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.

项目概要/摘要 该项目的目标是构建和评估中耳肌肉反射 (MEMR) 测试系统 基于宽带声导抗（WAI）的测量。这个 WAI-MEMR 系统将是准确的， 科学技术合理、稳定可靠、安全、临床友好。声学诱发 MEMR 在听力损失的临床评估方面具有悠久的价值。虽然对中层敏感并受其影响 与传导性听力损失相关的耳部疾病，MEMR 还表现出对突触的特殊敏感性 和通过激活与第八神经和听觉脑干通路相关的突触后疾病 中耳生理反应的同侧和对侧神经通路。 MEMR 是客观的 快速提供信息而不需要患者的行为反应，并且这种客观性 方便其在婴儿中的使用。在 WAI 背景下测量 MEMR 比当前的方法具有明显的优势 基于在更广泛的频率范围内评估响应并引发响应的能力的方法 较低强度的刺激。 WAI 的宽带特性在婴儿测试中是一个有据可查的优势。 然而，尽管 MEMR 是一种稳健且敏感的测量方法，但由于以下原因，它在临床上并未得到充分利用： 关注点包括响应确定的主观性、受试者内部变异、MEMR 的不确定性 反应的存在，以及临床医生对解释反应缺乏信心。具体目标为 该二期项目的目标是 (1) 构建双探头 WAI-MEMR 系统，能够进行同侧、对侧、 和双耳刺激范例，并允许灵活、精确地操纵测试参数； (2) 开发 用于分析和量化 WAI-MEMR 响应的自动化流程，以提供一种客观的方法 测试解释； (3) 开发和测试伪影剔除方法、用户友好的探头和校准 方法; (4) 通过对婴儿进行人体测试进一步定义刺激和采集参数， 听力正常和有听力损失的儿童和成人； (5) 实施新范式并评估 新的二期双通道系统适用于听力正常的成人和婴儿。所取得的成就 第一阶段完成的双探针系统原型已在成人中进行了测试 正常听力和听力损失，效果良好。自动化分析的工作已经开始 定义婴儿和成人的频率、幅度和阈值特征。持续的、富有成效的 Mimosa Acoustics 的 Jeng 博士和范德比尔特大学的 Hood 博士之间的合作将继续 在 WAI-MEMR 方法的开发和评估的第二阶段项目期间。 创建使用这种方法的硬件和软件应该减少临床医生解释中的主观性 并鼓励增加所有年龄段患者的临床利用和应用。此外，扩展的 WAI 和双探针系统提供的功能将促进对 MEMR在不同人群中的特点，并促进其在临床实践中的应用。