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Eriksholm Workshop on Wideband Absorbance Measures of the Middle Ear

Feeney, M. Patrick

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doi: 10.1097/AUD.0b013e31829c70f0
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The Oticon Foundation established the Eriksholm Workshop series as a mechanism for gathering small groups of experts in audiology and hearing science to have a focused discussion and exchange of information about an important area of study for the purpose of describing the topic, suggesting areas for further study, and, if appropriate, developing a consensus statement. Eriksholm Workshop participants have been tasked with generating a report including recommendations that should be published in a major scientific journal. Two of the previous three Workshop reports have been published in Ear and Hearing (1995 & 2000) and the third in the International Journal of Audiology (2003).

In November 2010, Claus Elberling met with me on behalf of the Oticon Foundation to ask that I convene an Eriksholm Workshop on “Wideband Absorbance Measures of the Middle Ear.” He explained that the Oticon Foundation’s role was to select the convenor of the Workshop, but beyond this it was to be a hands-off event as with the previous Eriksholm Workshops; that is, the Foundation would not interfere with decisions made by the convenor, including the selection of participants for the Workshop and the agenda. However, the Foundation had a stipulation regarding the form of the Supplement as explained below. The Foundation’s role in the Workshop was mainly to support the convenor and facilitate the conduct of the meeting including transportation, food, and lodging costs for the participants. All Workshop invitees were unpaid volunteers.

We decided to hold the 2012 Eriksholm Workshop at the Portland Veterans Affairs (VA) Medical Center, within the National Center for Rehabilitative Auditory Research (NCRAR) of which I am the Director. The NCRAR is one of the VA Rehabilitation Research and Development’s Centers of Excellence. We offered the conference room at the NCRAR to hold the Workshop rather than the venue for the previous Workshops, which was the Eriksholm Research Center in Denmark, a part of Oticon A/S. This decision was made for organizational simplicity in that most of the Workshop invitees came from North America, which is where the majority of wideband absorbance research has occurred. A total of 14 individuals participated in the 2012 Eriksholm Workshop held from November 5 to 7, 2012, in Portland, Oregon. In addition to funding the expense of holding the Workshop, the Oticon Foundation made a $10,000 donation to the Portland VA Research Foundation for the support of research at the NCRAR.

As the convenor, I made a decision that individuals associated with commercial applications of wideband absorbance measurements would not be invited to participate in the Workshop. This was done with the intention of removing conflict of interest from the discussions among participants at the meeting. I assigned paper topics to the participants that were related to absorbance measures of the middle ear. I also assigned coauthors for the papers based on areas of expertise. The first authors of each paper were asked to write papers in advance of the meeting with their coauthors. The presentation of these papers occupied the first 2 days of the Workshop. The morning of the third day was devoted to general discussion and consensus development. The papers presented during the Workshop were modified by the authors after receiving feedback on their presentations during the meeting. First authors completed revisions that were edited by the coauthors after the Workshop. These were collected in this Supplement after minor editing by the Ear and Hearing Editorial Board. It was a stipulation of the Oticon Foundation that the articles in the Supplement be the work of each author with peer feedback from the group of experts assembled at the Workshop, rather than being a group of traditionally peer-reviewed articles. At the same time, all articles in this Supplement received substantial peer input from all attendees at the Workshop.

Invitee John Rosowski from the Department of Otology and Laryngology, Harvard Medical School and the Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston led the Workshop with an excellent overview of wideband absorbance and related middle ear measures. This was followed by an in-depth discussion of methods for establishing normative data by Joseph Kei, Ph.D., from the Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Australia. The afternoon session of the first day included a talk by Navid Shahnaz, Ph.D., of the School of Audiology and Speech Sciences at the University of British Columbia, who presented an overview of normative absorbance data for adults, for which his lab has provided much of the data. This was followed by a presentation by Lisa Hunter, Ph.D., from the Cincinnati Children’s Hospital Medical Center, and Department of Otolaryngology, University of Cincinnati, Cincinnati, Ohio, on pediatric applications of wideband absorbance, an area of great promise for wideband absorbance measures. The final article of the first day of the Workshop was presented by Kim Schairer, Ph.D., from the Audiology and Speech-Language Pathology Service, James H. Quillen VA Medical Center, Mountain Home, Tennessee, on the use of wideband absorbance to measure the acoustic stapedial reflex.

During the morning session of the second day of the Workshop, Heidi Nakajima, M.D., Ph.D., from the Department of Otology and Laryngology, Harvard Medical School and the Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, gave a presentation on the assessment of middle ear disorders using wideband absorbance measures, including some recent data on this topic from her lab. This was followed by a presentation by Beth Prieve, Ph.D., Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York, on using wideband absorbance to predict the presence and degree of conductive hearing loss. The last presentation of the morning was given by Susan Voss, Ph.D., Picker Engineering Program, Smith College, Northampton, Massachusetts, on factors influencing the variability of ear canal absorbance measures, which has been informed by her measurements in human cadaver ears. Chris Sanford, Ph.D., Department of Communication Sciences and Disorders, Idaho State University, Pocatello, Idaho, led the afternoon session with a presentation on tympanometric measures of wideband absorbance, including recent infant data. Finally, Stephen Neely, Ph.D., of the Department of Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska gave a stimulating presentation on alternative ear-canal measures related to absorbance and the importance of both magnitude and phase data.

In addition to the main presenters at the Workshop, three participants were invited for their expertise in clinical audiology, including middle ear assessment, to comment on the work being presented and add to the discussions. These included Stefan Stenfelt, Ph.D., Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Robert Margolis, Ph.D., University of Minnesota, Minneapolis, Minnesota, and Audiology Incorporated, Arden Hills, Minnesota; and David Lilly, Ph.D., an investigator at the NCRAR. Drs. Lilly and Margolis also prepared a historical introduction to middle ear measurements for the Supplement, and served as authors on papers for the Workshop.

I received an overwhelming response from participants that they found the Workshop to be an enjoyable and rewarding experience. The articles in this Supplement are a testament to the wide range of topics covered in the Workshop that stimulated interesting discussion and interactions. The final day of the Workshop was dedicated to an exploration of topics for which there was some consensus in the group. The final article in the Supplement provides an overview of these items. The underlying theme in this evolving area of study is that additional research is needed to answer a number of important questions. With many studies currently underway in various labs, we hope to be able to fill in the knowledge gaps as we go forward with this promising technology.

We thank the Oticon Foundation for sponsoring the 2012 Eriksholm Workshop. Special thanks are due to Claus Elberling for inviting us to engage in this Workshop. Special thanks are also due to Bonnie Becker, Angela Garinis, Ph.D., and Dan Putterman, Au.D., of the NCRAR for their support during the Workshop, and Bue Kristensen of Interacoustics who helped facilitate the meeting. Last, we thank Michael Davey, M.D., Ph.D., Associate Chief of Staff for Research and Development at the Portland VA Medical Center for his enthusiastic support for the Workshop.

© 2013 by Lippincott Williams & Wilkins