OTOACOUSTIC EMISSION COCHLEOGRAPHY

我们的研究计划的长期目标是建立一个临床 基于畸变产物耳声的耳蜗功能测试 发射（DPOAE）。到目前为止，该项目的工作已经取得了以下成果： 开发几种可应用的DPOAE测试协议 在实际环境中，包括儿科和成人， 听力诊断诊所 这项研究计划已经完成， 在我们的实验室中，与基础动物研究（由其他机构资助）平行， 目的是为了更好地了解 耳声发射（OAE）产生。 计划中的研究 竞争的更新建议集中在四个独立的，但相互关联的 具体目标：（i）提高DPOAE检测的灵敏度 感音神经性听力损失（SNHL）通过优化刺激参数 用于测量DPOAE。具体来说，我们将研究的影响， f2/f1比值对正常耳最佳LI-L2水平差异的影响，利用 纯音曝光直接确定这些刺激的影响 参数，并证明优化DPOAE刺激参数， 改善SNHL患者耳蜗缺陷的检测。（二） 采用基于决策理论的分析来评估测试性能 DPOAE和瞬态诱发耳声发射（TEOAE）的特征。 我们 将检查我们目前的数据库，以确定这两个因素的影响， 对发射进行积分的带宽和听力水平标准， 采用优化的DPOAE刺激参数沿着程序， 最大限度地减少噪音，形成一个新的数据库，重新评估测试 在最佳刺激条件下的DPOAE性能，并使用这些 联合数据库，以评估听力损失病因对 OAE测试性能。(3)采用多元回归/相关分析 为了确定DPOAE水平和/或检测阈值的程度， 从优化的DPOAE-I/O功能获得的可靠估计听力 水平(4)确定除了DPOAE生产的其他措施， 振幅提供了用于确定状态的新信息 耳蜗功能 具体而言，DPOAE抑制将在 正常的耳朵，以确定最佳参数，然后评估 SNHL检测。DPOAE潜伏期将通过直接测量确定 的时间波形开始延迟和从群延迟程序。 最 将评估可靠的DPOAE潜伏期测量对耳蜗刺激的敏感性。 纯音暴露创伤和SNHL患者研究。最后 将通过以下方式测试2f 2-f1 DPOAE对轻度耳蜗创伤的敏感性： 采用纯音曝光和性能检测SNHL 通过确定正常与受损的这种排放的减少来评估 耳朵这些研究的完成将导致 我们对DPOAE和OAE临床能力的理解， 将军

The long term goal of our program of research is to establish a clinical test of cochlear function based upon distortion-product otoacoustic emissions (DPOAEs). To date, the work on this project has resulted in the development of several DPOAE-test protocols which can be applied effectively in practical settings including the pediatric and adult diagnostic-audiology clinics. This program of research has been performed in our laboratory in parallel with basic animal studies (funded by other sources) designed to provide a better understanding of the nature of otoacoustic emission (OAE) generation. The planned studies of this competing renewal proposal focus on four separate, but interrelated specific aims: (i) improve the sensitivity of DPOAEs for detecting sensorineural hearing loss (SNHL) by optimizing the stimulus parameters used to measure DPOAEs. Specifically, we will examine the influence of the f2/f1 ratio on optimum LI-L2 level differences in normal ears, utilize pure-tone exposures to directly determine the effects of these stimulus parameters, and demonstrate that optimized DPOAE-stimulus parameters improve the detection of cochlear deficits in patients with SNHL. (2) employ analyses based upon decision theory to evaluate test-performance features of DPOAEs and transient-evoked otoacoustic emissions (TEOAEs). We will examine our current databases to determine the influences of both the bandwidth over which emissions are integrated and hearing level criteria, employ optimized DPOAEs stimulus parameters along with procedures that maximize noise reduction to form a new databases to re-evaluate the test performance of DPOAEs under optimal-stimulation conditions, and use these combined databases to evaluate the influence of hearing-loss etiology on OAE-test performance. (3) employ multiple regression/correlation analyses to determine the extent that DPOAE level and/or detection thresholds, obtained from the optimized DPOAE-l/O functions reliably estimate hearing level. (4) determine if other measures of DPOAE production in addition to amplitude provide new information that is useful for determining the status of cochlear function. Specifically, DPOAE suppression will be measured in normal ears to determine optimal parameters and then evaluated for the detection of SNHL. DPOAE latency will be determined by direct measurement of time waveform onset latencies and from group delay procedures. The most reliable DPOAE latency measures will assessed for sensitivity to cochlear trauma with pure-tone exposures and studies in patients with SNHL. Finally the 2f2-f1 DPOAE will be tested for sensitivity to mild cochlear trauma by employing pure-tone exposures and performance for detection of SNHL evaluated by determining reductions in this emission in normal vs impaired ears. Completion of these studies will result in a significant increase in our understanding of the clinical capabilities of DPOAEs and OAEs, in general.