A Wide-band Reflectance - DPOAE (WR-DP)Screener

描述（申请人提供）：新生儿听力筛查的目的是识别感音神经性听力损失（SNHL）的婴儿，但大多数筛查失败的新生儿是传导性听力损失（CHL）而不是感音神经性听力损失，导致假阳性率高，后续诊断评估费用高。罗得岛研究（1993年）表明，CHL的患病率为17/1000，SNHL为3-6/1000。而在NICU中，CHL的患病率高于SNHL，分别为36/1000和23/1000。SNHL和CHL的后果是不同的，因此在新生儿听力筛查时准确分型是必不可少的。本提案的主要目的是构建一种听力筛查设备，该设备将宽带反射测量系统（RMS）与DPOAE测量系统结合为一个系统，其中前者提供传导性听力损失的诊断评估，后者提供SNHL的诊断评估。因此，在一个测试中，评估传导路径和耳蜗状态两者。由于反射率测量和DPOAE测量共享相同的测量，因此使用组合筛查设备执行听力筛查所需的额外时间将不超过几分钟。预期结果的好处是降低假阳性率，降低随访诊断成本，减少父母的担忧。 第一阶段的具体目标是（1）通过在用于听力筛查原型仪器的单个仪器中结合使用畸变产物耳声发射（DPOAE）和宽带功率反射测量（WB-PR），证明区分传导障碍（CD）和内耳病变（IEP）的可行性。(2)开发一个原型仪器，证明使用WB-PR解决驻波问题的可行性。

DESCRIPTION (provided by applicant): The goal of newborn hearing screening is to identify infants with sensorineural hearing loss (SNHL), but most neonates who fail screening have conductive hearing loss (CHL) rather than sensorineural hearing loss, resulting in high false positive rate and costly follow-up diagnostic evaluation. The Rhode Island study (1993) has shown that the prevalence of CHL over SNHL to be 17 vs. 3-6 per 1000. While in NICU the prevalence of CHL over SNHL raises to 36 vs. 23 per 1000. The ramifications of SNHL and CHL are different, so an accurate typing of the loss at the time of a newborn hearing screening is essential. This main objective of this proposal is to build a hearing screening device that combines wideband reflectance measurement system (RMS) with DPOAE measurement system into one system, where the former provides diagnostic evaluation for conductive hearing loss and the later provides diagnostic evaluation for the SNHL. So in one test, both conductive path and cochlear status are evaluated. Since both the reflectance measurement and the DPOAE measurement share an identical measurement, the extra time needed to perform hearing screening using the combined screening device will be no more than few minutes. The benefit of the expected outcome is reduced false positive rate, reduce follow up diagnostic cost, and reduced parental concern. The specific aims of Phase I is (1) to demonstrate the feasibility of distinguishing between conductive disorders (CD) and the inner ear pathologies (IEP) by combining the use of distortion product otoacoustic emission (DPOAE) and wide-band power reflectance measurements (WB-PR) in a single instrument used for hearing screening prototype instrument. (2) To develop a prototype instrument that will demonstrate the feasibility of using WB-PR to address the standing wave problem.