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

描述（由申请人提供）：目的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。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评价常规1 kHz鼓室导抗法和WB中耳测试（例如反射率、导纳）在门诊耳声发射（OAE）再筛查测试中正确分类通过或参考结果的能力方面的测试性能。将使用临床决策理论分析评价测试性能。鉴定可在新生儿听力筛查和后续再筛查期间使用的中耳功能的有效测试将1）帮助卫生保健专业人员更准确地解释和传达OAE和听性脑干反应（ABR）筛查和再筛查测试结果，以及2）提高中耳评估的准确性，使得能够就额外诊断测试和/或医疗护理转诊的建议做出更明智的决定。目标二：另一个长期目标是更好地了解耳道和中耳中与年龄相关的变化对耳道和耳蜗之间正向和反向声音传输的影响。婴儿和成人耳声发射反应的差异已被解释为耳道和中耳的影响，但只有在6千赫。目的2的拟议研究调查婴儿中耳传输特性，使用前向和反向传递函数之间的耳道和耳蜗的基础上测量失真产品（DP）OAE。具体而言，DPOAE输入/输出（I/O）功能将在1.5至8 kHz的半倍频程频率下在听力正常的成人和幼儿中获得。为拟合成人DPOAE I/O功能而生成的模型将用于拟合婴儿功能，以计算耳道和耳蜗之间的正向和反向传输增益。将评价婴儿相对于成人的传播增益变化，以及婴儿的频率变化。这些信息可能1）有助于解释OAE反应中与年龄相关的变化，2）为关于潜在耳道/中耳影响的婴儿言语感知和听力敏感性研究提供信息。 公共卫生相关性：这项研究的结果可能有助于改善婴儿中耳功能障碍的诊断和治疗的临床程序。此外，关于耳道和中耳如何影响声音进出耳朵的信息可能有助于解释临床听力测试结果的发育差异。

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.