Middle-ear reflex testing using wideband acoustic immittance

使用宽带声导抗进行中耳反射测试

• 批准号: 10260596
• 负责人: LINDA J. HOOD
• 金额: $ 78.72万
• 依托单位: MIMOSA ACOUSTICS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-05 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10260596
• 关键词: Academic Medical Centers; Acoustics; Address; Adult; Affect; Age; Area; Audiology; Auditory; Binaural; Brain Stem; Calibration; Characteristics; Child; Clinical; Clinical Protocols; Collaborations; Computer software; Conductive hearing loss; Contralateral; Data; Development; Devices; Diagnostic; Disease; Ear; Evaluation; External auditory canal; Fostering; Frequencies; Growth; Infant; Ipsilateral; Lead; Link; Longevity; Manuals; Measurement; Measures; Methods; Mimosa; Morphologic artifacts; Nature; Nerve; Neural Pathways; Neurophysiology - biologic function; Newborn Infant; Pathway interactions; Patients; Pattern; Persons; Phase; Physiological; Population; Process; Publishing; Recording of previous events; Reflex action; Research; Secure; Sensory; Source; Stimulus; Synapses; System; Techniques; Testing; Time; Uncertainty; Universities; Variant; Work; aged; automated analysis; base; behavioral response; clinical development; clinical practice; design; ear muscle; electric impedance; flexibility; hearing impairment; hearing screening; human subject; improved; innovation; middle ear; middle ear disorder; normal hearing; novel strategies; patient response; phase 1 study; postsynaptic; prototype; relating to nervous system; research clinical testing; response; sound; standard of care; tool; user-friendly

PROJECT SUMMARY/ABSTRACT The objective of this project is to build and evaluate a middle-ear muscle reflex (MEMR) test system that is based on measurement of wideband acoustic immittance (WAI). This WAI-MEMR system will be accurate, scientifically and technically sound, stable, reliable, safe, and clinician friendly. Acoustically elicited MEMRs have a long history of value in the clinical evaluation of hearing loss. While sensitive to and affected by middle- ear disorders linked to conductive hearing losses, MEMRs also demonstrate particular sensitivity to synaptic and postsynaptic disorders related to the eighth nerve and auditory brainstem pathways through activation of neural pathways ipsilateral and contralateral to the physiologic middle-ear response. MEMRs are objective in providing information rapidly without requiring behavioral responses from the patient, and this objectivity facilitates their use in infants. Measuring MEMRs in the context of WAI provides clear advantages over current methods based on the ability to evaluate responses over a broader frequency range and to elicit responses to lower-intensity stimuli. The broadband nature of WAI is a well-documented advantage in infant testing. However, even though MEMR is a robust and sensitive measure, it is underutilized clinically on account of concerns that include subjectivity in response determination, intrasubject variation, uncertainty about MEMR response presence, and lack of confidence among clinicians in interpreting responses. The specific aims for this Phase II project are to (1) build a dual-probe WAI-MEMR system that is capable of ipsilateral, contralateral, and binaural stimulus paradigms and allows flexible and precise manipulation of test parameters; (2) develop automated processes for analyzing and quantifying WAI-MEMR responses to provide a method for objective test interpretation; (3) develop and test artifact rejection methods, a user-friendly probe, and calibration methods; (4) define stimulus and acquisition parameters further through human-subject testing of infants, children, and adults with normal hearing and with hearing loss; and (5) implement new paradigms and evaluate the new Phase II dual-channel system in adults and infants with normal hearing. The accomplishments completed during Phase I have resulted in a prototype dual-probe system that has been tested in adults with normal hearing and hearing loss with promising results. Work has begun toward automated analysis as well as defining frequency, amplitude, and threshold characteristics in infants and adults. The ongoing, productive collaboration between Dr. Jeng at Mimosa Acoustics and Dr. Hood at Vanderbilt University will continue throughout the Phase II project period for the development and evaluation of the WAI-MEMR approach. Creating hardware and software that uses this approach should reduce subjectivity in clinician interpretation and encourage increased clinical utilization and application in patients of all ages. In addition, the expanded capabilities that both WAI and a dual-probe system provide will foster advancement in understanding the characteristics of the MEMR in various populations and facilitate applications in clinical practices.

项目摘要/摘要 该项目的目的是构建和评估中耳肌肉反射（MEMR）测试系统 基于测量宽带声学止痛（WAI）。这个WAI-MEMR系统将是准确的， 科学和技术上的声音，稳定，可靠，安全和临床医生友好。声学引起的梅尔 在听力损失的临床评估中有悠久的价值历史。虽然对中间的敏感和影响 与导电性听力损失有关的耳部疾病，MEMR还表现出对突触的特殊敏感性 通过激活与第八神经和听觉的脑干途径有关的突触后疾病 神经途径的同侧和与生理中间反应的对侧。 MEMR是客观的 迅速提供信息而无需患者的行为反应，而这种客观性 促进他们在婴儿中的使用。在WAI的背景下测量MEMR，比当前具有明显的优势 基于评估频率范围内响应并引起对响应的能力的方法 低强度刺激。 WAI的宽带性质是婴儿测试中有据可查的优势。 但是，即使MEMR是一种强大且敏感的措施，但由于 关注包括主观性确定的主观性，主体内变化，对MEMR的不确定性 临床医生在解释反应方面的反应存在以及缺乏信心。具体目标 该第二阶段项目是（1）构建一个双重探针WAI-MEMR系统，该系统具有同侧，对侧， 和双耳刺激范式，并允许对测试参数的灵活而精确的操纵； （2）发展 用于分析和量化WAI-MEMR响应的自动化过程，以提供目标的方法 测试解释； （3）开发和测试伪影拒绝方法，一种用户友好的探针和校准 方法; （4）通过对婴儿的人类受试者测试进一步定义刺激和采集参数， 儿童，听力正常和听力损失的成年人； （5）实施新范式并评估 新的II期双通道系统在成人和婴儿正常的婴儿中。成就 在阶段我完成的完成，产生了一个原型双探针系统，该系统已在成人中进行了测试 正常的听力和听力损失，有希望的结果。工作已经开始进行自动分析以及 定义婴儿和成人的频率，振幅和阈值特征。正在进行的，富有成效的 Mimosa Acoustics的Jeng博士与范德比尔特大学的Hood博士之间的合作将继续 在整个II期项目期间，用于开发和评估WAI-MEMR方法。 创建使用这种方法的硬件和软件应降低临床医生解释中的主观性 并鼓励在所有年龄段的患者中增加临床利用和应用。此外，扩展了 WAI和双探针系统提供的功能将促进理解 MEMR在各种人群中的特征，并促进在临床实践中的应用。