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Effects of Earmold Alteration Upon Sound Pressure Levels Generated in the Human Auditory Meatus

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Effects of Earmold Alteration Upon Sound Pressure Levels Generated in the Human Auditory Meatus This dissertation has been microfilmed exactly as received 69-18, 5 Mc Do n a l d , Frank Douglas, 1932- EFFECTS OF EARMOLD ALTERATION UPON SOUND PRESSURE LEVELS GENERATED IN THE HUMAN AUDITORY MEATUS. The University of Oklahoma, Ph.D., 1969 Health Sciences, general University Microfilms, Inc.. Ann Arbor, Michigan THE UNIVERSITY OF OKUHOMA GRADUATE COLLEGE EFFECTS OP EARMOLD ALTERATION UPON SOUND PRESSURE LEVELS GENERATED IN THE HUMAN AUDITORY MEATUS A DISSERTATION SUBMITTED TO THE GRADUATE FACULTY in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY BY FRANK DOUGLAS McDONALD (Kclahoma City, (Xclahoma 1969 EFFECTS OF EARMOLD ALTERATION UPON SOUND PRESSURE LEVELS GBfERATED IN THE HUMAN AUDITORY MEATUS APPROVED BY DISSffîTATKW COIWTIffi ACKNOHLEDOfEtiTS The author wishes to express his gratitude to the following: To Dr. Gerald A. Studebaker, for his guidance and encouragement through out the preparation and conduct of this experiment. To Dr. Joseph Barry, for his technical advice during the pre­ paration of the e^qwrimental apparatus. To Dr. William A. Cooper, for allowing use of Veterans Admin­ istration Attdiology facilities for the purposes of screening of sub­ jects and preparation of earmolds used in this study. To the dissertation reading committee and final examination committee, comprised of the aforementioned and Doctors John E. Allison and Howard B. Rohm. To the Veterans Administration Hospital, (Mclahcma City, for providing fUnds to support this study through their traineeship pro­ gram in Audiology, and for providing the services of their ENT staff for the otological examination of subjects used in this study. To the Speech and Hearing Center, Ihiiversity of Oklahoma Medical Center, for fimishing instrumentation and testing facilities for this study. To my wife, Betty, for her patient, understanding and inspira­ tional attitude, and for skillful management of the household and our four children during my studies. iii TABLE OP CONTSrrS Page LIST OP TABLES......................................... ^ LIST OP ILLUSTRATIONS.................................. vil Chapter I. INTRODUCTION....................... 1 II. REVIEW OP THE LITffiATURE......................... 5 Introduction ................................ 5 Rearing Aide and Eamolde . ................... 5 Development of the 2-ee C o u p l e r ............. « U The 2-cc Coupler fraqjuncj Re s p o n s e ................ 14 Acoustic Effects of Eamold Modification ........ 19 Early Saxmold Observations .............. 19 SPL Observations on Earmolds After Standardisation of the 2-cc Coupler ...... 21 Sound C h a n n e l ......... 21 Tubing......... 25 Damping Plugs ................... 28 Snap-ring Recess ............. ......... 29 Volume Between the Earmold Tip and the Eardrum . 30 VMits and Leaks ............. 30 Effects of Drastic Earmold Modification on Speech- Stimnli S c o r e s ............ 36 Vented Earmold.............. 36 Open Earmold................................ 39 Concluding Statement............................. 40 in. INSTRUMQITATION AND PROCECURE...................... 42 Lotroduction.............................. 42 Subjects................... 42 Acoustic Environment......... 43 Earmolds...................................... 44 Instrumentation........... 48 Receiver-Standard Coupler Measurements............. 49 Receiver-Earmold A-Special Coui^er Measurements . 51 In-the-Ear Measurements................... 53 Sound-Input System ..... ................. 53 Measuring System............ 55 Calibration .............................. 55 Procedure..................................... 57 Receiver-Standard Coupler Measurements............. 57 Receiver-Earmold A-Special Coupler Measurements . 58 Probe-tube Effects l ^ n Measuremen t s .............. 58 iv Chapter Page Ih-the-Ear Measurements......................... 59 The Teat Sequence ............... 59 IV» RESULTS AND CONCLUSIONS............................ 62 Receiver-Standard Coupler Findings................. 62 Receiver^Earaold A-Special Coupler Findings.......... 65 Comparison of Earmold A Findings with Those of the Standard Coupler's Tubular Entr a n c e .......... 65 Probe-tube Effects upon Measurements as Determined on the Special Coupler Using Earmold A .......... 70 Effects of Open Versus Closed Probe-tube Conditions upon Results Obtained with the One-half Inch Microphone . • . ....... 70 Effects of Open Versus Closed Probe-tube Conditions upon Results Obtained with the One Inch Acro- l À o n e ........... ..••.•70 Probe-tube Effects upon SPL Readings from the Qae- half Inch Ifterophone...................... 70 Coupler MBasurcment Vaxdability •••••.......... 73 Receiver-Earmold A-Special Cou;ù.er Findings Co^>ared with the Receiver-Earmold A-Real Ear Findings......... 73 Receiver-Earmold Findings Obtained in the Human Auditory Meatus • • • ............................... 76 Earmold A ............... 76 Earmold B ......................... 79 Earmold C .................................... 83 Earmold D .................................... 90 Concluding Statement...... •••••............96 V. SUMMARY........................................ 100 Coupler Findings ......... ......... .101 Real Ear Findings............ 102 BIBLIOGRAPHY......................................... 104 LIST OP TABI£S Table Page 1. Test Order for Receiver-Earmold A-Special Coupler Measurements........................ 60 2. Test Order for Ih-the-Ear Measurements 61 3, Intrasubject and Ihtersubject Standard Deviations From Earmold A Results (Real Ear) Di dB ...... 78 k. Intrasubject and Ditersubject Standard Deviations From Earmold B Results (Real Ear) In d B ...... 81 5. Intrasubject and Intersubject Standard Deviations From Earmold C Results (Real Ear) In dB . • • . • . 85 6« Intrasubject and Intersubjeet Standard Deviations From Earmold D Results (Real Ear) In dB ......... 92 vi LIST OF ILLUSTRATIONS Figure Page 1. Earmold Nomenclature of a Conventional Earmold for the Left E a r ............ 6 2. Earmold Forma Used in This S t u d y .................. A5 3. Instrumentation Used in Making Coupler Measurements • . • 50 4. Receiver-Earmold A-Coupler Relationship %*ile Making Mea­ surements with Earmold A on the Special 2-cc Coupler . • 52 5. Instrumentation Used in Making In-the-Ear Measurements . • 54 6. Head-home Device Used for Support of the Probe-tube Micro­ phone Assembly and the Hearing-AidReceiver ........ 56 7. The Mean Frequmcy-Response Cuirve of the Hearing-Aid Receiv­ er System on the Standard 2-cc Coupler............... 63 8. The Mean Fkmquency-Response Curve Obtained with Earmold A on the Special 2-cc C o u p l e r ...................... 66 9. The Mean FTequency-Response Curve Obtained with Earmold A on the Special 2-cc Coupler Plotted Relative to the Re­ sponse of the Hearing-Aid Receiver System on the Stan­ dard 2-cc Coupler............................ 67 10. The Mean Frequency-Response Curves of Earmold A (Open Probe Condition) on the Special 2-cc Coupler as Measured by the One-half Inch Probe-Tube AcrofAone (line A) and as Measured by the One Inch Artiflcial-Ear Microphone (line B) Plotted Relative to the Response Curve Obtained Using the One Inch Microphone Ibider the Closed Probe-Tube Con­ dition ........................................ 71 11. The Mean Frequency-Response Curves Obtained with Earmold A in the Real Ear (Line A) and with Earmold A on the Special 2-cc Couder (line B) .......... 74 12. The Mean Frequency-Response Curve (line A) and Range of Individual Levels (Area B) Obtained when Testing Earmold A in the Real Ear ................ 77 13. The Mean Frequency-Response Curve (line A) and Range of Lidividual Levels (Area B) Obtained Wien Testing Earmold B in the Real Ear ............... 80 vii Figure Page 14. The Mean FVequencj-Response Curve Obtained with Eamold B in the Seal Ear Plotted Relative to the Mean Frequencj- Response Curve Obtained With Eamold A in the Real Ear . 82 15. The Mean Frequency-Response Curve (line A) and Range of Individual Levels (Area B) Obtained when Testing Ear­ mold C in the Real Ea r ............... 84 16. The Mean Frequency-Response Curve Obtained with Eamold C in the Real Ear Plotted Relative to the Mean Are- queney Response Curve Obtained with Eamold A in the Real Ear 86 17. % e Mean Frequency-Response Curve (line A) and Range of Individual Levels (Area B) Obtained when Testing Ear­ mold D in the Real Ea r ................. 91 18. The Mean Frequen y-Response Curve Obtained with Eamold D in the Real Ear Plotted Relative to the Mean Fre­ quency Response Curve Obtained with Eamold A in the Real E a r ...................................... 93 19. The Msan Frequency-Response Curves Obtained in the Real Ears of the Subjects Using all Earaolds (A, B, C> O) . 97 20. The Mean Frequency-Response Curves Obtained with Eamolds B, C and D in the Real Ear Plotted Relative to the Mean Frequency-Response Curve of Eamold A in the Real Ear . 99 viii THE EFFECTS OP EARMOLD ALTERATION UPON SOUND PRESSURE LEVELS GENERATED IN THE HUMAN AUDITORY MEATUS CHAPTER I INTRODUCTION The eamold Is a retentive-coupling device idilch channels sound from a hearing-aid receiver to the tympanic membrane of the wearer's ear. At various times this device has been referred to by names such as ear-insert, ear-plece, ear-stopple, ear-retainer, re­ tentive auditory prosthesis, aural prosthesis and eamold. The tern eamold, because it Is the most widely used and accepted tern, will be used in this study. The first need for the eamold as a device tdilch couples the hearlng-ald receiver to
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