Clinical Application of the Threshold Equalizing Noise Test in Patients with Hearing Loss of Various Etiologies: A Preliminary Study

BACKGROUND AND OBJECTIVES: We aimed to make a preliminary assessment of the prevalence of cochlear dead regions (DRs) and the factors affecting the results of the threshold-equalizing noise (TEN) test in patients with hearing loss of various etiologies. SUBJECTS AND METHODS: Between May and July 2014, 109 patients (191 ears) with hearing loss who visited our outpatient clinic were prospectively enrolled. Pure tone audiometry and TEN (HL) test were performed for all the patients. DR at each frequency was indicated by masked thresholds of ≥10 dB above the TEN level and ≥10 dB above the absolute threshold. RESULTS: DR was present in 15.7% (n=30) of the 191 ears. According to disease entity, 16.6% of patients with sensorineural hearing loss had a DR. However, DR was absent in patients with chronic otitis media. According to audiometric configurations, DR was most common in moderately severe, flat hearing loss. Significantly worse hearing thresholds for both mean hearing level and hearing threshold at each frequency were found in the presence of DR (p<0.001). Logistic regression analysis showed that only the mean hearing level (odds ratio: 1.053, 95% confidence interval: 1.021-1.085) affected the presence of DR. CONCLUSIONS: Although performance of the TEN test is limited by frequencies and hearing levels, it provides additional information regarding DRs and may therefore have the potential to be used as a prognostic tool for diverse diseases causing hearing loss.