scholarly journals Acquisition and Repeatability of High-Frequency Distortion Product Otoacoustic Emissions Using Two Different Calibration Methods in Newborns

2019 ◽  
Vol 9 (15) ◽  
pp. 2947
Author(s):  
Laura Dreisbach Hawe ◽  
Nicholas Portugal ◽  
Eliza Aguilar ◽  
William Hansen ◽  
Daniela Kite ◽  
...  

Distortion-product otoacoustic emissions (DPOAEs) elicited with high-frequency (HF; up to 16 kHz) stimuli are measurable and repeatable in normal-hearing adults and children, adult patients, and are sensitive to ototoxic insults in adults. However, objective tests for monitoring basal cochlear function in those too young to respond subjectively need to be developed. DPOAE levels recorded at frequencies <10 kHz are well characterized, but DPOAE levels measured up to 16 kHz do not exist for newborns. The goal of the current study is to determine if HF DPOAEs are measurable and repeatable in newborns. DPOAEs were measured from 2–16 kHz (f2/f1 of 1.22; L1/L2 = 65/55 dB SPL) using two different calibration methods (forward pressure level—FPL and in-the-ear—SPL) in 26 newborns. To assess repeatability, the probe was removed then re-inserted for a second round of testing. Results indicate that HF DPOAEs can be evoked and are repeatable in newborns and the use of FPL calibration shows promise for measuring HF responses and maximizing repeatability. To be implemented in monitoring programs where the highest frequencies with responses are continuously tested, stimulus parameters used to evoke newborn HF DPOAEs and calibration methods need further exploration.

2007 ◽  
Vol 25 (10) ◽  
pp. 1190-1195 ◽  
Author(s):  
Kristin R. Knight ◽  
Dale F. Kraemer ◽  
Christiane Winter ◽  
Edward A. Neuwelt

Purpose The objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children. Patients and Methods Baseline and serial measurement of conventional pure-tone audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy. Seventeen children also had baseline and serial measurement of extended high-frequency (EHF) audiometry (9 to 16 kHz). Audiologic data were analyzed to determine the incidence of ototoxicity using the American Speech-Language-Hearing Association criteria, and the relationships between the different measures of ototoxicity. Results Of the 32 children, 20 (62.5%) acquired bilateral ototoxicity in the conventional frequency range during chemotherapy treatment, and 26 (81.3%) had bilateral decreases in DPOAE amplitudes and dynamic range. Of the 17 children with EHF audiometry results, 16 (94.1%) had bilateral ototoxicity in the EHF range. Pilot data suggest that EHF thresholds and DPOAEs show ototoxic changes before hearing loss is detected by conventional audiometry. Conclusion EHF audiometry and DPOAEs have the potential to reveal earlier changes in auditory function than conventional frequency audiometry during platinum chemotherapy in children.


2004 ◽  
Vol 194 (1-2) ◽  
pp. 87-96 ◽  
Author(s):  
Ana E Vázquez ◽  
Ana M Jimenez ◽  
Glen K Martin ◽  
Anne E Luebke ◽  
Brenda L Lonsbury-Martin

2016 ◽  
Vol 22 ◽  
pp. 2028-2034 ◽  
Author(s):  
Ualace De Paula Campos ◽  
Stavros Hatzopoulos ◽  
Lech K. Śliwa ◽  
Piotr H. Skarżyński ◽  
Wiesław W. Jędrzejczak ◽  
...  

2017 ◽  
Vol 3 (2) ◽  
pp. 453-456
Author(s):  
Dennis Zelle ◽  
Ernst Dalhoff ◽  
Anthony W. Gummer

AbstractAs a by-product of nonlinear amplification in the cochlea, the inner ear emits sound waves in response to two tones with different frequencies. These sound waves are measurable in the ear canal as distortion-product otoacoustic emissions (DPOAEs). DPOAEs putatively consist of two components emerging at different locations in the cochlea. Wave interference between the two components limits the accuracy of DPOAEs as a noninvasive measure of cochlear function. Using short stimulus pulses instead of continuous stimuli, the two DPOAE components can be separated in the time domain due to their different latencies. The present work utilizes a nonlinear hydrodynamic cochlea model to simulate short-pulse DPOAEs in the time domain. When adding irregularities to the mechanical parameters of the model, the simulated DPOAE signals show two distinguishable components and long-lasting beat tones, similar to band-pass filtered experimental data from normal-hearing human subjects. The model results suggest that the beat tones can occur solely due to interference of the coherent-reflection component with the fading nonlinear-distortion component.


2016 ◽  
Vol 27 (1) ◽  
pp. 3-7
Author(s):  
Suchetha Rao ◽  
Ranjith Kumar ◽  
Jayashree Bhat ◽  
Nutan Kamath

Context: Vincristine chemotherapy has dose dependent ototoxicity. Early detection of ototoxicity is better with otoacoustic emissions and high frequency audiometry than conventional pure tone audiometry. The study was done to see if vincristine treatment interferes with hearing sensitivity in children.Methods and Material: A prospective study was conducted on twenty-three children with acute lymphoblastic leukemia (ALL) on Multi Center Protocol (MCP 841).These were subjected to conventional audiometry, high frequency audiometry and distortion product otoacoustic emissions (DPOAEs) before starting chemotherapy. The follow up audiological evaluation after early intensive phase chemotherapy (approximately 6 months) was conducted in thirteen children, who received 12 doses of vincristine (1.4 mg/m2), cranial irradiation of 1800cGy (>3 years) as per protocol and antibiotics as per clinical demands.Results: Baseline audiological evaluation was normal. Follow-up evaluation DPOAEs showed a declining tendency, however changes did not reach statistical significance. Differences in median hearing thresholds prior and post treatment in higher frequency audiometry were also minimal which was not statistically significant. Conventional audiometric thresholds were not altered.Conclusions: The reduction in the signal noise ratio of DPOAE, and reduced hearing sensitivity in high frequencies in post chemotherapy in comparison with baseline measures cannot be ignored though it has failed to reach the level of statistical significance. children on vincristine should have a pre chemotherapy and follow up audiological evaluation with DPOAE The results of the present study needs to be strengthened by including larger sample and long term follow up.Bangladesh J Medicine Jan 2016; 27(1) : 3-7


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.


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