Assessing repeatability and reproducibility using hierarchical modeling: a case-study of distortion product otoacoustic emissions

2010 ◽  
Vol 19 (4) ◽  
pp. 567-585
Author(s):  
Alessandra R. Brazzale ◽  
Paolo Galloni ◽  
Marta Parazzini ◽  
Carmela Marino ◽  
Paolo Ravazzani
Keyword(s):  
Otoacoustic Emissions ◽  
Hierarchical Modeling ◽  
Distortion Product Otoacoustic Emissions ◽  
Distortion Product ◽  
Repeatability And Reproducibility

Technical Report: Distortion Product Otoacoustic Emissions That Are Not Outer Hair Cell Emissions

2009 ◽  
Vol 20 (05) ◽  
pp. 306-310
Author(s):  
Shlomo Silman ◽  
Michele B. Emmer ◽  
Carol A. Silverman
Keyword(s):  
Otoacoustic Emissions ◽  
Outer Hair Cell ◽  
Reliability And Validity ◽  
External Auditory Meatus ◽  
Intermodulation Distortion ◽  
Distortion Product Otoacoustic Emissions ◽  
Distortion Product ◽  
Technical Report ◽  
Emissions Testing

Purpose: To present a case study in order to alert clinicians to the possibility of occurrence of intermodulation distortion during otoacoustic emissions testing that arises from the cavity formed by the external auditory meatus and tympanic membrane rather than from the inner ear, compromising the reliability and validity of otoacoustic emissions testing. Research Design: Prospective case study. Study Sample: A young (26-year-old) female adult with a longstanding, bilateral, essentially moderate to severe sensorineural hearing loss presented with robust distortion product otoacoustic emissions. Results: Repeat otoacoustic emissions testing with another device of the same model revealed essentially absent distortion product otoacoustic emissions and transient otoacoustic emissions. Calibration of both otoacoustic emissions devices using a 1 cc membranous cavity indicated present intermodulation distortion for the device that yielded robust distortion product otoacoustic emissions for the patient but absent intermodulation distortion for the device that revealed absent distortion product otoacoustic emissions and absent transient evoked otoacoustic emissions for the patient. The calibration findings for the device yielding intermodulation distortion in the cavity were confirmed by an engineer of a technical instrumentation company. The device was shipped back to the manufacturer of the device for repair. The manufacturer's engineers diagnosed the problem as an interruption in the relay system. Following repair, calibration revealed the absence of intermodulation distortion in the 1 cc membranous cavity. Conclusions: The findings have implications for the reliability and validity of otoacoustic emissions. Clinicians should routinely calibrate otoacoustic emissions devices using 1.0 and 0.5 cc membranous cavities to rule out intermodulation distortion that could produce artifactual otoacoustic emissions in patients.

Efficacy of Carnitine in Treatment of Tinnitus: Evidence from Audiological and MRI Measures—A Case Study

2015 ◽  
Vol 26 (03) ◽  
pp. 311-324 ◽  
Author(s):  
Kamakshi V. Gopal ◽  
Binu P. Thomas ◽  
Deng Mao ◽  
Hanzhang Lu
Keyword(s):  
Auditory Cortex ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Auditory Brainstem ◽  
Distortion Product Otoacoustic Emissions ◽  
Distortion Product ◽  
Brainstem Response ◽  
The Right ◽  
Functional Connectivity Mri

Background: Tinnitus, or ringing in the ears, is an extremely common ear disorder. However, it is a phenomenon that is very poorly understood and has limited treatment options. Purpose: The goals of this case study were to identify if the antioxidant acetyl-L-carnitine (ALCAR) provides relief from tinnitus, and to identify if subjective satisfaction after carnitine treatment is accompanied by changes in audiological and imaging measures. Research Design: Case Study. Patient Case: A 41-yr-old female with a history of hearing loss and tinnitus was interested in exploring the benefits of antioxidant therapy in reducing her tinnitus. The patient was evaluated using a standard audiological/tinnitus test battery and magnetic resonance imaging (MRI) recordings before carnitine treatment. After her physician's approval, the patient took 500 mg of ALCAR twice a day for 30 consecutive days. The audiological and MRI measures were repeated after ALCAR treatment. Data Collection and Analysis: Pure-tone audiometry, tympanometry, distortion-product otoacoustic emissions, tinnitus questionnaires (Tinnitus Handicap Inventory and Tinnitus Reaction Questionnaire), auditory brainstem response, functional MRI (fMRI), functional connectivity MRI, and cerebral blood flow evaluations were conducted before intake of ALCAR and were repeated 30 days after ALCAR treatment. Results: The patient’s pretreatment pure-tone audiogram indicated a mild sensorineural hearing loss at 6 kHz in the right ear and 4 kHz in the left ear. Posttreatment evaluation indicated marginal improvement in the patient’s pure-tone thresholds, but was sufficient to be classified as being clinically normal in both ears. Distortion-product otoacoustic emissions results showed increased overall emissions after ALCAR treatment. Subjective report from the patient indicated that her tinnitus was less annoying and barely noticeable during the day after treatment, and the posttreatment tinnitus questionnaire scores supported her statement. Auditory brainstem response peak V amplitude growth between stimulus intensity levels of 40–80 dB nHL indicated a reduction in growth for the posttreatment condition compared with the pretreatment condition. This was attributed to a possible active gating mechanism involving the auditory brainstem after ALCAR treatment. Posttreatment fMRI recordings in response to acoustic stimuli indicated a statistically significant reduction in brain activity in several regions of the brain, including the auditory cortex. Cerebral blood flow showed increased flow in the auditory cortex after treatment. The functional connectivity MRI indicated increased connectivity between the right and left auditory cortex, but a decrease in connectivity between the auditory cortex and some regions of the “default mode network,” namely the medial prefrontal cortex and posterior cingulate cortex. Conclusions: The changes observed in the objective and subjective test measures after ALCAR treatment, along with the patient’s personal observations, indicate that carnitine intake may be a valuable pharmacological option in the treatment of tinnitus.

Relationship Between Distortion Product Otoacoustic Emissions and Hearing Loss

2006 ◽  
Vol 2 (1) ◽  
pp. 2-9
Author(s):  
Tiffany A. Johnson ◽  
Stephen T. Neely ◽  
Michael P. Gorga
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Distortion Product Otoacoustic Emissions ◽  
Distortion Product

Distortion product otoacoustic emissions upon ear canal pressurization

2013 ◽  
Vol 133 (4) ◽  
pp. EL331-EL337 ◽  
Author(s):  
Makram Zebian ◽  
Volker Schirkonyer ◽  
Johannes Hensel ◽  
Sven Vollbort ◽  
Thomas Fedtke ◽  
...  
Keyword(s):  
Otoacoustic Emissions ◽  
Distortion Product Otoacoustic Emissions ◽  
Ear Canal ◽  
Distortion Product

Dependence of distortion‐product otoacoustic emissions on primary levels in normal and impaired ears. II. Asymmetry in L1,L2 space

1995 ◽  
Vol 97 (4) ◽  
pp. 2359-2377 ◽  
Author(s):  
M. L. Whitehead ◽  
B. B. Stagner ◽  
M. J. McCoy ◽  
B. L. Lonsbury‐Martin ◽  
G. K. Martin
Keyword(s):  
Otoacoustic Emissions ◽  
Distortion Product Otoacoustic Emissions ◽  
Distortion Product

scholarly journals Reducing reflected contributions to ear-canal distortion product otoacoustic emissions in humans

2006 ◽  
Vol 119 (6) ◽  
pp. 3896-3907 ◽  
Author(s):  
Tiffany A. Johnson ◽  
Stephen T. Neely ◽  
Judy G. Kopun ◽  
Michael P. Gorga
Keyword(s):  
Otoacoustic Emissions ◽  
Distortion Product Otoacoustic Emissions ◽  
Ear Canal ◽  
Distortion Product
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