SITE OF LESION TESTING - University of Florida病变检测-佛罗里达大学网站.ppt

SITE OF LESION TESTING: Distinguishing: Sensory (cochlear) from neural (retro-cochlear) disorder. Different sources of conductive disorder MEASURES OF SUCCESS: SENSITIVITY Percentage of persons with a disorder who show up on your test as having that disorder. In this application, % of persons with neural disorder that show a “neural result” on the site of lesion test. MEASURES OF SUCCESS: SPECIFICITY percentage of persons without a disorder who show up on your test as not having that disorder. In this application, % of persons with a cochlear disorder (or no auditory disorder at all) who show up on your test as not having any neural disorder. Loudness Recruitment Tests Based on the changes in loudness perception that accompany different auditory disorders. Loudness Growth Patterns Recruitment: Abnormal growth of loudness or, persistence of normal loudness above threshold. More common at higher frequencies. Complete: loudness curve meets normal line Partial: loudness curve approaches normal line Hyper- loudness curve crosses above normal line Recruitment is consistent with cochlear damage from noise ototoxic substances aging and other causes Decruitment: Abnormal impairment of loudness growth loudness curve actually moves away from normal line lack of functioning nerve cells to code intensity associated with retro-cochlear (VIIIth n.) lesions. Decruitment The Alternate Binaural Loudness Balance (ABLB)Test requires: - normal hrg in one ear at freq to be used - difference in ? between ears 25 dB ABLB tones pulse alternating between ears 2 or 3 times per judgement. pt is asked which ear is louder or same - begin at 20 SL in poorer ear, - 0 SL in better ear. - adjust level in better ear 5 dB steps. ABLB - find level where loudness judged equal. - increase poorer ear by 10 or 20 dB and repeat adjustments in better ear. PLOTTING ABLB RESULTS: Use the “LADDERGRAM” Connect decibel values judged equally loud ABLB SUCCESS? Sensitivity = 51% Specifi