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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要事实上，大多数感觉性听力损失的诊断和治疗与“感音神经性听力损失”没有什么区别。然而，过去几年的有希望的结果表明耳声发射。 (OAE) 可以区分听力图上相似的感觉性听力损失和非非感觉性听力损失。可以在正常听力者和听力正常者中记录耳蜗健康和功能障碍的侵入性指标尽管它们提供了一个非侵入性的、前神经窗口来了解听力。耳蜗，尽管其在听力学诊所的应用在过去二十年中停滞不前，尽管目前 OAE 的临床应用仅包括听力损失的检测；一旦检测到听力损失的病因，该项目建议将其转化为了解。听力学诊所是一种快速、经过研究证明的技术，可以通过清脆的音调唤起 OAE，从而使高效、几乎同时记录两个基本 OAE 类别：人工耳蜗产生的发射非线性，例如畸变产物 OAE (DPOAE)，以及由耳蜗反射产生的非线性，例如作为刺激频率 OAE (SFOAE)，这两种类型的发射阐明了不同的耳蜗特性，每个对不同的听觉病理学和病因都有独特的敏感性。结果产生新的关系指标，利用两者提供的独特诊断信息，这此外，我们先进的 OAE 系统还具有感知性听力损失的鉴别诊断功能。结合了创新的校准技术，可减轻耳道驻波干扰的影响，这些先进的校准提高了重复测试的可靠性。发射，可以更准确地连续监测听力状态和扩展的高频在这个项目中，我们将：1）集成现有的校准、测量和分析软件模块。将扫频 OAE 集成到一个连贯且用户友好的软件程序中，用于 DPOAE 的交错记录和 SFOAE；2) 以组合方式分析 DPOAE 和 SFOAE 测量，以检测和监测听力损失并对已确定病因的听力障碍进行鉴别诊断；3) 策略性地减少听力损失；记录组合 OAE 概况并在独立的参与者组中验证其性能为诊断感觉性听力损失进行简化的临床测试，这些步骤将实现现代化和现代化。 OAE 评估远远超出了检测听力损失的基本目标，并提供了一定程度的诊断特异性将有助于对听力损失患者进行个性化干预。