Abstract
One of the many reported advantages of the insert earphone over the supra-aural earphone is increased interaural attenuation (IA). Minimum values of IA determine the need for masking of the non-test ear in air-conduction audiometry. The aim of the present study was to measure interaural attenuation for the Etymotic Reserach ER-3A insert earphone (with deep and shallow insertion of the ear plug within the ear canal) and compare this with the supra-aural Telephonies TDH-39/MX41-AR earphone/cushion combination. Subjects were 18 adults ranging in age from 3 8 to 68 years (mean 50 years). Each subject had no hearing in one ear following translabyrinthine surgery for removal of an acoustic neuroma. The opposite ear had hearing thresholds better than 40 dB HL and an air-bone gap of less than 10 dB at any audiometric frequency. Pure tone air-conduction thresholds were obtained in the range 0.25–8 kHz. Deep insertion of the insert earphone was deemed to occur when the outside edge of the ear plug was flush with the entrance of the ear canal. Shallow insertion was deemed to occur when half of the ear plug (6 mm) was inside the entrance of the ear canal. IA was defined operationally as the difference between the goodear and poor-ear not-masked air conduction threshold for a given audiometric frequency and earphone. The results show that the TDH-39/MX41-AR combination provides a median IA of approximately 60 dB with a lower limit of approximately 45 dB. Greater IA was obtained with the ER-3 A insert earphone but this depended on the depth of insertion. With a deep insertion, the IA values were some 15–20 dB greater than with the supra-aural earphone. Although frequency-specific IA values are provided, a simple rule of thumb is to apply masking to the non-test ear when the pure tone air conduction signal from the ER-3A insert earphone exceeds the bone conduction threshold of the non-test ear by 55 dB HL or more. If it is not possible to obtain a deep insertion depth this value should be reduced by 5 dB.