OTOACOUSTIC EMISSION COCHLEOGRAPHY

我们研究计划的长期目标是建立一种临床 基于失真度积耳声测试的耳蜗声功能测试 排放(DPOAE)。到目前为止，这个项目的工作已经产生了 几种可应用的DPOAE测试协议的开发 在包括儿科和成人在内的实际环境中有效 听力学诊断诊所。这项研究计划已经完成 在我们的实验室同时进行基础动物研究(由其他 资料来源)旨在更好地了解 耳声发射(OAE)产生。计划中的这方面的研究 相互竞争的续订提案侧重于四个独立但相互关联的方案 具体目标：(一)提高DPOAES的检测灵敏度 通过优化刺激参数实现感音神经性耳聋 用于测量DPOAE。具体地说，我们将审查 F_2/F_1比值对正常耳朵LI-L2最佳水平差异的研究 直接确定这些刺激效果的纯音暴露 参数，并证明了优化的DPOAE-刺激参数 提高SNHL患者耳蜗病的检测水平。(2) 使用基于决策理论的分析来评估测试性能 DPOAES和瞬变诱发耳声发射(TEOAEs)的特点我们 将检查我们当前的数据库以确定这两个因素的影响 集成发射的带宽和听力水平标准， 采用优化的DPOAEs刺激参数以及以下程序 最大限度地降低噪音，形成新的数据库，以重新评估测试 DPOAE在最佳刺激条件下的性能，并使用这些 联合数据库评估听力损失病因对儿童听力的影响 OAE-测试性能。(3)采用多元回归/相关分析 为了确定DPOAE水平和/或检测阈值的程度， 优化后的DPOAE-L/O函数可靠地估计听力 水平。(4)确定DPOAE生产的其他措施是否除 幅度提供了对确定状态有用的新信息 对耳蜗功能的影响。具体地说，DPOAE抑制将以 正常耳朵确定最佳参数，然后进行评估 SNHL的检测。DPOAE延迟将通过直接测量确定 时间波形起始潜伏期和群发延迟程序的影响。最多的 将评估可靠的DPOAE潜伏期测量对耳蜗的敏感度 纯音暴露的创伤和SNHL患者的研究。终于 2F2-F1 DPOAE将通过以下方式测试其对轻度耳蜗损伤的敏感性 使用纯色调曝光和性能检测SNHL 通过确定正常与受损的排放量中的减少量进行评估 耳朵。这些研究的完成将大大增加 我们对DPOAE和OAE临床能力的理解 将军。

The long term goal of our program of research is to establish a clinical test of cochlear function based upon distortion-product otoacoustic emissions (DPOAEs). To date, the work on this project has resulted in the development of several DPOAE-test protocols which can be applied effectively in practical settings including the pediatric and adult diagnostic-audiology clinics. This program of research has been performed in our laboratory in parallel with basic animal studies (funded by other sources) designed to provide a better understanding of the nature of otoacoustic emission (OAE) generation. The planned studies of this competing renewal proposal focus on four separate, but interrelated specific aims: (i) improve the sensitivity of DPOAEs for detecting sensorineural hearing loss (SNHL) by optimizing the stimulus parameters used to measure DPOAEs. Specifically, we will examine the influence of the f2/f1 ratio on optimum LI-L2 level differences in normal ears, utilize pure-tone exposures to directly determine the effects of these stimulus parameters, and demonstrate that optimized DPOAE-stimulus parameters improve the detection of cochlear deficits in patients with SNHL. (2) employ analyses based upon decision theory to evaluate test-performance features of DPOAEs and transient-evoked otoacoustic emissions (TEOAEs). We will examine our current databases to determine the influences of both the bandwidth over which emissions are integrated and hearing level criteria, employ optimized DPOAEs stimulus parameters along with procedures that maximize noise reduction to form a new databases to re-evaluate the test performance of DPOAEs under optimal-stimulation conditions, and use these combined databases to evaluate the influence of hearing-loss etiology on OAE-test performance. (3) employ multiple regression/correlation analyses to determine the extent that DPOAE level and/or detection thresholds, obtained from the optimized DPOAE-l/O functions reliably estimate hearing level. (4) determine if other measures of DPOAE production in addition to amplitude provide new information that is useful for determining the status of cochlear function. Specifically, DPOAE suppression will be measured in normal ears to determine optimal parameters and then evaluated for the detection of SNHL. DPOAE latency will be determined by direct measurement of time waveform onset latencies and from group delay procedures. The most reliable DPOAE latency measures will assessed for sensitivity to cochlear trauma with pure-tone exposures and studies in patients with SNHL. Finally the 2f2-f1 DPOAE will be tested for sensitivity to mild cochlear trauma by employing pure-tone exposures and performance for detection of SNHL evaluated by determining reductions in this emission in normal vs impaired ears. Completion of these studies will result in a significant increase in our understanding of the clinical capabilities of DPOAEs and OAEs, in general.