title: Mobile tablet audiometry in fluctuating autoimmune ear disease.
abstract: BACKGROUND
  Autoimmune inner ear disease (AIED) is a rare condition characterized by bilateral fluctuating sensorineural hearing loss (SNHL). The labile nature of this hearing loss makes it difficult to accurately quantify with conventional methods, and therefore it is challenging to rehabilitate.
  
  
  METHODS
  Over a 9-month period one pediatric patient with severe AIED was monitored and conducted home audiograms using a previously validated testing system (Shoebox Audiometry). During this period he also underwent several clinical audiograms. The correlation between clinical and home audiograms was analyzed with a Pearson coefficient, and the range and frequency of fluctuations was recorded.
  
  
  RESULTS
  Sixty-four automated home audiograms and nine clinical audiograms were conducted. When tested at home using a calibrated system the pure tone average (PTA) fluctuated between 12 dB and 72 dB indicating large variability in hearing. Fluctuations were frequent: on 28 occasions the PTA varied by at least 5 dB when retested within 4 days. The mean PTA was 50 dB and 95% of the thresholds were within 36 dB of the mean. Clinical audiograms obtained on the same day or within 1 day of home testing were highly concordant (with a Pearson coefficient of 0.93).
  
  
  CONCLUSIONS
  AIED can result in significant fluctuations in hearing over short periods of time. Home testing enables a more granular look at variations over time and correlates well with clinical testing, and thus facilitates rapid action and informed rehabilitation.
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, Canada.|Department of Otolaryngology - Head and Neck Surgery, The Ottawa Hospital, Ottawa, Canada.|Department of Otolaryngology - Head and Neck Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8 L1, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Kohlert
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, Canada. mbromwich@cheo.on.ca.|Department of Otolaryngology - Head and Neck Surgery, The Ottawa Hospital, Ottawa, Canada. mbromwich@cheo.on.ca.|Department of Otolaryngology - Head and Neck Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8 L1, Canada. mbromwich@cheo.on.ca.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bromwich
mesh_terms: D000293:Adolescent; D001299:Audiometry / Q000295:instrumentation* / Q000379:methods; D001327:Autoimmune Diseases / Q000175:diagnosis; D002648:Child; D015331:Cohort Studies; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D005260:Female; D005544:Forecasting; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000639:trends; D012189:Retrospective Studies
keywords: Audiology; Audiometry; Autoimmune inner ear disease; Hearing loss; Tablet