Interpreting auditory brainstem evoked responses and distortion product otoacoustic emissions in diabetic patients with normal hearing

2020 ◽  
Author(s):  
Won Ki Cho ◽  
Woo Seok Kang ◽  
Jung Bok Lee ◽  
Hong Ju Park ◽  
Jong Woo Chung ◽  
...  
2005 ◽  
Vol 48 (5) ◽  
pp. 1165-1186 ◽  
Author(s):  
Tracy S. Fitzgerald ◽  
Beth A. Prieve

Although many distortion-product otoacoustic emissions (DPOAEs) may be measured in the ear canal in response to 2 pure tone stimuli, the majority of clinical studies have focused exclusively on the DPOAE at the frequency 2f1-f2. This study investigated another DPOAE, 2f2-f1, in an attempt to determine the following: (a) the optimal stimulus parameters for its clinical measurement and (b) its utility in differentiating between normal-hearing and hearing-impaired ears at low-to-mid frequencies (≤2000 Hz) when measured either alone or in conjunction with the 2f1-f2 DPOAE. Two experiments were conducted. In Experiment 1, the effects of primary level, level separation, and frequency separation (f2/f1) on 2f2-f1 DPOAE level were evaluated in normal-hearing ears for low-to-mid f2 frequencies (700–2000 Hz). Moderately high-level primaries (60–70 dB SPL) presented at equal levels or with f2 slightly higher than f1 produced the highest 2f2-f1 DPOAE levels. When the f2/f1 ratio that produced the highest 2f2-f1 DPOAE levels was examined across participants, the mean optimal f2/f1 ratio across f2 frequencies and primary level separations was 1.08. In Experiment 2, the accuracy with which DPOAE level or signal-to-noise ratio identified hearing status at the f2 frequency as normal or impaired was evaluated using clinical decision analysis. The 2f2-f1 and 2f1-f2 DPOAEs were measured from both normal-hearing and hearing-impaired ears using 2 sets of stimulus parameters: (a) the traditional parameters for measuring the 2f1-f2 DPOAE (f2/f1 = 1.22; L1, L2 = 65, 55 dB SPL) and (b) the new parameters that were deemed optimal for the 2f2-f1 DPOAE in Experiment 1 (f2/f1 = 1.073, L1 and L2 = 65 dB SPL). Identification of hearing status using 2f2-f1 DPOAE level and signal-to-noise ratio was more accurate when the new stimulus parameters were used compared with the results achieved when the 2f2-f1 DPOAE was recorded using the traditional parameters. However, identification of hearing status was less accurate for the 2f2-f1 DPOAE measured using the new parameters than for the 2f1-f2 DPOAE measured using the traditional parameters. No statistically significant improvements in test performance were achieved when the information from the 2 DPOAEs was combined, either by summing the DPOAE levels or by using logistic regression analysis.


1997 ◽  
Vol 106 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Xue Zhong Liu ◽  
Valerie E. Newton

Eight patients with Waardenburg's syndrome (WS) with normal hearing and 3 additional patients exhibiting a low-frequency hearing loss were tested for the level of the acoustic distortion product 2f1-f2 by means of the Otodynamics Distortion Product Analyser (ILO92). Wide notches in distortion product otoacoustic emissions (DPOAEs) between 1,000 and 3,000 Hz were found in 7 (12 ears, 87.5%) examined patients with normal audiograms, which was a significantly higher rate than that found in the control group (10%). The 3 patients with low-frequency hearing loss gave a consistent pattern in audiometric configuration shown by both pure tone audiograms and DPOAEs. It is concluded from these initial results that DPOAEs may be a useful approach to identifying subclinical pathologic aberrations in the inner ear in WS patients, and may be a predictor of low-frequency sensorineural hearing loss.


2011 ◽  
Vol 22 (05) ◽  
pp. 253-264 ◽  
Author(s):  
Kim S. Schairer ◽  
Brooke Morrison ◽  
Ellyn Szewczyk ◽  
Cynthia G. Fowler

Background: The overall goal of the current study was to examine the relationships among uncompensated admittance (Ya) at ambient pressure extracted from tympanograms, energy reflectance (ER) measures at ambient pressure from wideband acoustic transfer functions (WATF), and distortion product otoacoustic emissions (DPOAEs). If WATF measures of Ya are comparable to tympanometric measures of Ya at ambient pressure, it would be further evidence that the two systems provide comparable information at ambient pressure. Such a relationship could be used as a cross-check or validation for WATF measures and support the use of WATFs in lieu of tympanograms in some applications. Finally, if WATF measures of Ya and/or ER at DPOAE stimulus frequencies can account for some of the variability observed in DPOAE levels and/or signal-to-noise ratios (SNRs) in ears with normal hearing, the relationships could be used to improve hearing screening procedures. Purpose: The hypotheses were as follows: (1) measures of Ya at ambient pressure are significantly correlated as measured with tympanometric and WATF procedures and (2) measures of Ya and ER at DPOAE stimulus frequencies are significantly correlated with DPOAE level and SNR. Research Design: Repeated measures in human adults. Study Sample: Forty ears of 20 adults with normal hearing and middle ear function were included in the final sample. Data Collection and Analysis: Tympanograms were obtained using probe frequencies of 226, 678, and 1000 Hz; WATFs were obtained using a click probe, and DPOAEs were elicited with f2's of 1000, 2000, and 4000 Hz. A repeated measures analysis of variance (RM-ANOVA) was completed to identify significant differences between ears and among probe frequencies for Ya measured at ambient pressure from the Tympstar and for Ya measured at the three closest frequencies on the WATFs. Lines were fit to the comparison of Ya from the Tympstar and WATF, and percent variance accounted for (r2) was calculated. Ya and ER were extracted at all stimulus frequencies that were used to elicit DPOAEs and were compared to DPOAE levels and SNRs. RM-ANOVAs were completed to identify any significant differences in DPOAE level and SNR between ears and among f2 conditions. Lines were fit to the comparison of Ya and ER measures at f1 and f2 with the DPOAE levels and SNRs. The relationship between behavioral air conduction threshold at each f2 and DPOAE level (and SNR) was examined with regression analysis. Results: Ya was significantly correlated between the tympanometric and WATF measures at all three probe-tone frequencies. Ya and ER at f1 and f2 were significantly correlated with DPOAE level for f2 = 4000 Hz. Conclusions: The implications are as follows: (1) WATFs, which can be obtained with the same probe microphone system as DPOAEs, could be used as a supplement to tympanometry in a diagnostic test battery, and the relationship between Ya measured on the two systems could be used for verification, and (2) Ya and ER measures from WATFs at both DPOAE stimulus frequencies account for some of the variability observed in DPOAE levels at f2 = 4000 Hz in normal ears.


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