Correlation of transiently evoked to distortion-product otoacoustic emission measures in healthy children (original) (raw)
Related papers
Otoacoustic emissions: A new method to diagnose hearing impairment in children
European Journal of Pediatrics, 1993
Otoacoustic emissions (OAEs) are epiphenomena of sensitive, amplifying processes during hearing which can be detected in persons with normal inner ear function. They originate from the cochlea and are interpreted as an energy leakage of cochlear processes, perhaps resulting from active outer hair cell movements. OAEs travel from the cochlea through the middle ear to the external auditory canal where they can be detected using sensitive miniature microphones. Transient evoked (TEOAE) tests allow to otoacoustic emissions non-invasively check the integrity of the cochlea. In the neonatal period, registration of OAEs can be accomplished during natural sleep. In infants and neonates TEOAEs can be used as screening test with a screening level at 30 dB HL in paediatric audiology. They are less time consuming and elaborate than auditory brainstem responses (ABR) and they are more sensitive than behavioral tests. TEOAEs are constant over long periods of time and they are reduced or absent due to various adverse influences in the inner ear. These latter characteristics may allow monitoring of the inner ear function over time e.g. during disease and/or during ototoxic therapeutic interventions. Limitations of this new method are due to the fact that TEOAEs are absent in patients with a more than 30 dB HL hearing loss. Thus a hearing threshold cannot be determined. Diseases of the inner ear which are common in early childhood (like otitis media) reduce the transfer of TEOAEs and may wrongly indicate a cochlear hearing disorder. New methods for evaluation and interpretation of TEOAE test results are currently developed which may allow to circumvent this problem. When used by an experienced examiner who is aware of the possibilities as well as of the limitations of this new method, registration of TEOAEs is a promising new tool which complements our current-armamentarium to diagnose hearing disorders in children.
Otoacoustic emissions as a screening test for hearing impairment in children
Archives of Disease in Childhood, 1995
Transient evoked otoacoustic emissions (TEOAEs) are low amplitude sound waves produced by the healthy cochlea. They can be recorded with a microphone in the external ear. TEOAEs are abolished by hearing losses of 30 dB or more. The feasibility of using TEOAEs as a screening test for hearing loss in children was studied. TEOAE recordings were attempted in 56 children attending an audiology clinic. Recordings were possible from both ears in 52 children; of these 104 ears, 32 had hearing deficits of 30 dB or more. Hearing status was compared with the results ofsix TEOAE screening criteria. All criteria had a sensitivity of 1 00. Four standard TEOAE criteria yielded specificities of 0*46-0*58. Two new criteria derived from analysis of limited frequencies from the TEOAE waveform gave specificities of 0*76 and 0*82. It can be concluded that, when appropriate pass/fail criteria are employed, TEOAEs are a feasible screening test in children.
Clinical Pediatrics: Open Access, 2016
Introduction: Hearing impairment is one of the commonest congenital disabilities in the world. Early diagnosis is essential to minimize or to prevent the disability. There are many screening methods and protocols for newborn hearing screening. TEOAE has high sensitivity and less time consuming than DPOAE. DPOAE is highly specific but more time consuming than TEOAE. This study aims to compare the accuracy of DPOAE and TEOAE by using ABR evaluation on high risk newborn. Methods: This study was conducted on 1000 high risk newborns admitted to SCBU, CWH (Mandalay). Cases were selected with inclusion and exclusion criteria. The newborns after day 3 were screened with both DPOAE and TEOAE tests on every Monday, Wednesday and Friday. All included newborns underwent ABR confirmation at ENT Department, EENT Hospital (Mandalay). Result: For the 1000 left ears, DPOAE yielded 787 'pass' and 213 'refer'. For the 1000 right ears, DPOAE yielded 776 'pass' and 224'refer'. For the 1000 left ears, 737 had passed TEOAE and 263 were not passed the test. For the 1000 right ears, 752 had passed TEOAE and 248 were referred. Sensitivity of DPOAE is 97.57% and specificity is 95.39%.False positive rate is 4.60% and false negative rate is 2.42%. Sensitivity of TEOAE is 96.49% and specificity is 90.60%. False positive rate is 9.39% and false negative rate is 3.50%. Conclusion: It can be concluded that TEOAEs are useful for universal newborn hearing screening because it has short duration with acceptable accuracy and DPOAEs are useful for high-risk neonates as a hearing screening test because of good correlation between DPOAE and threshold of wave V of ABR.
Hearing, Balance and Communication, 2020
Background: DPOAEs are acoustic energy within the external auditory canal (EAC) arising from the non-linear interaction within the cochlea; of 2 pure tones presented simultaneously; of primary frequencies f1 and f2. DPOAEs are recorded in nearly any normal-hearing subject and in patients with hearing loss up to 50 dBHL while recordings may be deceiving in the presence of severe to profound hearing loss. Objective: To determine the intensity levels of f1 and f2 at which DPOAEs truly reflect the active metabolic processes within the cochlea. Setting: University Hospital Study: Prospective Methods: One-hundred and forty ears were categorized into three groups; A (n ¼ 50), B (n ¼ 50) and C (n ¼ 40); according to subjects' age (12 to 18, 2 to 12 and <2 years, respectively). A fourth group D was included; which entailed recordings from a dummy cavity simulating a child's external auditory canal. Each group was further subdivided into two subgroups according to hearing levels; either normal or severe to profound hearing loss. DP-grams were interpreted at 3 points/octave steps for all groups and reviewed as 'Pass' or 'Fail' according to set criteria. Stimulus levels were adjusted such that L1 exceeded L2 by 10 dB. Start levels for L1 and L2 were 80 and 70 dBSPL. Levels were reduced simultanueously in 5 dB steps for the following recordings; to reach 65 and 55 for the last recording. Results: Using the higher three stimulation levels, all subgroups had 'Pass' DP grams. On using the last and lowest recording level, only subgroups of normal hearing ears had 'Pass' DP grams; while subgroups of ears with sensorineural hearing loss (SNHL) demonstrated 'Failed' DP grams at all frequencies. Conclusions: For audiometric screening purposes, DPOAEs show to be rather insensitive to hearing loss at higher stimulation levels and may reveal false positive results.
2001
Postmortem examination of temporal bones of Ménière's disease patients consistently show dilated endolymphatic spaces of the inner ear, for which the term endolymphatic hydrops has been coined. During the past decade, magnetic resonance imaging techniques for the inner ear appeared, advancing the diagnosis of Ménière's disease. They require, however, a field-strength of at least 3 T, are costly and not universally available. Alternative, noninvasive, cost-effective tests with high sensitivity and specifity for endolymphatic hydrops are desirable. In this study, we test the suitability of distortion product otoacoustic emissions (DPOAEs) for endolymphatic hydrops detection. Previous measurements of the commonly recorded cubic DPOAEs mainly register cochlear hearing loss and are not specific for Ménière's disease. Simultaneous recordings of cubic and quadratic DPOAEs might be more suitable to detect endolymphatic hydrops, because both DPOAE orders react differently to changes of the cochlear operating point as they might occur in Ménière's disease patients. Design: Cubic and quadratic DPOAEs were recorded in normal-hearing participants (N = 45) and in the affected and unaffected ears of patients with a diagnosis of definite Ménière's disease (N = 32). First, to assess the integrity of DPOAE-generating mechanisms, cubic DPOAE-grams were obtained with primary tone frequencies f 2 between 1 and 8 kHz with primary tone levels l 1 = 60 dB SPL and l 2 = 50 dB SPL, and a fixed primary tone frequency ratio of 1.22. Then, cubic and quadratic DPOAEs were simultaneously recorded with primary tone levels l 1 = l 2 = 65 dB SPL and at primary tone frequencies f 2 = 4 and 5 kHz, where f 1 was successively varied such that the ratio f 2 /f 1 ranged between 1.1 and 1.6 in 0.04 steps while quadratic and cubic DPOAE levels were extracted from the same recording. Results: Cubic DPOAEs were significantly reduced in the affected ears of Ménière's disease patients, and slightly reduced in the unaffected ears of Ménière's disease patients, relative to the ears of normal-hearing participants. In contrast, no significant changes could be seen in quadratic DPOAEs across the ears of normal-hearing participants and Ménière's disease patients. Conclusions: We could identify a relatively good preservation of quadratic DPOAE levels in relation to a reduction of cubic DPOAE levels as a potential noninvasive diagnostic approach in the early stage of suspected Ménière's disease. Future studies validating the differential diagnostic power of this parameter in control groups with nonhydropic forms of hearing loss are warranted.
Hippokratia, 2016
OBJECTIVE Comparison of the efficacy of Transitory Evoked Otoacoustic Emissions (TEOAEs) and Distortion Product Otoacoustic Emissions (DPOAEs) in a neonatal hearing screening protocol, based on a three-stage strategy. METHODS In the first stage, a hearing screening using both evoked emissions was conducted in 3,480 neonates from March 2006 through January 2012. Both TEOAEs and DPOAEs were recorded. Neonates, who did not undergo the test before being discharged, were examined within 30 days at a scheduled appointment. Follow-up of the referred newborns (second-stage screening) was performed as an outpatient re-screening, within a month. The third-stage evaluation, i.e., the diagnostic testing, included a clinical otolaryngological examination, high-frequency tympanometry at 1,000 Hz and Auditory Brainstem Response (ABR) measurements. RESULTS A total of 3,480 (97%) newborns (n =1,765 males) out of 3,595 infants were enrolled in the study. In the first-stage evaluation, 8.9 % of the in...
1996
This report describes a project in Utah to investigate the feasibility of using transient evoked otoacoustic emissions (TEOAE) as a tool for screening for hearing loss in children with developmental disabilities (DD). Study participants included 336 students (ages 5 to 7) with no identified DD and 765 students (ages 3 to 7) with one or more DD. Each participant was screened using two conventional pure tone hearing screening protocols and two TEOAE hearing screening protocols. The study found that, overall, the operant characteristics of one of the conventional hearing screening protocols (which used tympanometry screening for the 500 Hz pure tone) were superior to the other measures. However, for nearly one-third of the children with DD, screening results could not be obtained from either of the pure tone screening protocols, whereas successful results were obtained for over 98 percent of the same children using the TEOAE screenings. Results also supported previous findings of a substantially higher incidence of hearing loss in children with DD. The report addresses the project's importance, purpose, accomplishments, methodology, and results. Extensive appendices include necessary approvals for use of human subjects; data collection schedules and summary sheets; a consultant's report; a listing of data dissemination activities, and a summary of participant data. (Contains 59 references.). (DB)
Journal of Audiology & Otology, 2016
Background and Objectives: This paper aimed at evaluating the characteristics of highfrequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group. Subjects and Methods: Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0-104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram. Results: The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group. Conclusions: There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.
International Journal of Pediatric Otorhinolaryngology, 2006
Objective: The aim of this study was to examine the effect of the number of averaged responses on the measurement of transiently evoked otoacoustic emissions (TEOAEs). Methods: The study was performed on the background of a universal newborn hearing screening program implemented in Iaso Maternity Hospital. Two groups of full-term newborns with normal otoacoustic emissions were studied. The first group included 58 newborns (115) ears, in which 260 low-noise samples, provided by the default setting of the equipment used (ILO88), were presented. The second group included 58 newborns (113) ears, in which 20-50 averaged responses were presented, until the ''pass'' criteria would be met. Statistical comparison between the following parameters recorded during TEOAE measurement was performed: Overall response,