acoustic transfer function;

performing one or more other auditory tests on the patient, wherein the one or more other auditory tests comprise at least one of an admittance tympanometry test using a pump to vary static pressure, an Eustachian tube test, a middle-ear muscle reflex decay test, a middle-ear muscle reflex threshold test, an otoacoustic emission test, an otoacoustic emission test of medial olivocochlear status, an acoustic test of eardrum response based on probe response, an acoustic test of volume of air between the probe and eardrum, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal, an acoustic test of ear canal length, an auditory brain stem response test, and an audiometry test;

analyzing the acoustic reflectance data and results of the one or more other auditory tests; and

providing an output to the user representative of a probability of one or more auditory impairments in function of the patient'"'"'s auditory system based on both the acoustic reflectance data and results of the one or more other auditory tests.

219. The method of claim 218, wherein providing an output to the user comprises providing an output to the user representative of a probability that the patient has hearing loss associated with sound conduction through the middle-ear.

220. The method of claim 218, wherein providing an output to the user comprises classifying a normal hearing infant as having no permanent hearing loss.

221. The method of claim 218, wherein performing one or more other auditory tests on the patient comprises performing one or more of the other auditory tests using the test system used to perform the ambient pressure reflectance test.

223. The method of claim 218, wherein performing one or more other auditory tests on the patient using the test system comprises performing a middle-ear muscle reflex threshold test.

230. The method of claim 218, wherein performing one or more other auditory tests on the patient using the test system comprises performing at least an otoacoustic emission test.

234. The method of claim 218, wherein performing one or more other auditory tests on the patient using the test system comprises performing at least an auditory brain stem response test, wherein performing the auditory brain stem response test comprises:

connecting at least one electrode to the patient'"'"'s scalp, wherein the at least one electrode is electrically connected to the processing apparatus for control thereof, and

performing the auditory brain stem response test based on measurements taken using the at least one electrode.

236. The method of claim 234, wherein performing one or more other auditory tests on the patient using the test system further comprises performing an otoacoustic emission test.

244. The method of claim 218, wherein performing one or more other auditory tests on the patient using the test system comprises performing at least one audiometry test resulting in audiometry data using the test system.

222. (canceled)

224-229. -229. (canceled)

231-233. -233. (canceled)

235. (canceled)

237-243. -243. (canceled)

245-247. -247. (canceled)

249-286. -286. (canceled)

287. A method for use in assessing auditory function, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user; and

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic

response to the one or more acoustic stimulus signals;

performing a middle-ear muscle reflex threshold test on the patient using the test system;

performing one or more other auditory tests on the patient, wherein the one or more other auditory tests comprise at least one of an otoacoustic emission test, an acoustic reflectance test comprising at least one of an ambient pressure acoustic reflectance test and a reflectance tympanometry test using a pump to vary static pressure, an auditory brain stem response test, and an otoacoustic emission test of medial olivocochlear status;

analyzing results of the middle-ear muscle reflex threshold test and results of the one or more other auditory tests; and

providing an output to the user representative of a probability of an auditory impairment in function of the patient'"'"'s auditory system based on both the results of the middle-ear muscle reflex threshold test and the results of the one or more other auditory tests.

248. The method of claim 287, wherein performing a middle-ear muscle reflex threshold test on the patient using the test system comprises:

performing a non-immittance type middle-ear muscle reflex threshold test on the patient using the test system.

288-325. -325. (canceled)

326. A method for use in assessing auditory function, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user; and

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

performing, with use of the test system, at least one of an acoustic test of volume of air between the probe and the eardrum of the patient, an acoustic test of ear canal cross-sectional area at two or more locations along an axis of the ear canal of the patient, and an acoustic test of ear canal length of the patient between a tip of the probe and the eardrum; and

performing an acoustic reflectance test using the test system.

327-342. -342. (canceled)

343. A method for use in fitting a hearing aid, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user; and

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

performing reflectance tympanometry test using the test system resulting in reflectance data; and

fitting a hearing aid for the patient using results of at least the reflectance tympanometry test.

344-366. -366. (canceled)

367. A method for adjusting a hearing aid, comprising:

providing a hearing aid that comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal and at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

using the hearing aid, initiating and controlling performance of an acoustic transfer function test resulting in acoustic transfer function data, wherein the acoustic transfer function test resulting in acoustic transfer function data is an acoustic admittance test resulting in acoustic admittance data; and

adjusting one or more parameters of the hearing aid based on at least the acoustic transfer function data.

368-374. -374. (canceled)

375. A method for use in assessing auditory function, the method comprising:

providing a test system for use in performing one or more auditory tests on a patient, wherein the test system comprises;

a processing apparatus operable to initiate one or more tests upon receipt of input from a user; and

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

performing an acoustic reflectance test using the test system resulting in acoustic reflectance data; and

performing an audiometry test using the test system resulting in audiometry data.

376-384. -384. (canceled)

385. A method for use in assessing auditory function, the method comprising:

providing test system for use in performing reflectance tympanometry, wherein the test system comprises;

a processing apparatus, wherein the processing apparatus is configured to initiate one or more tests upon receipt of input from a user;

a probe electrically coupled to the processing apparatus and configured to be acoustically coupled into an ear canal in a substantially leak-free state, wherein the probe comprises at least one acoustic transmitter to present one or more acoustic stimulus signals into the ear canal, and further wherein the probe comprises at least one acoustic transducer to measure an acoustic response to the one or more acoustic stimulus signals;

a pump operatively coupled to the probe to vary the static pressure in the ear canal; and

a static pressure transducer to detect static pressure in the ear canal;

performing a reflectance tympanometry test on a patient using the test system, wherein performing the reflectance tympanometry test comprises;

providing a calibrated acoustic transfer function using the probe;

inserting the probe into the ear canal of the patient in a substantially leak-free state;

delivering an acoustic stimulus signal into the ear canal using the at least one acoustic transmitter of the probe;

controlling the static pressure in the ear canal using the pump, wherein controlling the static pressure comprises detecting actual static pressure in the ear canal using the static pressure transducer, comparing the detected static pressure to a desired static pressure, and controlling the pump to maintain the desired static pressure in the ear canal based on the comparison of the desired static pressure to the actual static pressure;

detecting a response to the acoustic stimulus signal using the at least one acoustic transducer of the probe; and

providing reflectance tympanometry data based at least on the response to the acoustic stimulus signal and the calibrated acoustic transfer function.

386-388. -388. (canceled)