Physiologically Derived DPOAE Measurement Methods

项目摘要/摘要 为了早期诊断导致早期干预，我们的诊断工具需要提供负担得起的、 可在任何医疗保健环境中进行方便、准确的听觉功能测试。事实上，失真乘积 耳声发射(DPOAE)测试为临床提供了一种客观、无创的检测手段 听力系统中与年龄相关的一个常见部位--外毛细胞的健康状况下降。DPOAE是一种 在新生儿听力筛查和其他听力学临床中广泛使用的熟悉工具 申请。我们认为DPOAE的测试性能可以通过将 方法用已知的哺乳动物耳蜗特定部位的机械特性来唤起它们。 目前使用的DPOAE测量方案未经优化以检测 整个耳蜗，特别是那些最早出现在耳蜗基底部的常见的与年龄相关的疾病。近期 校准技术和测量硬件的进步允许传递和记录准确的 高达20千赫的辐射水平[14-15]。这项提议通过开发一种 以耳蜗力学性能为指导的DPOAE测试方案及其测试性能评价。我们 将使用最先进的技术来校准刺激压力[-65]并校正DPOAE 压力[45]，以补偿耳道解剖中的个体差异，同时提供刺激 和记录DPOAE。刺激频率比和刺激水平将以一定的频率调整- 最大限度地产生DPOAE并提高听力筛查的测试性能的特定方式 听力损失和预测听力阈值。我们假设经过优化的DPOAE刺激参数 因为耳蜗处的刺激将唤起准确反映耳蜗健康的发射，因此 将与行为听力阈值密切相关。 我们计划追求以下目标：(1)开发一种新的优化的DPOAE测量协议 对于局部耳蜗力学特性，(2)评估新的DPOAE测量方法在 检测听力损失的存在，以及(3)将新的DPOAE测量方案应用于 听力阈值的预测。通过对生理学派生特征的详细研究 在年轻、听力正常的成年人中，我们预计DPOAE的幅度将显著相关 与听力正常和听力受损个体的行为听力阈值。 这项建议利用校准和测量硬件的最新发展来开发 DPOAE测量系统，针对本地耳蜗特性进行了优化。这些优化是意料之中的 为了显著提高DPOAE测试性能，将新测试定位为重要的、负担得起的、 可用于早期检测与年龄相关的耳蜗功能的工具。临床意义重大，因为 我们建议改进一种广为接受的临床工具，该工具可以很容易地自动化，以便广泛部署。

PROJECT SUMMARY/ABSTRACT For early diagnosis to lead to early intervention, our diagnostic tools need to provide affordable, accessible, and accurate tests of auditory function in any healthcare setting. As it is, distortion-product otoacoustic emission (DPOAE) testing provides an objective and noninvasive measure for evaluating the health of a common site of age-related declines in the auditory system – the outer hair cells. DPOAEs are a familiar tool due to their widespread use in newborn hearing screening and other audiological clinical applications. We contend that the test performance of DPOAEs can be improved significantly by aligning the methods to evoke them with known, place-specific mechanical properties of the mammalian cochlea. Currently utilized DPOAE measurement protocols are not optimized to detect dysfunction across the entire cochlea, especially those common age-related conditions that first manifest at the very base. Recent advances in calibration techniques and measurement hardware allows for delivery and recording of accurate emission levels up to 20 kHz [14-15]. This proposal tackles the remaining important step by developing a DPOAE test protocol guided by local cochlear mechanical properties and evaluating its test performance. We will use state-of-the art techniques for calibrating the stimulus pressure [64-65] and correcting the DPOAE pressure [45] to compensate for individual variations in ear canal anatomy while concurrently delivering stimuli and recording DPOAEs. The stimulus frequency ratio and stimulus levels will be adjusted in a frequency- specific manner to maximize DPOAE generation and improve test performance for both screening for hearing loss and predicting hearing thresholds. We hypothesize that DPOAE stimulus parameters that are optimized for the cochlear place of stimulation will evoke emissions that accurately reflect cochlear health and therefore will be closely related to behavioral hearing thresholds. We plan to pursue the following aims: (1) Develop a novel DPOAE measurement protocol optimized to local cochlear mechanical properties, (2) Evaluate the novel DPOAE measurement protocol in detecting the presence of hearing loss, and (3) Apply the novel DPOAE measurement protocol for the prediction of hearing thresholds. Through detailed investigation of physiologically derived characteristics of DPOAEs in young, normal-hearing adults, we expect that DPOAE amplitudes will be significantly correlated with behavioral hearing thresholds in normal-hearing and hearing-impaired individuals. This proposal leverages the latest developments in calibration and measurement hardware to develop a DPOAE measurement system that is optimized for local cochlear properties. These optimizations are expected to improve DPOAE test performance significantly positioning the new test as an important, affordable, and accessible tool for early detection of age-related cochlear function. The clinical implications are significant as we propose to improve a well-accepted clinical tool that can easily be automated for widespread deployment.