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Loudness, Recruitment, and Differential Diagnosis

Loudness, Recruitment, and Differential Diagnosis Abstract As defined in American Standard Acoustical Terminology,1 "Loudness is the intensive attribute of an auditory sensation, in terms of which sounds may be ordered on a scale extending from soft to loud." In the normal human ear, this scale has been found to extend from a threshold level of detectability (the acoustic reference level of 0 db.=0.0002 dynes/cm.2 in sound pressure) to a level designated as the threshold of feeling (approximately 140 db.). Between these two defined limits lies a psychological continuum related to the physical intensity scale, but not identical with it. The relationship established between the measurable physical units and the observable psychological units constitutes the loudness function. In the pathological human ear, the dimensions of these psychological units are sometimes found to differ substantially from those normally observed. The term recruitment has been employed in reference to these abnormalities in loudness function, and the present References 1. American Standard Acoustical Terminology , Acoustical Society of America in Cooperation with Institute of Radio Engineers, Inc., New York, American Standards Association, 1951. 2. Bangs, J. L., and Mullins, C. J.: Recruitment Testing in Hearing and Its Implications , A. M. A. Arch. Otolaryng. 58:582-592, 1953.Crossref 3. von Békésy, G.: A New Audiometer , Acta Oto-laryng. 35:411-422, 1947.Crossref 4. von Békésy, G.: The Recruitment Phenomenon and Difference Limen in Hearing and Vibration Sense , Laryngoscope , 57:765-777, 1947.Crossref 5. Best, C. H., and Taylor, N. B.: The Physiologic Basis of Medical Practice , Ed. 5, Baltimore, Williams & Wilkins Company, 1950. 6. de Bruine-Altes, J. C.: The Symptom of Regression in Different Kinds of Deafness, Thesis, University of Groningen, Holland, 1946. 7. de Bruine-Altes, J. C., and Huizing, H. C.: The Monaural Method for Recruitment Testing in Symmetrical Deafness , Acta Oto-laryng. 37:385, 1939.Crossref 8. Denes, P., and Naunton, R. F.: The Clinical Detection of Auditory Recruitment , J. Laryng. & Otol. 64:375-398, 1950. 9. Dix, M. R.; Hallpike, C. S., and Hood, J. D.: Observations upon the Loudness Recruitment Phenomenon with Especial Reference to the Differential Diagnosis of Disorders of the Internal Ear and Eighth Nerve , J. Laryng. and Otol. 62:671-686, 1948. 10. Eby, L. G., and Williams, H. L.: Recruitment of Loudness in the Differential Diagnosis of End Organ and Nerve Fiber Deafness , Laryngoscope 61:400-414, 1951. 11. Eisenberg, R. B.: A Study of the Auditory Threshold in Normal and in Hearing-Impaired Persons, with Special Reference to the Factors of the Duration of the Stimulus and Its Sound Pressure Level; and a Discussion of the Implications, Clinical and Physiological, of the Reciprocal Relationship Between These Factors, Thesis, The Johns Hopkins University, Baltimore, 1956. 12. Fowler, E. P.: Marked Deafened Areas in Normal Ears , Arch. Otolaryng. 8:151-155, 1928. 13. Fowler, E. P.: Diagnosis of Diseases of the Neural Mechanism of Hearing by Aid of Sounds Well above Threshold , Laryngoscope 47:289-300, 1937. 14. Fowler, E. P.: The Recruitment of Loudness Phenomenon , Laryngoscope , 60:680-695, 1950. 15. Hallpike, C. S., and Hood, J. D.: Some Recent Work on Auditory Adaptation and Its Relation to the Loudness Recruitment Phenomenon , J. Acoust. Soc. America 23:270-274, 1951. 16. Harris, J. D.; Rawnsley, A. I., and Kelsey, P. A.: Studies in Short-Duration Auditory Fatigue: I. Frequency Differences as a Function of Intensity , J. Exper. Psych. 42:421-426, 1951. 17. Hood, J. D.: Studies in Auditory Fatigue and Adaptation , Acta Oto-laryng. , (Supp. 92) , pp. 1-57, 1950. 18. Hood, J. D.: Adaptation in Disorders of the Inner Ear and Its Relationship to the Loudness Recruitment Phenomenon , Proc. 5th Internat. Cong. Otol. Rhin. & Laryng. , Amsterdam, 1953. 19. Hood, J. D.: Auditory Fatigue and Adaptation in Differential Diagnosis of End-Organ Diseases , Ann. Otol. Rhin. & Laryng. 64:507, 1955. 20. Howell's Textbook of Physiology , edited by J. F. Fulton and others, Ed. 15, Philadelphia, W. B. Saunders Company, 1946. 21. Huizing, H. C.: The Symptom of Recruitment and Intelligibility of Speech , Acta Oto-laryng. , (Supp.) 36:346-355, 1948. 22. Huizing, H. C.: The Recruitment Factor in Hearing Tests, Proc. 1st Internat. Cong. in Audiology, Columbia Presbyterian Med. Ctr., 1950, N. Y. 23. Huizing, H. C., and Reyntjes, J. A.: Recruitment and Speech Discrimination Loss , Laryngoscope 62:521-527, 1952. 24. Jerger, J. F.: A Difference Limen Recruitment Test and Its Functional Significance , Laryngoscope 62:1316-1332, 1952. 25. Jerger, J. F.: Differential Intensity Sensitivity in the Ear with Loudness Recruitment , J. Speech & Hearing Disorders 20:183, 1955. 26. Lundberg, T.: Diagnostic Problems Concerning Acoustic Tumors: A Study of 300 Verified Cases and the Békésy Audiogram in the Differential Diagnosis , Acta Oto-laryng. , (Supp.) 99, 1952. 27. Lund-Iverson, L.: An Investigation on the Difference Limen Determined by the Method of Lüscher-Zwislocki in Normal Hearing and Various Forms of Deafness , Acta Oto-laryng. 53:221-260, 1952. 28. Lüscher, E.: The Difference Limen of Intensity Variations of Pure Tones and Its Diagnostic Significance , Proc. Roy. Soc. Med. 43:1116-1128, 1950. 29. Lüscher, E., and Zwislocki, J.: A Simple Method for Indirect Monaural Determination of the Recruitment Phenomenon (Difference Limen in Intensity in Different Types of Deafness) , Acta Oto-laryng. 78:156-168, 1949. 30. Miskolczy-Fodor, F.: Monaural Loudness-Balance Test and Determination of Recruitment-Degree with Short Sound-Impulses , Acta Otolaryng. 43:573-595, 1953.Crossref 31. Palva, T.: Studies on Per-Stimulatory Adaptation in Various Groups of Deafness , Laryngoscope 65:829-847, 1955.Crossref 32. Pohlman, A. G., and Kranz, F. W.: Binaural Minimum Audition in a Subject with Ranges of Deficient Acuity , Proc. Soc. Exper. Biol. & Med. 21:335-337, 1924. 33. Reger, S. N.: Differences in Loudness Response of the Normal and Hard-of-Hearing Ear at Intensity Levels Slightly above the Threshold , Ann. Otol. Rhin. & Laryng. 45:1029-1039, 1936. 34. Reger, S. N., and Kos, C. M.: Clinical Measurements and Implications of Recruitment , Ann. Otol. Rhin. & Laryng. , 61:810-821, 1953. 35. Simonton, K. M.: Diplacusis Binauralis Dysharmonica and Recruitment of Loudness: Their Clinical Significance, Instruction Course No. 476, American Academy of Ophthalmology and Otolaryngology, 1951. 36. Watson, L. A., and Tolan, T.: Hearing Tests and Hearing Instruments , Baltimore, Williams & Wilkins Company, 1949. 37. Wever, E. G., and Lawrence, M.: Physiological Acoustics , Princeton University Press, 1954. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Otolaryngology American Medical Association

Loudness, Recruitment, and Differential Diagnosis

A.M.A. Archives of Otolaryngology , Volume 68 (2) – Aug 1, 1958

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American Medical Association
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Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6894
DOI
10.1001/archotol.1958.00730020207011
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Abstract

Abstract As defined in American Standard Acoustical Terminology,1 "Loudness is the intensive attribute of an auditory sensation, in terms of which sounds may be ordered on a scale extending from soft to loud." In the normal human ear, this scale has been found to extend from a threshold level of detectability (the acoustic reference level of 0 db.=0.0002 dynes/cm.2 in sound pressure) to a level designated as the threshold of feeling (approximately 140 db.). Between these two defined limits lies a psychological continuum related to the physical intensity scale, but not identical with it. The relationship established between the measurable physical units and the observable psychological units constitutes the loudness function. In the pathological human ear, the dimensions of these psychological units are sometimes found to differ substantially from those normally observed. The term recruitment has been employed in reference to these abnormalities in loudness function, and the present References 1. American Standard Acoustical Terminology , Acoustical Society of America in Cooperation with Institute of Radio Engineers, Inc., New York, American Standards Association, 1951. 2. Bangs, J. L., and Mullins, C. J.: Recruitment Testing in Hearing and Its Implications , A. M. A. Arch. Otolaryng. 58:582-592, 1953.Crossref 3. von Békésy, G.: A New Audiometer , Acta Oto-laryng. 35:411-422, 1947.Crossref 4. von Békésy, G.: The Recruitment Phenomenon and Difference Limen in Hearing and Vibration Sense , Laryngoscope , 57:765-777, 1947.Crossref 5. Best, C. H., and Taylor, N. B.: The Physiologic Basis of Medical Practice , Ed. 5, Baltimore, Williams & Wilkins Company, 1950. 6. de Bruine-Altes, J. C.: The Symptom of Regression in Different Kinds of Deafness, Thesis, University of Groningen, Holland, 1946. 7. de Bruine-Altes, J. C., and Huizing, H. C.: The Monaural Method for Recruitment Testing in Symmetrical Deafness , Acta Oto-laryng. 37:385, 1939.Crossref 8. Denes, P., and Naunton, R. F.: The Clinical Detection of Auditory Recruitment , J. Laryng. & Otol. 64:375-398, 1950. 9. Dix, M. R.; Hallpike, C. S., and Hood, J. D.: Observations upon the Loudness Recruitment Phenomenon with Especial Reference to the Differential Diagnosis of Disorders of the Internal Ear and Eighth Nerve , J. Laryng. and Otol. 62:671-686, 1948. 10. Eby, L. G., and Williams, H. L.: Recruitment of Loudness in the Differential Diagnosis of End Organ and Nerve Fiber Deafness , Laryngoscope 61:400-414, 1951. 11. Eisenberg, R. B.: A Study of the Auditory Threshold in Normal and in Hearing-Impaired Persons, with Special Reference to the Factors of the Duration of the Stimulus and Its Sound Pressure Level; and a Discussion of the Implications, Clinical and Physiological, of the Reciprocal Relationship Between These Factors, Thesis, The Johns Hopkins University, Baltimore, 1956. 12. Fowler, E. P.: Marked Deafened Areas in Normal Ears , Arch. Otolaryng. 8:151-155, 1928. 13. Fowler, E. P.: Diagnosis of Diseases of the Neural Mechanism of Hearing by Aid of Sounds Well above Threshold , Laryngoscope 47:289-300, 1937. 14. Fowler, E. P.: The Recruitment of Loudness Phenomenon , Laryngoscope , 60:680-695, 1950. 15. Hallpike, C. S., and Hood, J. D.: Some Recent Work on Auditory Adaptation and Its Relation to the Loudness Recruitment Phenomenon , J. Acoust. Soc. America 23:270-274, 1951. 16. Harris, J. D.; Rawnsley, A. I., and Kelsey, P. A.: Studies in Short-Duration Auditory Fatigue: I. Frequency Differences as a Function of Intensity , J. Exper. Psych. 42:421-426, 1951. 17. Hood, J. D.: Studies in Auditory Fatigue and Adaptation , Acta Oto-laryng. , (Supp. 92) , pp. 1-57, 1950. 18. Hood, J. D.: Adaptation in Disorders of the Inner Ear and Its Relationship to the Loudness Recruitment Phenomenon , Proc. 5th Internat. Cong. Otol. Rhin. & Laryng. , Amsterdam, 1953. 19. Hood, J. D.: Auditory Fatigue and Adaptation in Differential Diagnosis of End-Organ Diseases , Ann. Otol. Rhin. & Laryng. 64:507, 1955. 20. Howell's Textbook of Physiology , edited by J. F. Fulton and others, Ed. 15, Philadelphia, W. B. Saunders Company, 1946. 21. Huizing, H. C.: The Symptom of Recruitment and Intelligibility of Speech , Acta Oto-laryng. , (Supp.) 36:346-355, 1948. 22. Huizing, H. C.: The Recruitment Factor in Hearing Tests, Proc. 1st Internat. Cong. in Audiology, Columbia Presbyterian Med. Ctr., 1950, N. Y. 23. Huizing, H. C., and Reyntjes, J. A.: Recruitment and Speech Discrimination Loss , Laryngoscope 62:521-527, 1952. 24. Jerger, J. F.: A Difference Limen Recruitment Test and Its Functional Significance , Laryngoscope 62:1316-1332, 1952. 25. Jerger, J. F.: Differential Intensity Sensitivity in the Ear with Loudness Recruitment , J. Speech & Hearing Disorders 20:183, 1955. 26. Lundberg, T.: Diagnostic Problems Concerning Acoustic Tumors: A Study of 300 Verified Cases and the Békésy Audiogram in the Differential Diagnosis , Acta Oto-laryng. , (Supp.) 99, 1952. 27. Lund-Iverson, L.: An Investigation on the Difference Limen Determined by the Method of Lüscher-Zwislocki in Normal Hearing and Various Forms of Deafness , Acta Oto-laryng. 53:221-260, 1952. 28. Lüscher, E.: The Difference Limen of Intensity Variations of Pure Tones and Its Diagnostic Significance , Proc. Roy. Soc. Med. 43:1116-1128, 1950. 29. Lüscher, E., and Zwislocki, J.: A Simple Method for Indirect Monaural Determination of the Recruitment Phenomenon (Difference Limen in Intensity in Different Types of Deafness) , Acta Oto-laryng. 78:156-168, 1949. 30. Miskolczy-Fodor, F.: Monaural Loudness-Balance Test and Determination of Recruitment-Degree with Short Sound-Impulses , Acta Otolaryng. 43:573-595, 1953.Crossref 31. Palva, T.: Studies on Per-Stimulatory Adaptation in Various Groups of Deafness , Laryngoscope 65:829-847, 1955.Crossref 32. Pohlman, A. G., and Kranz, F. W.: Binaural Minimum Audition in a Subject with Ranges of Deficient Acuity , Proc. Soc. Exper. Biol. & Med. 21:335-337, 1924. 33. Reger, S. N.: Differences in Loudness Response of the Normal and Hard-of-Hearing Ear at Intensity Levels Slightly above the Threshold , Ann. Otol. Rhin. & Laryng. 45:1029-1039, 1936. 34. Reger, S. N., and Kos, C. M.: Clinical Measurements and Implications of Recruitment , Ann. Otol. Rhin. & Laryng. , 61:810-821, 1953. 35. Simonton, K. M.: Diplacusis Binauralis Dysharmonica and Recruitment of Loudness: Their Clinical Significance, Instruction Course No. 476, American Academy of Ophthalmology and Otolaryngology, 1951. 36. Watson, L. A., and Tolan, T.: Hearing Tests and Hearing Instruments , Baltimore, Williams & Wilkins Company, 1949. 37. Wever, E. G., and Lawrence, M.: Physiological Acoustics , Princeton University Press, 1954.

Journal

A.M.A. Archives of OtolaryngologyAmerican Medical Association

Published: Aug 1, 1958

References