Automated pure-tone audiometry using true wireless stereo earbuds with active noise control.

Objective: Automated pure-tone audiometry (PTA) conducted outside a sound booth is heavily affected by environmental noise. This study aims to evaluate the performance of an automated PTA system, employing commercially available true wireless stereo earbuds with active noise cancellation (ANC) in noisy environments.

Design: The electroacoustic characteristics of earbuds are thoroughly evaluated. Hearing thresholds were measured by ANC earbuds and TDH-39 in three noise levels and two types of noise.

Study sample: 21 normal-hearing participants for calibration and 22 participants below mild hearing loss for evaluation experiments.

Results: The average absolute differences between hearing thresholds measured via the standard manual audiometer in quiet and the automated PTA in various noise conditions, across octave frequencies ranging from 125 to 8000 Hz, were as follows: 5.2 (quiet environment without ANC), 5.4 (40 dBA pink noise with ANC), and 9.3 dB (55 dBA pink noise with ANC).

Conclusion: ANC can mitigate the impact of low-frequency noise (below 1000 Hz) on the accuracy of hearing level measurements, aligning with trends observed in objective experimental results. However, the influence of ANC on output levels warrants serious consideration in further practices.