title: Onset overmasking of a brief amplitude increment in a pure tone and sensorineural hearing impairment.
abstract: OBJECTIVE
  The goal of this investigation was to determine, in patients with sensorineural hearing loss who may show an audiologic alteration in onset overmasking, whether different pathologic conditions differ in this respect, and whether patients with a vestibular neurotomy damaging the cochlear efferents will be affected.
  
  
  BACKGROUND
  Auditory detection of brief signals, when presented at the beginning of a simultaneous long masking sound, may require a higher acoustic level than when presented after several hundred milliseconds. The proposed explanation, in terms of auditory nerve fibers adaptation has been based on the observation of a proportionally smaller increase of firing in response to an amplitude increment at the onset of a stimulus. However, this may not explain all the data, and other underlying processes are certainly involved. The degree or type of sensorineural pathologic condition may be a contributing factor. In addition, the cochlear efferent system, which exhibits a time course and a high-frequency predominance compatible with that of onset overmasking, could be involved.
  
  
  METHODS
  Onset overmasking of a brief amplitude increment in one pure tone was examined in 6 normal subjects, 12 patients who had undergone vestibular neurotomy, 8 subjects with Meniere's-like symptoms, 5 subjects with presbyacusis, and 3 patients with a small neuroma. Both ears of all subjects were tested. Detection thresholds, amount of onset overmasking, and differences between the two ears were examined.
  
  
  RESULTS
  All results from subjects with presbyacusis and neuroma were within the range observed in the group of normal subjects. In the group of eight Ménière's syndrome patients, four had results outside the normal range, three had deteriorated detection, and one had better detection. Among the 12 subjects who had undergone neurotomy, 2 had better detection in the unoperated ear.
  
  
  CONCLUSIONS
  The results from Ménière's patients indicate that, in addition to the previously reported improved detection threshold for short onset delay, a deterioration of detection thresholds may occur in some subjects. Overall, the results from neurotomized ears do not provide evidence for an involvement of cochlear efferents in this tested psychoacoustic task.
authors.affiliation: Inserm EPI 9902, Laboratoire Otologie NeuroOtologie, Université de la Méditerranée Aix-Marseille II, Faculté de Médicine Nord, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Cazals
authors.forename: A
authors.initials: A
authors.lastname: Chays
authors.forename: J
authors.initials: J
authors.lastname: Magnan
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods*; D003056:Cochlear Nerve / Q000502:physiology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications; D009412:Nerve Fibers / Q000502:physiology; D010470:Perceptual Masking; D012720:Severity of Illness Index