Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction
Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction
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DOI：
10.1016/j.heares.2009.09.008
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发表时间：
2010-05-01
期刊：
影响因子：
2.8
通讯作者：
Gorga, Michael P.
中科院分区：
文献类型：
--
作者：
Keefe, Douglas H.;Fitzpatrick, Denis;Gorga, Michael P.
假设一个中耳状态的宽带（WB）听觉声学测试电池，包括声反射阈值（ARTs）和声传递函数（ATFs，即吸光度和导纳），在根据耳声发射对通过或参考新生儿听力筛查（NHS）方案的耳朵进行分类时，比1 khz鼓测法更准确。中耳状态的评估可以通过识别传导功能障碍和听神经病变存在的病例来改善NHS计划。单侧侧心房动脉炎的评估采用的刺激包括4个宽带噪声或音调激活器脉冲，在脉冲之前、之间和之后交替出现5次咔嗒声。反射位移被定义为最终和初始点击反应之间的差异。在低频率（0.8-2.8 kHz）和高频率（2.8-8 kHz）使用最大似然测量ARTs。与通过相比，NHS中低频ART的中位数提高了24 dB。ATF和ART测试的最佳组合在预测NHS结果方面优于单独的任何一种测试，WB测试优于1 khz鼓室测量。耳蜗功能的内耳蜗传出移位可能影响ar，但它们的存在也与正常的传导功能一致。还比较了成人同侧和对侧测量的基线临床和WB art。(C) 2009 Elsevier B.V.版权所有
A wideband (WB) aural acoustical test battery of middle-ear status, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs, i.e., absorbance and admittance) was hypothesized to be more accurate than 1-kHz tympanometry in classifying ears that pass or refer on a newborn hearing screening (NHS) protocol based on otoacoustic emissions. Assessment of middle-ear status may improve NHS programs by identifying conductive dysfunction and cases in which auditory neuropathy exists. Ipsi-lateral ARTs were assessed with a stimulus including four broadband-noise or tonal activator pulses alternating with five clicks presented before, between and after the pulses. The reflex shift was defined as the difference between final and initial click responses. ARTs were measured using maximum likelihood both at low frequencies (0.8-2.8 kHz) and high (2.8-8 kHz). The median low-frequency ART was elevated by 24 dB in NHS refers compared to passes. An optimal combination of ATF and ART tests performed better than either test alone in predicting NHS outcomes, and WB tests performed better than 1-kHz tympanometry. Medial olivocochlear efferent shifts in cochlear function may influence ARs, but their presence would also be consistent with normal conductive function. Baseline clinical and WB ARTs were also compared in ipsilateral and contralateral measurements in adults. (C) 2009 Elsevier B.V. All rights reserved.