Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. e Ren Wei long-term predicting intra-operatively in improvement tool hearing a ossiculoplasty: in via loudspeakers response brainstem auditory frequency-specific Tone-pip ol eaieyaettepeito ffiay o ujcswt omlEF h orlto ewe sAR n TIwas PTAI malfunction and fs-ABRI tube between Eustachian correlation the analysis. ETF, (P=.0407 above normal r=0.77 all with with in subjects PTAI=1.6*fs-ABRI+12.48 for fs-ABR P higher: efficacy, and even prediction (r=0.76, PTA the fs-ABR between affect with negatively difference correlation would no better showed P a analysis (r=0.67, showed before fs-ABRI Bland-Altman PTA room with operating group, correlation P in (r=0.88, better 3ms results a subjects PTA for showed hearing. the results. CHL PTAI with measure fs-ABR and group, relation and NH to linear 1ms PTA For high for test between a Results: showed standard agreement threshold surgery the the subjects. fs-ABR before compare the as (CHL) surgery, to anesthesia used loss used under was hearing were four fs-ABR PTA conductive analysis Forty-two take surgery, would Participants correlation intra-operatively. the subjects linear reconstruction after All and chain six-month analysis established. ossicular and were Bland-Altman the system before this after (PTA) for right calibrate audiometry latency to and tone V subjects outcome. wave (NH) Pure and hearing long-term normal threshold tests: the in ABR hearing used predicting standard were the in duration hearing 3ms and accuracy the and system assess and 2ms the to 1ms, efficiency loudspeakers with via its tone-pips system 1kHz observe Blackman-gated (fs-ABR) and Setting ABR frequency-specific intra-operatively a ossiculoplasty establish in to aimed improvement we study, this In Objective: Abstract 2021 8, February 1 Shi Bin-Yu l ujcswudtk orhaigtss uetn uimty(T)bfr n i-ot fe the after six-month and before (PTA) audiometry tone Pure established. were system tests: this hearing for latency four subjects V wave (NH) take and hearing would threshold normal ABR in subjects standard used the were All and duration system 3ms the and calibrate 2ms to 1ms, with tone-pips 1kHz Blackman-gated Setting studies Observational accuracy and efficiency Methods its observe outcome. and long-term intra-operatively the ossiculoplasty predicting in improvement in hearing the assess to a Objective: as consideration into taken be Abstract should promising ETF a as Besides, impairment. serve hearing would ossiculoplasty. the system of This influence efficacy negatively minutes. would the 15 that to optimize and 10 factor surgeons efficiently about risk help improvement short, was to hearing fs-ABR 6-month clinically the post-surgical for tool time the testing predict average and The intra-operatively accurately. chain ossicular reconstructed the hns L eea Hospital General PLA Chinese 1 e Ji Fei , nti td,w ie oetbihafeunyseicAR(sAR ytmvaloudspeakers via system (fs-ABR) ABR frequency-specific a establish to aimed we study, this In 1 u zhao hui , 1 ogXu Cong , 1 n h-igYang Shi-Ming and , 1 a-u Zheng Fan-Jun , 1 1 1 < igYang Ying , .5.CnlsosTi ytmcudmntrtefnto of function the monitor could system This Conclusions 0.05). < < 0)wt h qain PTAI=2.15*fs-ABRI-3.49; equation: the with .01) 0)wt h qainPTA=0.93*fs-ABR+3.48. equation the with .01) 1 ioRen Xiao , < 00) o H olwu results: up follow CHL For .0001). 1 e-iJiang Pei-yi , 1 , Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. iie ujcs nte btcei htisr pneerhnsaentsial o ideersurgeries. middle-ear for suitable not are enrolled earphones and sponge results, insert follow-up stapes that eligible on is reported focused obstacle that few mainly Another membrane, studies demonstrated tympanic those subjects. and However, uninjured linear limited stapedectomy and rate(6). high in intact surgery af- a ABR with revision have being the intra-operative surgery thresholds to reduce PTA applied rarely low-frequency could reported firstly is estimate monitoring was Hsu could ABR and 1kHz S. ABR at clinically Tone-burst Griffith threshold used hearing accurately(8). noise. and widely environmental threshold measurement PTA and with hearing correlation anesthesia noninvasive of sleep, and few by bones, objective fected temporal patients. an cadaver in is in methods the ABR out the these of overestimation carried of tested the were usage directly to experiments the lead methods confirming all could mechanical them nearly electrocochleogra- which Additionally, changes (TM), TM membrane ability(4). stimulation(4), the hearing tympanic ignored been which the field movement had stimulating chain(OC) electromagnetic ossicular of Chirp- efficiency and Instead responses(ASSR) ossiculoplasty (3), steady-state ASSR(7). auditory of Vibrometry(LDV) response(ABR)(6), surgeon’s brainstem measurements the auditory Laser-Doppler on phy(ECochG)(5), intra-operative depends acoustical mainly to it tried: and 8%(1) that from mechanical is ranging variety Various surgeons great and presents patients long-term hearing HI for of improve long-term both judgments. prerequisites risk that to subjective are a reason by way prosthesis remains The influenced effective ossicular rate are most of surgery 13.2%(2). improvement(HI) coupling revision the the and hearing be However, greatly positioning post-surgery HI. to which which However, proved among gap(ABG). hardship factors, been air-bone communication several has the and Ossiculoplasty minimize hearing quality. and present life loss(CHL) their hearing lower conductive with Patients Introduction points Key surgeons help to clinically ment predict tool and promising intra-operatively a Keywords: chain be ossiculoplasty. ossicular would of reconstructed and efficacy the improvement the of optimize hearing 6-month function the post-surgical monitor the could system This was PTAI negatively and fs-ABRI would between malfunction correlation Conclusions (P=.0407 tube the r=0.77 ETF, Eustachian with normal PTAI=1.6*fs-ABRI+12.48 with analysis. higher: subjects above even for all efficacy, in prediction the fs-ABR affect and PTA between difference P (r=0.76, fs-ABR P Results: subjects. (CHL) loss between hearing agreement conductive Forty-two the intra- compare reconstruction to chain used ossicular Participants were the analysis after results. correlation right fs-ABR linear and and PTA and surgery Bland-Altman before anesthesia operatively. under fs-ABR surgery, < 0)wt h qain TI21*sAR-.9 o m ru,PAsoe etrcreainwith correlation better a showed PTA group, 3ms for PTAI=2.15*fs-ABRI-3.49; equation: the with .01) • • • hsf-B ytmwssgetdt ea ffiin olt oio n rdc h ern outcome hearing the predict and monitor to tool efficient an be intra-operatively. to ossiculoplasty corre- suggested of high was showed system reconstruction fs-ABR result. ossicular This PTA the post-surgery challenging. after with remains threshold lation ossiculoplasty fs-ABR during tone-pip chain 1kHz ossicular Intra-operative reconstructed of monitoring Objective o H olwu eut:fr1sgop TIsoe etrcreainwt sAR (r=0.67, fs-ABRI with correlation better a showed PTAI group, 1ms for results: up follow CHL For siuolsy rqec-pcfi-B ytm nr-prtv oioig ern improve- hearing monitoring, intra-operative system, frequency-specific-ABR ossiculoplasty, < 0)wt h qainPA09*sAR34.BadAta nlsssoe no showed analysis Bland-Altman PTA=0.93*fs-ABR+3.48. equation the with .01) 2 < 0.05). Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. codn oterPArslst anaC.Teitniylvlwste erae y0d ni there until dB by10 real decreased the then determine to was of used implemented level times was were intensity SPL 3 decrement dB The clear and least 90 increment CR. a at to smaller and a elicit 80 then 40nV gain to of response, exceeded level to used repeatable stimulation response results was no start the PTA was SPL higher of their a dB amplitude to subjects, 70 the CHL according subjects, For as Newborn defined NH British level(15). by For was noise background issued CR 2.1) 2013(15). A (version in (CR). Guidance (NHSP) response ABR Program with accordance Screening in Hearing determined A- was 20.59 threshold was ABR level noise OR(9). background Determination in Procedure averaged dB 10dB. Threshold the A-weighted of ABR and step 48.46 a paper, and by previous SPC OR loudspeaker in our and the SPC dB in from in away weighted illustrated cm both was 30 Norway) was Lierskogen, calibration which (Norsonic, point of meter reference level the sound at a calibrated loudspeaker. were using the signals the of of that levels with Output line in 95% was with axis wiped Calibration central was reference Signal Skin whose 3k the nasion. canal than to1500Hz. line, the lower ear on 300 was hair external electrode from impedance the forehead ground filter inter-electrodes repetition from and the the pass stimulus ear at ensure band with tested was to the and used alcohol of electrode 100k were cheek of (S3) recording ipsilateral gain 3ms on used: amplifier electrode and were 1024, (S2) electrodes of 2ms tone- button number (S1), 1kHz Non-invasive sweep gated 1ms 27.1/second, Blackman of system. of durations recording rate different the as three used with were pips (Denmark) 25 Eclipse Acoustic TestingInternational ABR skin and canal the external System before recovered Presentation with anesthesia Signal reconstruction general was 3 the under and 0.5/1/2/4kHz after test pre-operative right of whose fs-ABR the test 2019 PTA pre-operative required: fs-ABR flap. to (average intra-operative were SPC; 2016 OR; tests in kHz from in hearing tests enrolled 8 surgery Four PTA were table1. to post-surgery hospital Supplemental 6-month Hz our the to in 250 in ossiculoplasty listed from take were thresholds to frequency etiologies (PTA) determined each audiometry were tone who at pure subjects HL whose dB old) the years 25 4.38 21.88 of than age commence average less 4F4M, the were ears, before (16 review] subjects enrollment. Eight for before participants [blinded the of all by Committee Participants signed Ethics was consent the written by A approved experiment. was study This post- long-term considerations the Ethical predicting in monitoring Methods system efficiency and fs-ABR and its Material HI test post-surgery on system, ETD of fs-ABR effect the efficiency. previous explore work(9). and modified previous intra-operatively normal Blackman- our HI we in both The surgery chamber(SPC) in paper, sound-proof earplug. threshold standard insert this hearing and sound the OR measuring In in the replace in both to accurate of patients and loudspeaker CHL leakage and efficient the hearing(NH) the demonstrated used was to firstly tone-pip we leading 1kHz obstacles, sponge gated reconstruction, these The the to stimulus to response surgery. after of In needed the canal shift. change TM after external threshold the and TM unknown the mastoid causing artificial reconstructed seal leisured and surgery, and involves to intensity cavity during often fail middle-ear CHL effusion earplug changed other, and insert leaves the which blood On repaired, absorb shift. be will threshold and sponge intensity the sound hand, one On ± .6 eeerle oudrof-B nSCadO osadrietesse.FrytoCHL Forty-two system. the standardize to OR and SPC in fs-ABR undergo to enrolled were 4.96) 3 Ω. h on orewspt3c away 30cm put was source sound The Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 55 BSL PTA SPL, PTA dB between 45.58 correlation ( (PTA The caused 0.5/1/2kHz Y=0.41*X+35.38 showed test. of (Y): be threshold analysis PTA might average ( PTA Bland-Altman dot in the dissociative between high analyzed, patient correlation This were was the (CI). ears) interval of thresholds confidence CHL corporation 95% (Y) 42 the poor and within the NH were one by (16 except subjects dots all all that of data OR fs-ABR ( in SPC The subjects in than enrolled thres- higher fs-ABR all ( dB The of t-test 6.08 OR. Results in paired SPL, fs-ABR two-sided 7.33 37.33dB S3 and by was was PTA and found OR S1 between S1 was in difference group group, hold OR statistical for S2 no and latencies showed of SPC analysis V that in Bland-Altman wave than latency the smaller V was OR, wave group between in S2 S1 subjects and of OR. NH S1 bias the For for in mean study the threshold further Since fs-ABR for D). and chosen and PTA were C between (Figure2 difference SPC statistical ( in (Figure2B). no difference S2 showed statistical and analysis no S1 ( Bland-Altman had from difference different S2 statistical 37.36 statistically showed and and ANOVA was S1 31.25 One-way S3 that 31.25, respectively. the were revealed S3 and thresholds comparisons and S2 fs-ABR multiple S2 Further S1, The S1, for (Figure2A). group 8.79ms S3 ( for and from S2 dB 7.54ms different and 7.305ms, statistically S1 was were between SPL 0.0008) ( difference 70dB difference statistical at statistical no latency showed showed ANOVA V the wave One-way OR of the respectively. and range SPC, S3 SPC Dynamic in OR. in subjects 1). in NH Subjects (Table SPL For NH dB dB of 0 40-100 Results and near loudspeaker SPC is standardization: the in level System SPL (P holding pressure dB significantly sound arm 20-100 was at of was level flexible points output (DRD) pressure two a loudspeaker difference sound those measured point with between and reference value difference cart dial to the test the point, between custom-made reference correlation linear the a showed stimuli into All integrated (Figure1). were facilities All Calibration and Signal used different. were statistically t-tests as post-surgery Student’s considered between unpaired was Results and correlation 0.05 Paired the than 3) less out p results. find of fs-ABRI to clinical values and used between PTAI agreement was the intra-fs-ABR, agreement analysis comparing the and in measure regression PTA accurate to Linear more used is was 2) method analysis This measurements(11). Bland-Altman 1) results. PTA methods: and ETD. fs-ABR Statistical between as used. diagnosed was 8 be version would Prism ETS-7[?]7 and points 10 ta- when analysis is (Supplemental sound Statistics ETS-7 ETF (clicking of of subjective score combines measures total which An tympanometry) The used (tubomanometry, ble2). Medizintechnik). was objective (ETS-7) (Spiggle&Theis, and Score Tubomanometer Valsalva) Tube swallowing, by Eustachian measured of was test (ETF) extended function tube Eustachian testing ensure function to independently tube results Eustachian the analyzed threshold. audiologists the experienced of Two 5dB. recognition of exact step precise a in threshold (0.5/1/2kHz) r =0.84, r =0.88, hudb ihnnra ern range. hearing normal within be should p < .01 FgrS) codnl,we sARtrsodwslwrthan lower was threshold fs-ABR when Accordingly, (FigureS1). 0.0001) p < .01 ihY04*+42(iueB.W loaaye the analyzed also We Y=0.46*X+34.25(Figure3B). with 0.0001) p 4 latency p 07)wiebt 1( S1 both while =0.77) =0.0039 p (0.5/1/2kHz) < .01.Frhrmlil comparisons multiple Further 0.0001). ± < .9s n osaitcldifference statistical no and 0.39ms, .1 (Figure2F). 0.01) ()adtef-B threshold fs-ABR the and )(X) p < =0.63 .0) h vrg dial average The 0.001). p (1kHz) p < threshold .01 n 2( S2 and 0.0001) > p .1 (Figure2E). 0.01) X n fs-ABR and (X) =0.0033 > .9 while 0.99) < 0.05). p= Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. lcmngtd1H oeppARwre etri sesn o-omdhaigfeuniswihare of which range frequencies wide hearing a low-to-mid click-ABR, assessing to for Compared in thresholds thresholds. noises. better PTA PTA environmental worked 4kHz the to ABR and 2kHz predict tone-pip sleep on to focused 1kHz anesthesia, only Blackman-gated reported by ABR evoked been affected click while rarely had frequencies measurement ABR hearing tone-burst objective Blackman-gated an is ABR ( intra-fs-ABR 27.5dB Discussion and was PTA Sub1 post-surgery in with between ABG PTAI=1.6*fs-ABRI+12.48 relation ( (Figure5B); the fs-ABRI linear and and clear PTAI Sub2, no the of was 10dB that there and than Sub1, 17.22dB For 30.56dB, smaller (Figure6A). HL, Sub2 26dB 46.5dB of was Sub1, that Sub1 for than and in higher 36dB PTAI and The 31.50dB 19dB, respectively. ( HL, 7. PTA 28.5dB of were post-surgery point PTAI cutoff in and the ETS different with with statistically ABGI( (ETS) rest were score and the ETF and Sub2 Subgroup1(Sub1) the and in to were Sub1 according ETS[?]7 subgroups with two into subjects Eleven divided was recovery S1 long-term in on Patients function tube Eustachian of Impact PTA for 0.1 and 0.22 was PTA S3, In PTA FigureS2). and (Figure4 with o 1adS,BadAta nlsssoe odffrnebtentomtosfrbt PTA both for methods two between difference no showed analysis PTA Bland-Altman PTA S3, and and S1 For itcldffrnebtengopS n 3ps-ugr T olwu eut o ahaoeprmtr( parameter above each for sta- results follow-up no PTA showed post-surgery test S3 T 41.92+- and unpaired S1 HL, =0.68, Two-sided group 37.92+-16.85dB between respectively. S3, difference 21.54+-11.42dB for tistical and respectively; 26.15+-14.88dB 19.11+-14.67dB HL, 16.17dB and 24.5+-15.3dB HL, 37.22+-17.53dB PTA post-surgery S1, For PTAI ( +17.44 intra-fs-ABR PTA for PTA methods was relation two the 18.97 between of difference ABGI average an PTA (ABG 1kHz post-surgery at ABG the subjects, (Supplemental CHL hospital 38.52 the 42 from post-surgery all and remote pre- For living of S1. difference of subjects by the PTA. because 3 was 27 and were analysis and and PTAI fs-ABR and group the S3 ABG, fs-ABRI by S3 from (ABGI), improvement tested of excluded ABG were were subjects The Table3). subjects Two group 15 follow-up. S1 females), 6-month the 26 the of and completed males (88.10%) (16 patients patients Thirty-seven CHL forty-two Result the PTA Follow-up Among and me- fs-ABR two Intra-operative between PTA between difference =0.50* Correlation show fs-ABR not correlation: did high showed analysis also Bland-Altman analysis surgery, ( regression before Linear OR (Figure3C). in thods group CHL the For r= 0.66, (0.5/1/2kHz) (0.5/1/2kHz) r ± (0.5/1/2kHz) 66 BH ihteaeaeH f19.41 of HI average the with HL dB 16.67 06 ( =0.67 p p =0.95, (0.5/1/2kHz) < p .01 Fgr3) n sAR=0.40*PTA = fs-ABR and (Figure3D), 0.0001) =0.037 p 08*nr-sAR99 with =0.83*intra-fs-ABR+9.92 10*nr-sAR1.7with =1.01*intra-fs-ABR-18.37 14*sAR-.5 ( =1.44*fs-ABRI-2.956 =0.0063 p (1kHz) =0.38, (1kHz) < nS,PTA S1, In . .5 ytts Fgr5adS) o u2 h enps-ugr T,AG ABI ABG, PTA, post-surgery mean the Sub2, For S3). and (Figure5 t-test by 0.05) r Y 05*itaf-B 95 ( +9.56 intra-fs-ABR =0.58* (Y) < p (1kHz) (1kHz) n .//kz(ABG 0.5/1/2kHz and ) p =0.34, .1 o n PTAI and for 0.01) ± > 09 epciey (Figure4A). respectively) =0.95 86 Bad22.79 and dB 18.66 .9.FrSb,PA32*nr-sAR127with PTA=3.22*intra-fs-ABR-162.7 Sub2, For 0.99). PTA , n PTA and p =0.04 (0.5/1/2kHz) (1kHz) (1kHz) r < =0.52, (0.5/1/2kHz) .5.PTAI 0.05). 12*nr-sAR3.5with =1.22*intra-fs-ABR-30.35 09*nr-sAR34 with =0.93*intra-fs-ABR+3.48 r (0.5.1.2kHz) (1kHz) r r 07 ( =0.77 ± p ABG , 07 ( =0.71 ± 12d n 13.37 and dB 21.2 04 ( =0.46 (1kHz) < (0.5/1/2kHz) 82d epciey ln lmnaayi hwdno showed analysis Altman Bland respectively. 18.21dB Fgr4)adPTA and (Figure4B) .1 (FigureS2). 0.01) epciey(iueEadFigureS2D). and (Figure4E respectively 5 p (1kHz) (1kHz) 24*sAR-.6with =2.43*fs-ABRI-8.76 r p n PTA and =.0407 p (0.5/1/2kHz) =0.42, =0.0068 =0.03 a 25.15 was ) 13*sAR+.4( =1.31*fs-ABRI+1.74 n ABG and < p .5 (Figure5C). 0.05) < (0.5/1/2kHz) p ± =0.014 < .5.PTAI 0.05). 17 B epciey h post-surgery The respectively. dB, 21.74 .1.FrPA n sAR,pvalue p fs-ABRI, and PTAI For 0.01). 3.6( +35.66 =0.036 (0.5/1/2kHz) ± (0.5/1/2kHz) < 49 Bad19.15 and dB 14.93 .5 n PTA and 0.05) < r r r .5,PTAI( 0.05), a 37.65 was > 07 ( =0.76 =0.80, 05( =0.5 eei Subgroup2(Sub2). in were 7 (1kHz) r ee3.7-91d HL, 36.67+-19.13dB were r FgrSA.Telinear The (FigureS2A). 06 ( =0.69 06 ( =0.65 r p p 21*fs-ABRI-3.49 =2.15* =0.48, p < ± =0.0026 0.0001)(FigureS1). 80 BH and HL dB 18.06 =0.02 (0.5/1/2kHz) p p p p ± =0.0012 =0.0042 p =0.042 53d with 15.39dB =0.47 (1kHz) < < < .5 and 0.05) .1 and 0.01) .5 and 0.05) > =0.44* +32.17 < < < 0.05), (1kHz) 0.05) 0.01) 0.05) p Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. .L T ’onl P ae B elrR,LmetP.Ttnu siua hi Reconstruction Chain Ossicular Titanium PR. reconstruc- Lambert chain RG, Ossicular Otorhinolaryngol. Keller J AB, al. Braz Baker et BP, factors. O’Connell M, prognostic PT, Silva of Le J, analysis Jacques and 2. L, results Chueiri hearing M, media: Mello otitis 2020;86(1):49-55. MM, chronic Seerig in SA, tion Kotzias 1. review]. for [blinded at References available otologists are help data may the interest. system patients’ of Parts the This to statement clinically intra-operatively. long-term availability is 0.5/1/2kHz post-surgery Data which of the rate 6. average surgery predicting revision and and reduce 1kHz prosthesis and at high of HI PTA showed improve position loudspeakers for the via both optimizing system HI in monitoring accuracy intra-operative and ABR efficiency tone-pip the 1kHz minimize Blackman-gated further The to an trying ossiculoplasty. Thirdly, are of models. we kinds more animal and Conclusion different in Firstly, benefit. study studied patients’ among under be optimize work. method now also to should this is future time shift testing method of in threshold determination feasibility the consideration threshold on the into errhysis automatic test taken of to impact be the enrolled Secondly, statistically should be any conditions should find several didn’t subjects We are there (r=0.5). However, S1 HI. follow-up whole the diagnostic optimize of a ETD to Sub1(ETS that as that ETF in than valuable observed to parameters higher be patients also post-surgery among 0.8, to between We of factor correlation to demonstrated coefficient 70% significant surgery(11). the rose been and in ear intra-fs-ABR had outcome HI presented middle and ETS-7 better PTA showed and of way. ETS[?]7 HI adult with negative that Subjects long-term a in agree method(12). better in 1% otologists the HI Most of for the prevalence cholesteatoma(10). the affected critical or a at is media with hemostatic ETF otitis CHL chronic with better by for sponge caused etiology gelatin tympanoplasty known using undergoing like a errhysis, was steps local ETD Necessary 3-6 of in testing. loss. took up impact before hearing pile usually the canal conductive would It minimize ear serum artificial and external to cause system. blood would taken Secondly, which transducer been unavoidable. monitoring, acoustic had was membrane during which of tympanic canal absorbed revised mass external be the S3 the S1 the to firstly, and cartilage for increase factors: the average S1 would following for in for the cartilage months 14.09 by 14.09dB underneath and caused and the 6.024 be 6.024dB pre- might for and were the which post-PTA biases of respectively the two S3 that underestimated the and than SPC, intra-fs-ABR between smaller in meant prediction. difference was that That of the intra-fs-ABR efficiency than respectively. and and the higher PTA pre-fs-ABR, on 6.08dB post-surgery and impact was between PTA little OR testing. bias pose in while mean would NH the open and of Additionally, left significant, fs-ABR was clinically of machine not threshold was anesthesia hearing it various the mean of but only the influence Therefore, electronic that and noticed monitoring. magnetic We the machine, anesthesia affect the and might predicting conditioner than machines fs-ABRI in air longer S1, better the was In was of S3 value noise phase. of intra-fs-ABR Background rise absolute latency shorter the V to wave S3, compared The in fiber HI. OR. and nerve long-term correlation in less activates well better phase worked showed PTAI rise S3 principle. and longer and aseptic because S1 S1 and both intensity of stimuli, that minutes. sound different 15 maintaining to of in 10 terms for better In surgery was the loudspeaker prolonged only earplug, intra-fs-ABR insert and pre- of The Instead patients. CHL in impaired mainly 6 < ) hrfr,i srcmeddt a attention pay to recommended is it Therefore, 7). Posted on Authorea 8 Feb 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161282722.24937213/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. tool-in-predicting-long-term-hearing-improvement-intra-operatively frequency-specific-auditory-brainstem-response-via-loudspeakers-in-ossiculoplasty-a- Tables.pdf file Hosted Laryngoscope. tool-in-predicting-long-term-hearing-improvement-intra-operatively results. two-year frequency-specific-auditory-brainstem-response-via-loudspeakers-in-ossiculoplasty-a- tuboplasty: eustachian Figures.pdf Laser R. file Metson Hosted JF, Grimmer Type DS, in hearing 2007;117(2):231-7. Aeration Poe intra-operative Ear 2009;2(2). of Modified Middle Otorhinolaryngology. a application and 11. Experimental Using Hearing Preliminary Function and Postoperative Tube Clinical Eustachian Good al. Patients. of of Tympanoplasty et Evaluation Predictive 1 Pre-operative G, is JW. Test Xu Chung Equilibration R, JH, 2017;137(2):167-73. Pressure Han Liu Otolaryngol. SH, Q, Acta Choi Hao loudspeakers. 10. via J, ABR Zeng pip F, tone of Ji by combination monitoring W, a Ren Using ST. Ear 9. Neely thresholds. pure-tone CA, estimate Garner to measurements KL, 2006;27(1):60-74. response Beauchaine steady- brainstem Hear. JK, auditory auditory evoked intraoperative Kaminski toneburst of TA, and monitoring Johnson click Threshold MP, Z. 2018;138(7):625-32. Gorga Gao Otolaryngol. Y, 8. Acta Qiao surgery. C, ossiculoplasty Chi for Y, Shang responses G, state Feng Q, Liu ossicular Otolaryngol 7. and response. brainstem 2011;144(1):60-3. stapedectomy auditory intraoperative Surg. with in Neck stapedectomy in Head electrocochleography hearing Improving Intra-operative GS. Hsu 1997;18:707-13. D. 6. Otology. Foyt of R, Journal Real- Intraoperative American Emerson New The JJ, A reconstrction. M. 2016;37(10):1601-7. Wazen Neudert Neurotology. & N, Otology Lasurashvili 5. Surgery. M, Ear Bornitz Middle Reconstructive H, for Seidler System Monitoring M-L, time Metasch T, Zahnert and Hear- of 4. 2014;150(6):1043-7. Responses, Monitoring Brainstem Surg. Intraoperative Auditory Neck R. Vibrometry, Head Bartoszewicz Laser-Doppler Otolaryngol A, by Electrocochleography. Hryciuk Ossiculoplasty J, during Sokolowski Improvement K, ing Niemczyk K, Morawski 2017;157(1):99- 3. Surg. Neck Head Otolaryngol Success. 106. Predicting Factors Preoperative and Success Revision vial at available vial at available https://authorea.com/users/394592/articles/507936-tone-pip- https://authorea.com/users/394592/articles/507936-tone-pip- 7