Using Wideband Energy Reflectance and OAEs to Assess Infant Middle-Ear Function

使用宽带能量反射和 OAE 评估婴儿中耳功能

• 批准号: 7614849
• 负责人: Chris A Sanford
• 金额: $ 3.33万
• 依托单位: BOYS TOWN NATIONAL RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2009-08-07
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7614849
• 关键词: Accounting; Acoustics; Admission activity; Adult; Age; Auditory Brainstem Responses; Auditory system; Birth; Caring; Characteristics; Clinical; Cochlea; Data; Decision Theory; Dependence; Development; Diagnosis; Diagnostic tests; Ear; External auditory canal; Frequencies; Functional disorder; Goals; Guidelines; Health Professional; Hearing; Hearing Tests; Infant; Measurement; Medical; Modeling; Newborn Infant; Outcome; Outpatients; Output; Patient Care; Procedures; Process; Public Health; Range; Recommendation; Relative (related person); Research; Role; Screening Result; Screening procedure; Speech Perception; Staging; Techniques; Test Result; Testing; Travel; Tympanometry; Week; age related; base; follow-up; improved; middle ear; otoacoustic emission; performance tests; pressure; programs; research study; response; sound; tool; transmission process; young adult

DESCRIPTION (provided by applicant): Objective 1: One long term goal is to identify tests that accurately detect middle-ear dysfunction in infants. Wideband (WB) measurements of middle-ear function in infants may overcome limitations of conventional single-frequency middle-ear assessment techniques. Aim 1 of the proposed study evaluates the test performance of conventional 1-kHz tympanometry and WB middle-ear tests (e.g. reflectance, admittance) in terms of their ability to correctly classify pass or refer outcomes on an outpatient otoacoustic emission (OAE) re-screening test. Test performance will be evaluated using clinical decision theory analysis. Identification of a valid test of middle-ear function, which might be used during the newborn hearing screening and follow-up re-screening, would 1) help health care professionals more accurately interpret and communicate OAE and auditory brainstem response (ABR) screening and re-screening test results and 2) improve the accuracy of middle-ear assessment, enabling more informed decisions regarding recommendations for additional diagnostic testing and/or referrals for medical care. Objective 2: Another long term goal is to better understand the effects of age-related changes in the ear-canal and middle-ear on forward and reverse sound transmission between the ear canal and cochlea. Differences in infant and adult OAE responses have been explained by ear-canal and middle-ear effects, but only at 6 kHz. Aim 2 of the proposed study investigates infant middle-ear transmission characteristics using forward and reverse transfer functions between the ear canal and cochlea based on measurements of distortion product (DP) OAEs. Specifically, DPOAE input/output (I/O) functions will be obtained at half-octave frequencies from 1.5 to 8 kHz in adults and young infants with normal hearing function. A model, generated to fit adult DPOAE I/O functions will be used to fit infant functions to calculate forward and reverse transmission gain between the ear canal and cochlea. Changes in transmission gain will be evaluated in infants relative to adults, and across frequency in infants. This information may 1) help interpret age-related changes in OAE responses and 2) inform studies of infant speech perception and hearing sensitivity with regard to potential ear-canal/middle-ear effects. PUBLIC HEALTH RELEVANCE: Results from this study may help improve clinical procedures for the diagnosis and treatment of middle-ear dysfunction in infants. Also, information about how the ear canal and middle ear influence sound as it travels in and out of the ear may help explain developmental differences in clinical hearing test results.

描述(由申请人提供)：目标1：一个长期目标是确定准确检测婴儿中耳功能障碍的测试。对婴儿中耳功能的宽带(WB)测量可以克服传统单频中耳评估技术的局限性。拟议研究的目的1评估传统的1-kHz鼓室导纳测试和WB中耳测试(如反射、导纳)的测试性能，以衡量它们正确分类通过或参考门诊耳声发射(OAE)重新筛查测试结果的能力。测试性能将使用临床决策理论分析进行评估。识别有效的中耳功能测试，可用于新生儿听力筛查和后续再筛查，将1)帮助医疗保健专业人员更准确地解释和传达OAE和听性脑干反应(ABR)筛查和重新筛查测试结果，以及2)提高中耳评估的准确性，使之能够就额外诊断测试和/或转诊医疗的建议做出更明智的决定。目的2：另一个长期目标是更好地了解与年龄相关的耳道和中耳改变对耳道和耳蜗间正向和反向声音传递的影响。婴儿和成人耳声发射反应的差异可以用耳道和中耳效应来解释，但仅在6千赫。本研究的目的2是利用耳道和耳蜗之间的正向和反向传递函数，基于失真积(DP)OAEs的测量，研究婴儿中耳的传播特性。具体地说，听力功能正常的成年人和幼儿将在1.5至8 kHz的半倍频程频率下获得DPOAE输入/输出(I/O)功能。为适应成人DPOAE I/O功能而生成的模型将用于拟合婴儿功能，以计算耳道和耳蜗间的正向和反向传输增益。传播增益的变化将在婴儿中相对于成年人进行评估，并在婴儿中进行跨频率评估。这些信息可以1)帮助解释与年龄相关的OAE反应的变化，2)为关于潜在的耳道/中耳效应的婴儿言语感知和听力敏感度的研究提供信息。 公共卫生相关性：这项研究的结果可能有助于改进婴儿中耳功能障碍的诊断和治疗的临床程序。此外，有关耳道和中耳在声音进出耳朵时如何影响声音的信息，可能有助于解释临床听力测试结果的发育差异。