OTOREFLECTANCE ASSESSMENT OF MIDDLE-EAR FUNCTIONING

中耳功能的耳反射评估

• 批准号: 6744273
• 负责人: Douglas H Keefe
• 金额: $ 9.98万
• 依托单位: SONICOM, INC.
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-26 至 2005-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6744273
• 关键词: bioengineering /biomedical engineering; biomedical equipment development; clinical research; conductive hearing loss; diagnosis design /evaluation; ear disorder diagnosis; hearing; hearing tests; human subject; measurement; middle ear; middle ear disorder; otitis media; otoacoustic emission; sensory signal detection; speech recognition; tympanum

DESCRIPTION (provided by applicant): Otoreflectance (OR) is a new class of hearing test instruments utilizing acoustic signals presented and recorded in the ear canal. OR instruments address limitations in existing screening and diagnostic instruments in such areas as: (1) detecting otitis media, (2) predicting conductive hearing loss, (3) augmenting the newborn hearing screening protocol to test for middle-ear dysfunction, and (4) the general assessment of middle-ear functioning at frequencies important for speech perception. OR provides calibrated measurements over a frequency range from approximately 0.25 to 8 kHz of such transfer functions as reflectance and admittance, and the power absorbed by the ear canal and middle ear. Energy reflectance and absorbed power are OR functions that are relatively insensitive to the position of the probe in the ear canal. This property may allow clinical interpretation of these functions at moderate and high frequencies at which the tympanometric admittance, which is sensitive to probe position, becomes difficult to interpret. One proposed class of OR instruments can be used with probes similar to otoacoustic emission probes to screen middle-ear functioning in several seconds at ambient pressure in the ear canal. Such rapidly performed measurements at ambient pressure may provide a test of middle-ear dysfunction in newborn hearing screening programs, and a test to screen for conductive hearing loss in children at risk for otitis media with effusion. Another proposed class of OR instruments, for which a static pressure pump will be added to the probe system, will be used to measured reflectance, admittance and absorbed power as functions of both frequency and static pressure in the ear canal. Such OR tympanometry instruments may have general audiological and screening utility for diagnosing middle-ear pathology due to the fact that the energy reflectance tympanogram has more orderly patterns at moderate and high frequencies than multifrequency tympanometers based only on admittance. A third proposed class of OR instruments may provide a sensitive test of the acoustic reflex threshold by measuring the wideband shift in OR responses elicited by a contralateral or ipsilateral activator sound. A protocol to measure supra-threshold reflex decay may provide additional wideband information that is unavailable in clinical reflex testing.

描述（由申请人提供）：耳反射（OR）是一种新型的听力测试仪器，利用耳道中呈现和记录的声学信号。OR仪器解决了现有筛查和诊断仪器在以下领域的局限性：（1）检测中耳炎，（2）预测传导性听力损失，（3）增强新生儿听力筛查方案以测试中耳功能障碍，以及（4）在对言语感知重要的频率下对中耳功能的一般评估。OR提供在大约0.25至8 kHz的频率范围内对诸如反射率和导纳的传递函数以及耳道和中耳吸收的功率的校准测量。能量反射率和吸收功率是OR函数，其对探头在耳道中的位置相对不敏感。这种性质可以允许在中高频下对这些功能进行临床解释，在中高频下，对探头位置敏感的鼓室导纳变得难以解释。一种提出的OR仪器可以与类似于耳声发射探头的探头一起使用，以在耳道中的环境压力下在几秒钟内筛查中耳功能。这种在环境压力下快速进行的测量可以在新生儿听力筛查项目中提供中耳功能障碍的测试，以及在有渗出性中耳炎风险的儿童中筛查传导性听力损失的测试。另一类建议的手术室仪器，其中静压泵将被添加到探头系统，将被用来测量反射率，导纳和吸收功率作为频率和静压在耳道中的函数。由于能量反射鼓室图在中高频下比仅基于导纳的多频鼓室图具有更有序的模式的事实，这种OR鼓室图仪器可以具有用于诊断中耳病理的一般听力学和筛查实用性。第三类提出的OR仪器可以通过测量由对侧或同侧激活器声音引起的OR响应中的宽带偏移来提供声反射阈值的灵敏测试。测量阈上反射衰减的方案可提供临床反射测试中不可用的额外宽带信息。