ABR Masking Noise Calculator 2019

Instructions:
Click in pale yellow cells to enter options and appropriate levels then press Enter / Return
Warning: some variables will be unknown (e.g. air-bone gaps) so enter several likely values; if in doubt use the higher nois
This calculator is a time-saving guide; the user must carry clinical responsibility for any decisions they make
Result is the dB "dial" level of noise for the selected system, stimulus type, transducer, corrected age & stimulus level
Offset is an alternative way of specifying noise level: it is the dB noise level relative to the stimulus level
Warning! High Noise Level
ABR System: Interacoustics Eclipse
Stimulus Transducer: BC Warning! There is a moderate risk of
Noise Transducer: Insert cross-masking
Stimulus type: 4k CE-Chirp Warning! Stimulus level exceeds
Patient corrected age (weeks): 6 to 8 recommended maximum:
Test ear air-bone gap, dB: 0
Non-test ear air-bone gap, dB: 0
dBeHL non-test BC ABR threshold: 0
dBnHL Stimulus Level: 10 15 dBeHL

Equation: Stim(dBnHL) +dBage +RML +ABGnt -IA -Nt -Nc

dBnoise = 10 10 28 0 20 10 -9

Variables for the current settings (dB): Risk of cross-hearing without maskin
RMLlower = 13 26
Nt = 10 RMLupper = 28
Nc = -9 ABGnt = 0
BC age correction = 10 IAs = 0
Risk of cross-masking if masking is u
Stimulus dBeHL = 15 IAn = 54
Stimulus dBeHLnt = -5 IAa = 20
Max noise SPL crossing to test cochlea = -48

Please email comments, further data, errors & omisions to: [email protected]
For ERA/ABR courses: eratraining.co.uk For peer review training/addreditation & clinical support please visit
Revision history:
2011:
Transcranial transmission loss (TTL) has been renamed interaural attenuation (IA).
Values for insert & BC age-related corrections and dBnHL to dBeHL conversions reflect changes in the NHSP Early Assessment Guidelines 2011.
2012:
AC values of IA in Table 3 have been reduced by 10dB to address concerns over potential undermasking by AC. This affects when masking should be app
BC 500Hz values in Table 4 increased by 5dB (and 1kHz values confirmed) from data on normal BC ABR thresholds in babies <6 weeks by Inga Ferm
2dB added for safety to decision on whether masking is needed.
2013:
Age ranges in Tables 4, 5 & 6 have been extended, based on available data.
BC 500Hz & 1kHz values in Table 4 increased based on data by Ferm et al 2013.
CE-Chirp stmuli have been added; eHL offsets are 5dB less than corresponding click/pip stimuli based on larger response and lower thresholds. See Tabl
Warning against the use of low frequency BC stimuli with babies has been deleted - age-related BC offset data produced by Inga Ferm (values changed in
2013b:
age range error correctred.
2018:
Noise calibration added for the Vivosonic V500, based on SPL-based noise. Age range error for max level warning corrected.
2019:
MHRA confirmed this spreadsheet does not constitute a "medical device" but users must recognise this is a guide only and take resposibility for clinical de
Disclaimer: the author has produced this in good faith but can accept no responsibility for errors or inappropriate use.
 <-3
es; if in doubt use the higher noise level
cisions they make
rrected age & stimulus level Label Freq 4k -3 to -1
stimulus level Click Wband 0 to 2
Warning! High Noise Level 4k pip 4k 3 to 5
2k pip 2k 6 to 8
ing! There is a moderate risk of 1k pip 1k 9 to 12
cross-masking 500 pip 500 13 to 16
ning! Stimulus level exceeds CE-Chirp WBand 17 to 24
ecommended maximum: 4k CE-Chirp 4k 25 to 104
2k CE-Chirp 2k >104
dBnHL 1k CE-Chirp 1k
-3 -61 500 CE-Chirp 500
No need to mask

Result Offset
25 +15

Risk of cross-hearing without masking

Custom
Risk of cross-masking if masking is used

abrpeerreview.co.uk

rly Assessment Guidelines 2011.

This affects when masking should be applied, the noise level and the risk of cross-masking.
olds in babies <6 weeks by Inga Ferm

esponse and lower thresholds. See Table 8.

oduced by Inga Ferm (values changed in this version)

only and take resposibility for clinical decisions.

Notes:
1. BC & Insert age corrections taken from NHSP 2013 Early Assessment Guidelines.
2. Upper 95% (for noise level) and lower 95% (for cross masking warning) confidence level RML values taken from Lightfo
3. Assumptions: ABR stimuli are calibrated to ISO 389-6 / NHSP recommended levels and noise is calibrated as manufact
4. Warning of stimulus level exceeding NHSP recommended maximum appears for all ages except >24 weeks.
5. Masking is needed if the stimulus level reaching the non-test cochlea exceeds the non-test BC ABR threshold (both in d
6. Cross-masking is considered a posibility if the noise SPL reaching the test ear cochlea exceeds the corrected stimulus l
7. CE-Chirps are assumed to have eHL corrections 5 dB lower than their click/pip counterpart.
8. The following data are needed: frequency/age corrections for tone pip insert SPL lift caused by small occluded canal vo
9. New warning of high noise levels provided if noise SPL >100dB
10. ABR systems' masking should be set to white noise, dBHL. Vivosonic: select SPL-based noise.
See also notes on Data Sheet

Don't have Microsoft Excel on your ABR system? (you must be using another computer at the moment, otherwise you wou
You can download a free Excel viewer (you may need to ask your friendly local IT department to do this for you) for compu
el RML values taken from Lightfoot et al 2010.
d noise is calibrated as manufacturers original specification.
es except >24 weeks.
-test BC ABR threshold (both in dBeHL).
exceeds the corrected stimulus level (in dBnHL) reaching the test ear cochlea plus the lower EML minus 20dB (moderate risk) or 10dB

used by small occluded canal volume in newborns; frequency/age IA caused by unfused cranial plates in newborns.

t the moment, otherwise you wouldn't be reading this!)

ment to do this for you) for computers or as a smartphone app
us 20dB (moderate risk) or 10dB (high risk)

s in newborns.
Table 1: ABR system noise calibration. dB SPL noise for Table 2: RML After Lightfoot et al
0dBdial (2010)
System Nc Phones Nc Ins/2cc Nc Ins/711 Stimulus RMLupper RMLlower
Biologic Nav Pro 21 19 28 Click 33 18
Interacoustics Eclipse 0 -9 0 4k pip 28 13
GSI Audera 0 -9 0 2k pip 33 13
Nicolet Spirit 20 17 26 1k pip 28 13
GN EP200/Chartr 0 0 9 500 pip 33 18
Medelec Synergy 8 -9 0 CE-Chirp 33 18
Vivosonic Integrity 0 -9 0 4k CE-Chirp 28 13
Custom 2k CE-Chirp 33 13
Notes: Based on a sample of available systems (6cc NBS 9A 1k CE-Chirp 28 13
and 2cc HA-2 couplers) or manufacturer information and 500 CE-Chirp 33 18
assumes the noise calibration of your system is similar - Notes: Relative masking level.
check with your calibration agent. Ensure any "offset" in the Based on subjective masking data in
test protocol is zero when calibrating the noise level and that adults. Chirps: assume same as
the transducer type being used matches the type for the click/pip data.
calibration file. Custom values may be entered if desired.
Table 3: Minimum adult IAs versus transducer & Table 4: IAa. Additional age-related minimum IA versus
stimulus stimulus
Stimulus IA phones IA inserts IA BC Corrected age (weeks) Wband 4k 2k
Click 38 45 0 <-3 20 20 20
4k pip 42 54 0 -3 to -1 20 20 20
2k pip 35 44 0 0 to 2 20 20 20
1k pip 37 46 0 3 to 5 20 20 20
500 pip 35 40 0 6 to 8 20 20 20
CE-Chirp 38 45 0 9 to 12 20 20 20
4k CE-Chirp 42 54 0 13 to 16 15 15 15
2k CE-Chirp 35 44 0 17 to 24 5 5 5
1k CE-Chirp 37 46 0 25 to 104 0 0 0
500 CE-Chirp 35 40 0 >104 0 0 0
Notes: Data on how IA changes with frequency is Notes: IA is assumed to be greater in immature skulls because of
incomplete. Further research is needed. Source: incomplete fusion of cranial bones. Further research is needed to
TDH: average of a number of published studies for define how these values change with age and frequency. Applicable
pure tones, lower 95% confidence level. Click value to clicks, pips & chirps. Wband = clicks & CE chirps.
taken as mean of 2k & 4kHz. Inserts: Munro &
Contractor, 2010, minimum of range in 15 subjects.
BC: 0dB taken as conservative value. 2012: TDH &
insert IA values have been reduced by 10dB at all
frequencies to address concerns over undermasking
by AC.
ted minimum IA versus Table 5: Insert canal volume SPL lift (used for both stimulus
and noise)
1k 500 Corrected age (weeks) Wband 4k 2k 1k 500
20 20 <-3 10 10 5 5 5
20 20 -3 to -1 10 10 5 5 5
20 20 0 to 2 10 10 5 5 5
20 20 3 to 5 10 10 5 5 5
20 20 6 to 8 10 10 5 5 5
20 20 9 to 12 10 10 5 5 5
15 15 13 to 16 5 5 0 0 0
5 5 17 to 24 5 5 0 0 0
0 0 25 to 104 0 0 0 0 0
0 0 >104 0 0 0 0 0
mmature skulls because of Notes. From NHSP Early Assessment Guidelines, 2013. Further
her research is needed to research is needed to further refine these data. Applicable to clicks,
ge and frequency. Applicable pips & chirps. Wband = clicks & CE chirps.
& CE chirps.
 Table 6. BC age correction. Click data after Webb (1993). Table 7. Maximum AC stimulus
levels
Corrected age (weeks) Wband 4k 2k 1k 500 Stimulus Phones Inserts
<-3 12 10 5 20 25 Click 100 85
-3 to -1 10 10 5 20 25 4k pip 105 85
0 to 2 8 10 5 20 25 2k pip 110 95
3 to 5 6 10 5 20 25 1k pip 115 100
6 to 8 5 10 5 20 25 500 pip 110 100
9 to 12 3 10 5 20 25 CE-Chirp 100 85
13 to 16 0 5 0 15 20 4k CE-Chirp 105 85
17 to 24 0 5 0 15 20 2k CE-Chirp 110 95
25 to 104 0 0 0 10 15 1k CE-Chirp 115 100
>104 0 0 0 0 0 500 CE-Chirp 110 100
Notes. Click data from Webb (1993), extrapolated using exponential Notes: From NHSP Early
function. 1k & 500Hz: Data from study by Ferm 2013. Applicable to Assessment Guidelines, 2013. The
clicks, pips & chirps. Wband = clicks & CE chirps. spreadsheet applies these levels up
to 24 weeks corrected age.
 Table 8. nHL-eHL
offsets
Stimulus dB
Click 5
4k pip 10
2k pip 10
1k pip 15
500 pip 20
CE-Chirp 0
4k CE-Chirp 5
2k CE-Chirp 5
1k CE-Chirp 10
500 CE-Chirp 15
Notes: Chirp values are
5dB less than click/pip
values. Data derived
from pip/chirp study by
Ferm, Lightfoot &
Stevens 2013.