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

描述(申请人提供)：新生儿听力筛查的目标是确定婴儿患有感觉神经性听力损失(SNHL)，但未通过筛查的新生儿大多是传导性听力损失(CHL)而不是感觉神经性听力损失，导致假阳性率高，后续诊断评估昂贵。罗德岛的研究(1993)表明，慢性淋巴细胞性白血病的患病率比非霍奇金淋巴瘤高17‰，而非恶性淋巴瘤的患病率为3-6‰。而在NICU，CHL的患病率比SNHL的患病率上升到36/1000，而SNHL的患病率为23/1000。SNHL和CHL的后果是不同的，因此对新生儿听力筛查时的损失进行准确的分类是至关重要的。该方案的主要目标是建立一种听力筛查装置，将宽带反射测量系统(RMS)和DPOAE测量系统结合在一起，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，在一次测试中，既要评估传导路径，也要评估耳蜗状态。由于反射率测量和DPOAE测量使用相同的测量，使用组合筛查设备进行听力筛查所需的额外时间将不会超过几分钟。预期结果的好处是降低了假阳性率，降低了随访诊断成本，并减少了父母的担忧。 第一阶段的具体目标是(1)论证在听力筛查样机中结合使用失真产物耳声发射(DPOAE)和宽带功率反射比测量(WB-PR)来区分传导性疾病(CD)和内耳病变(IEP)的可行性。(2)研制了一台样机，演示了利用宽带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.