OTOREFLECTANCE ASSESSMENT OF MIDDLE-EAR FUNCTIONING

中耳功能的耳反射评估

• 批准号: 7056571
• 负责人: Douglas H Keefe
• 金额: $ 43.07万
• 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 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7056571
• 关键词: bioengineering /biomedical engineering; biomedical equipment development; clinical biomedical equipment; clinical research; conductive hearing loss; diagnosis design /evaluation; ear disorder diagnosis; hearing tests; human subject; middle ear; middle ear disorder; otitis media; patient oriented research; 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 the following limitations in existing instruments to screen and diagnose middle-ear function: (1) detection of otitis media, (2) prediction of conductive hearing loss, (3) detection of middle-ear dysfunction in infants receiving a newborn hearing screening exam or follow-up audiologic assessment, and (4) general use to assess middle-ear function at frequencies in the bandwidth of speech. An OR test provides measurements over a wideband range (approximately 0.25 to 8 kHz) of such transfer functions as reflectance and admittance, and power absorbed by the ear canal and middle ear. Energy reflectance and absorbed power are OR functions that are relatively insensitive to probe position in the ear canal, and thus are well suited to interpreting middle-ear function at higher frequencies. One type of OR instrument can be used with probes similar to otoacoustic emission probes to screen middle-ear function in several seconds at ambient ear-canal pressure. Phase I of this project established the feasibility of measuring such OR responses in normal-hearing adults and children, as well as in children with surgically confirmed middle-ear fluid. Phase I also implemented a wideband OR test to assess the function of the middle-ear muscle reflex, and compared reflex thresholds in infants and adults with thresholds measured using conventional instruments. In Phase II, a wideband OR tympanometry instrument will be implemented, adding a pump to vary ear-canal static pressure, and OR tympanometry norms will be measured in adults. The test performance of ambient-pressure OR and conventional 226-Hz tympanometry will be compared in young children to detect middle-ear fluid and to predict a conductive hearing loss associated with otitis media with effusion. OR tympanometry will form part of a new objective and efficient wideband test to measure middle-ear muscle reflex thresholds, which will be compared to thresholds in adults and infants measured using a conventional test. The test performance of the ability of OR tympanometry, ambient-pressure OR, and conventional 1000-Hz tympanometry to detect middle-ear dysfunction will be compared in infants also receiving a standard newborn hearing screening exam. Outcomes from Phase II will evaluate whether OR is more accurate than conventional tests to screen and diagnose middle-ear dysfunction in clinical applications of important societal concern.

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仪器解决了现有仪器中用于筛查和诊断中耳功能的以下局限性：（1）中耳炎的检测，（2）传导性听力损失的预测，（3）在接受新生儿听力筛查检查或后续听力学评估的婴儿中检测中耳功能障碍，以及（4）通常用于在语音带宽中的频率下评估中耳功能。OR测试提供了在宽带范围（约0.25至8 kHz）内对反射率和导纳等传递函数以及耳道和中耳吸收的功率的测量。能量反射率和吸收功率是OR函数，其对耳道中的探头位置相对不敏感，因此非常适合于解释较高频率下的中耳功能。一种类型的OR仪器可以与类似于耳声发射探头的探头一起使用，以在环境耳道压力下在几秒钟内筛查中耳功能。该项目的第一阶段确定了在听力正常的成人和儿童以及手术证实的中耳积液儿童中测量这种OR反应的可行性。第一阶段还实施了宽带OR测试，以评估中耳肌肉反射的功能，并将婴儿和成人的反射阈值与使用传统仪器测量的阈值进行比较。在第二阶段，将实施宽带或鼓室导抗仪，增加一个泵，以改变耳道静压，或鼓室导抗标准将在成人中测量。将在幼儿中比较环境压力OR和传统226 Hz鼓室导抗测试的测试性能，以检测中耳液并预测与渗出性中耳炎相关的传导性听力损失。或鼓室压将形成一个新的客观和有效的宽带测试的一部分，以测量中耳肌反射阈值，这将是比较阈值在成人和婴儿使用传统的测试。在接受标准新生儿听力筛查检查的婴儿中，将比较OR鼓室导抗法、环境压力OR鼓室导抗法和传统1000 Hz鼓室导抗法检测中耳功能障碍的能力的测试性能。II期的结果将评估OR在具有重要社会意义的临床应用中，在筛查和诊断中耳功能障碍方面是否比传统测试更准确。