A two-step scenario for hearing assessment with otoacoustic emissions at compensated middle ear pressure (in children 1-7 years old) (original) (raw)
Related papers
Ear and Hearing, 2003
As part of a prospective study of possible effects of early-life otitis media on speech, language, cognition, and psychosocial development, we evaluated hearing both during episodes of middle-ear effusion (MEE) and when MEE was not present. The objective of this report is to describe age-specific hearing threshold levels in relation to the presence or absence of MEE in a large sample of young children. Design: Participants were 1055 children drawn from a sample of 6350 children who were enrolled in the larger study by 2 mo of age. Otologic evaluation of each child was conducted at least monthly. The protocol of the larger study called for hearing evaluations 1) after 8 wk of continuous unilateral or bilateral MEE and every 4 wk thereafter until one test had been conducted when MEE was no longer present; 2) immediately before developmental testing; and 3) in a sample of children without MEE to obtain age-specific normative data. Results: Results are presented by testing technique, age group, and middle-ear condition. In general, hearing threshold levels were highest in the youngest children tested with visual reinforcement audiometry and lowest in the oldest children tested with conventional audiometry. In general also, thresholds were lowest in children with normal middleear status, intermediate in children with unilateral MEE, and highest in children with bilateral MEE. On average, the presence of bilateral MEE was associated with hearing threshold levels 10 to 15 dB higher than the normative values for the corresponding age group. Conclusions: In infants and young children, audiometric results are influenced by testing technique, age group, and the presence or absence of effusion in each ear.
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.
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.
Association between failure in otoacoustic emissions and risk indicator for hearing loss
Revista CEFAC, 2021
Purpose: to describe the results of a neonatal hearing health program and verify whether there is an association between the presence of risk indicators for hearing loss and failure in the tests and diagnosis. Methods: a one-cohort, observational, retrospective study with secondary data contained in a spreadsheet concerning the family’s sociodemographic condition, clinical history, and examination results of 7,800 participants who were submitted to hearing screening between 2010 and 2016. Absolute frequency and percentages were used in the description of the first and second stages. In the association between risk indicators and failures in the otoacoustic emissions, the odds ratio, confidence interval, and significance level at 0.5% were used. Results: the risk indicators in 8 out of the 12 infants presented with hearing loss were ototoxic medication and intensive care unit (ICU) stay, whereas the likelihood of failure in the otoacoustic emissions occurred along with 11 indicators....
Objective-Hearing impairment is a major problem worldwide, significantly delaying acquisition of speech in children. Unfortunately delayed detection of hearing impairment especially in developing countries, adds a significant burden on the society and the nation. Hence early detection of hearing impairment is imperative and the need of the hour lies in developing an easy, cost effective and reliable method for testing large number of infants, Oto acoustic Emissions(OAE's) being one such test. The objective of this study was to asses the effectiveness and utility of Distortion Product Otoacoustic Emissions (DPOAE) as a screening tool for assessment of hearing impairment in infants and to assess the relationship between selected risk factors and hearing loss. Design-This cross sectional study involving a two stage DPOAE testing, with Brainstem Evoked Response Audiometry as a confirmatory test for infants failing the two stage test. Materials and method-One thousand infant were sel...
Audiologic evaluation of infants and preschoolers: a practical approach
American Journal of Otolaryngology, 2007
Many children suspected of having hearing loss are referred for audiologic evaluation every day. Cross-checking the results from more than one audiologic tests is considered crucial in pediatric audiology, preferably combining subjective and objective methods. The current recommended approach for hearing assessment of infants and preschoolers is based on physiologic tests, immittance measurements, and behavioral responses. As a consequence, a full examination usually takes more than 90 minutes. Because the number of referrals may be much greater than the actual performance of a modern audiologic department, it would be desirable to shorten the evaluation time without reducing its validity. The largest part of the population referred to our department for hearing evaluation consists of children 1O to 4 to 5 years old suspected of having hearing loss. The proposed triad history/otoscopy Y speech evaluation Y otoacoustic emissions (OAEs) has been proven very effective in sorting out all those children with normal hearing bilaterally. The suggested algorithm shows several advantages compared to the conventional approach. It is safe, inexpensive, noninvasive, and gives reliable results in a significantly faster way, thus increasing compliance and applicability in very young children. In this way, we can save time, bmoney,Q and bdiagnostic energy,Q which could be used for those children who really need them. D
Distortion-product otoacoustic emissions hearing screening in high-risk newborns
Otolaryngology - Head and Neck Surgery, 1998
Universal infant hearing screening has recently been recommended by the National Institutes of Health. Otoacoustic emissions have been proposed as the first-level screening technique. Although transient evoked otoacoustic emissions have shown limited applications, distortion-product otoacoustic emissions hold promise as a screening technique but have not been fully investigated. The purpose of this study was to determine the validity of distortion-product otoacoustic emissions as a hearing screening technique. A total of 208 ears of 104 infants at risk for hearing loss were tested with both automated auditory brain stem response and distortion-product otoacoustic emission screening protocols. Acoustic brain stem response results were used as the standard for normal hearing. Distortion-product otoacoustic emission results were analyzed by means of calculation of the difference between the mean of the response levels and the mean of the noise floor levels from five frequency pairs between 2000 and 4000 Hz. Pass-fail rates for response above noise floor criteria of 5, 10, and 15 dB were examined. The sensitivity of distortion-product otoacoustic emissions was 50%, 67%, and 87%, and the specificity was 94%, 68%, and 38% at the 5, 10, and 15 dB levels, respectively. The pass-fail criterion of distortion-product otoacoustic emissions should be based on instrumentation calibration, infant status, and an acceptable false-positive, false-negative yield. The ability to test rapidly the hearing of all infants with distortion-product otoacoustic emissions points to the feasibility of using this test as a first-stage screen.
Success rate of newborn and follow-up screening of hearing using otoacoustic emissions
International journal of pediatric otorhinolaryngology, 2006
During the last 6 years, and after a long period of pilot study, a universal newborn hearing screening program based on otoacoustic emissions is implemented in Iaso Maternity Hospital. Our purpose is to present the success rate of otoacoustic emission testing on discharge from the hospital and 1 month later. All full-term newborns who were screened during a period of 2 years and failed testing after one or more sessions of transiently evoked otoacoustic emissions, on discharge from the hospital, were included in the study. These newborns were retested approximately 1 month after discharge. Twenty-five thousand and thirty-two newborns were examined in total. We found 534 (2.1%) 'refer' cases. Only 223 of them (41.8%) returned to retest in follow-up after 1 month. From the rescreening, 59 (2.3 per thousand) newborns failed in the test again and were referred for diagnostic audiological evaluation. The rate of referrals was small, but efforts should be made to decrease it furth...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2023
The developed countries are well aware of the burden of congenital hearing loss and have taken significant steps in the direction of early identification and subsequent rehabilitation or interventions. However, developing countries like India have no accurate estimate of the ABSTRACT Background: Aim of the research was to study the incidence of hearing loss in high risk children up to 5 years age and determine the common etiological factors associated with it. Methods: Total 140 neonates falling under the norms of inclusion criteria and the children brought by parents with suspicion of having impaired hearing were subjected to thorough history taking and clinical examination followed by audiological examination in the form of otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA). Those showing REFER or FAIL were subjected to BERA. Results were documented accordingly and analysed for identifying the common risk factors and degree of hearing loss. Results: Maximum number of subjects with hearing loss were in the age group of 25-36 months age. Most common risk factor found was Consanguinity and most common postnatal risk factor was found to be hyperbilirubinemia. When compared to BERA, sensitivity of DPOAE was 97.59%, and the specificity was 92.98%. Conclusions: Universal hearing screening of neonates at birth in the form of DPOAE and followed by BERA can reduce the average age of diagnosis of hearing loss and therefore, can provide an opportunity to initiate an appropriate rehabilitative program.