Advanced Detection and Differential Diagnosis of Hearing Loss Using Otoacoustic Emissions

利用耳声发射对听力损失进行高级检测和鉴别诊断

• 批准号: 10021315
• 负责人: Carolina Abdala
• 金额: $ 46.41万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10021315
• 关键词: Audiology; Auditory; Calibration; Clinic; Clinical; Cochlea; Computer software; Decision Theory; Detection; Diagnosis; Diagnostic; Diagnostic Specificity; Diagnostic tests; Differential Diagnosis; Etiology; External auditory canal; Factor Analysis; Frequencies; Functional disorder; Goals; Health; Hearing; Hearing Tests; Individual; Intervention; Joints; Laboratories; Least-Squares Analysis; Measurement; Measures; Methods; Modernization; Monitor; Morphologic artifacts; Outcome; Participant; Pathology; Performance; Procedures; Property; Protocols documentation; Research; Resolution; Sensorineural Hearing Loss; Sensory; Source; Speed; Stimulus; System; Techniques; Test Result; Testing; Time; Translating; Weight; base; cohesion; cohort; hearing impairment; improved; innovation; normal hearing; otoacoustic emission; personalized intervention; preservation; pressure; programs; relating to nervous system; research clinical testing; user friendly software; user-friendly

Project Summary Most sensory hearing loss is diagnosed and treated with little distinction. Indeed, ”sensorineural hearing loss” is a catch-all term. However, promising results over the last few years suggest that otoacoustic emissions (OAEs) can distinguish among sensory hearing losses that appear similar by audiogram. OAEs are non- invasive indicators of cochlear health and dysfunction that can be recorded in normal hearers and those with up to moderate degrees of hearing impairment. Though they offer a non-invasive, pre-neural window into the cochlea, their application in the audiology clinic has stagnated over the last two decades despite significant advances in the laboratory. Current clinical utility of OAEs includes only the detection of hearing loss; nothing is learned about the etiology of the hearing loss once detected. This project proposes to translate into the audiology clinic a rapid, research-proven technique to evoke OAEs with sweeping tones, allowing for the efficient, near-simultaneous recording of the two basic OAE classes: emissions produced by cochlear nonlinearities such as the distortion-product OAE (DPOAE), and those produced by cochlear reflections such as the stimulus-frequency OAE (SFOAE). These two types of emissions elucidate distinct cochlear properties, and each is uniquely sensitive to different auditory pathologies and etiologies. Analyzing combined OAE outcomes produces new relational metrics that exploit the unique diagnostic information offered by both, which initiates differential diagnosis of sensory hearing loss. Additionally, our advanced OAE system has incorporated innovative calibration techniques that mitigate the effects of ear-canal standing-wave interference, a known source of undesirable variability. These advanced calibrations improve the test-retest reliability of emissions, which allows for more accurate serial monitoring of hearing status and an expanded high-frequency test range. In this project, we will: 1) integrate existing software modules that calibrate, measure, and analyze swept-tone OAEs into a cohesive and user-friendly software program for the interleaved recording of DPOAEs and SFOAEs; 2) analyze DPOAE and SFOAE measures in a combined fashion to detect and monitor hearing loss and perform differential diagnosis for hearing impairments of confirmed etiology; and 3) strategically pare down the Combined-OAE Profile and validate its performance in an independent group of participants to produce an abbreviated clinical test for the diagnosis of sensory hearing loss. These steps will modernize and advance OAE assessment well beyond the rudimentary goal of detecting hearing loss and provide a degree of diagnostic specificity that will facilitate personalized intervention for individuals with hearing loss.

项目摘要 大多数感觉性听力损失的诊断和治疗几乎没有区别。事实上，“感觉神经性听力损失” 是一个包罗万象的术语然而，在过去几年里，有希望的结果表明，耳声发射， 耳声发射（OAEs）可以区分听力图显示相似的感觉性听力损失。OAE是非- 耳蜗健康和功能障碍的侵入性指标，可以在正常听力者和那些 中度以上听力障碍。虽然它们提供了一个非侵入性的，前神经窗口， 耳蜗，它们在听力学诊所的应用在过去二十年中停滞不前，尽管有显著的进展， 实验室的进步。目前耳声发射的临床应用仅包括听力损失的检测; 听力损失的病因是什么？该项目旨在将 听力学诊所是一种快速的、经研究证明的技术，可以用扫频音调诱发耳声发射， 有效的，几乎同时记录两个基本的OAE类：由耳蜗产生的排放 非线性，如畸变产物OAE（DPOAE），以及由耳蜗反射产生的非线性， 刺激频率耳声发射（SFOAE）。这两种类型的发射阐明了不同的耳蜗特性， 并且每一种都对不同的听觉病理和病因唯一敏感。分析组合OAE 结果产生了新的关系指标，利用两者提供的独特诊断信息， 对感觉性听力损失进行鉴别诊断。此外，我们先进的OAE系统 结合了创新的校准技术，可以减轻耳道驻波干扰的影响， 已知的不希望的可变性的来源。这些先进的校准提高了 发射，这允许更准确的听力状态和扩展的高频串行监测 测试范围在这个项目中，我们将：1）整合现有的软件模块，校准，测量和分析 将扫音OAE转换为内聚且用户友好的软件程序，用于交错记录DPOAE 和SFOAE; 2）以组合方式分析DPOAE和SFOAE测量以检测和监测听力 听力损失，并对已确认病因的听力障碍进行鉴别诊断;以及3）战略性帕雷 在独立的参与者组中验证其性能， 制作一个简短的临床测试来诊断感觉性听力损失。这些措施将使现代化， 使OAE评估远远超出检测听力损失的基本目标，并提供一定程度的 诊断特异性，这将有助于对听力损失患者进行个性化干预。