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1.
DPOAE input/output (I/O) functions were measured at 7f2 frequencies (1 to 8 kHz; f2/f1 = 1.22) over a range of levels (-5 to 95 dB SPL) in normal-hearing and hearing-impaired human ears. L1-L2 was level dependent in order to produce the largest 2f1-f2 responses in normal ears. System distortion was determined by collecting DP data in six different acoustic cavities. These data were used to derive a multiple linear regression model to predict system distortion levels. The model was tested on cochlear-implant users and used to estimate system distortion in all other ears. At most but not all f2's, measurements in cochlear implant ears were consistent with model predictions. At all f2 frequencies, the ears with normal auditory thresholds produced I/O functions characterized by compressive nonlinear regions at moderate levels, with more rapid growth at low and high stimulus levels. As auditory threshold increased, DPOAE threshold increased, accompanied by DPOAE amplitude reductions, notably over the range of levels where normal ears showed compression. The slope of the I/O function was steeper in impaired ears. The data from normal-hearing ears resembled direct measurements of basilar membrane displacement in lower animals. Data from ears with hearing loss showed that the compressive region was affected by cochlear damage; however, responses at high levels of stimulation resembled those observed in normal ears.  相似文献   

2.
The medial olivocochlear efferent (MOC) system enhances signals in noise and helps mediate auditory attention. Contralateral suppression (CS) of distortion product otoacoustic emissions (DPOAEs) has revealed age-related MOC declines. Here, differences in CS as a function of contralateral noise intensity (43-67 dB sound pressure level) were measured; 2f1-f2 DPOAE grams were recorded for young adult CBA and C57 mice. In CBAs, CS was a monotonic function of contralateral noise level. The C57s showed normal hearing, measured with DPOAE amplitudes and auditory brainstem response thresholds, but showed little CS, suggesting a loss of efferent dynamics preceding any deficiencies of the afferent auditory system.  相似文献   

3.
Nonlinear phenomena as observed in the ear canal and at the auditory nerve   总被引:1,自引:0,他引:1  
We report here several measures of nonlinear effects in the mammalian ear made in the external auditory meatus and in single neurons of the auditory nerve. We have measured the 2f1-f2 and the f2-f1 distortion products and we have found that the neural distortion product threshold curve for 2f1-f2 mirrors the low-frequency side of the frequency threshold curve, when the neural distortion product threshold curve of 2f1-f2 is plotted versus log(f2/f1) its slope is about 50 dB/oct and its intercept is 10-20 dB above the frequency threshold at the characteristic frequency CF, substantial 2f1-f2 distortion was seen in all animals studied while the f2-f1 distortion product was only rarely found at substantial levels, and the distortion product pressure observed in the ear canal was at a level equal to that detected at threshold by the neural units under study. We have also made measurements of two-tone rate suppression thresholds using two new and consistent threshold paradigms. We find that for high and intermediate characteristic frequency neural units the suppression threshold is independent of frequency and at a level of about 70 dB SPL, the suppression above CF is much less than below CF, and the tip of the frequency tuning curve can be suppressed by up to 40 dB by a low-frequency suppressor.  相似文献   

4.
Distortion product otoacoustic emissions and auditory brainstem responses (ABRs) were measured in neonatal gerbils at three ages: at 15-16 days after birth (dab), near the onset of hearing when the endocochlear potential (EP) is known to be still immature; at 22 dab, when the EP first reaches mature levels; and at 30 dab. Comparing individual 15-16 dab animals to the 22 dab group, ABR threshold changes were typically larger than those for cubic distortion tone (CDT, 2f1-f2) emission thresholds which were, in turn, larger than those for the simple difference tone (DT, f2-f1). In contrast, from 22 to 30 dab there were no important changes in CDT or DT emission thresholds. Observed threshold-change relationships were very similar to those found in differential diagnosis investigations, where the EP was experimentally decreased using a chronic furosemide application. Therefore, most of the change in cochlear function over the two week period studied could be attributed to the maturation of EP during the first week. Model calculations further show that relative changes in CDT and DT emission thresholds are compatible with a movement of the operating point of the cochlear amplifier toward its symmetrical "central" point as the EP reaches mature levels.  相似文献   

5.
A new method for direct pure-tone threshold estimation from input/output functions of distortion product otoacoustic emissions (DPOAEs) in humans is presented. Previous methods use statistical models relating DPOAE level to hearing threshold including additional parameters e.g., age or slope of DPOAE I/O-function. Here we derive a DPOAE threshold from extrapolated DPOAE I/O-functions directly. Cubic 2 f1-f2 distortion products and pure-tone threshold at f2 were measured at 51 frequencies between f2=500 Hz and 8 kHz at up to ten primary tone levels between L2=65 and 20 dB SPL in 30 normally hearing and 119 sensorineural hearing loss ears. Using an optimized primary tone level setting (L1 = 0.4L2 + 39 dB) that accounts for the nonlinear interaction of the two primaries at the DPOAE generation site at f2, the pressure of the 2 f1-f2 distortion product pDP is a linear function of the primary tone level L2. Linear regression yields correlation coefficients higher than 0.8 in the majority of the DPOAE I/O-functions. The linear behavior is sufficiently fulfilled for all frequencies in normal and impaired hearing. This suggests that the observed linear functional dependency is quite general. Extrapolating towards pDP=0 yields the DPOAE threshold for L2. There is a significant correlation between DPOAE threshold and pure-tone threshold (r=0.65, p<0.001). Thus, the DPOAEs that reflect the functioning of an essential element of peripheral sound processing enable a reliable estimation of cochlear hearing threshold up to hearing losses of 50 dBHL without any statistical data.  相似文献   

6.
Temporal modulation transfer functions were obtained using sinusoidal carriers for four normally hearing subjects and three subjects with mild to moderate cochlear hearing loss. Carrier frequencies were 1000, 2000 and 5000 Hz, and modulation frequencies ranged from 10 to 640 Hz in one-octave steps. The normally hearing subjects were tested using levels of 30 and 80 dB SPL. For the higher level, modulation detection thresholds varied only slightly with modulation frequency for frequencies up to 80 Hz, but decreased for high modulation frequencies. The decrease can be attributed to the detection of spectral sidebands. For the lower level, thresholds varied little with modulation frequency for all three carrier frequencies. The absence of a decrease in the threshold for large modulation frequencies can be explained by the low sensation level of the spectral sidebands. The hearing-impaired subjects were tested at 80 dB SPL, except for two cases where the absolute threshold at the carrier frequency was greater than 70 dB SPL; in these cases a level of 90 dB was used. The results were consistent with the idea that spectral sidebands were less detectable for the hearing-impaired than for the normally hearing subjects. For the two lower carrier frequencies, there were no large decreases in threshold with increasing modulation frequency, and where decreases did occur, this happened only between 320 and 640 Hz. For the 5000-Hz carrier, thresholds were roughly constant for modulation frequencies from 10 to 80 or 160 Hz, and then increased monotonically, becoming unmeasurable at 640 Hz. The results for this carrier may reflect "pure" effects of temporal resolution, without any influence from the detection of spectral sidebands. The results suggest that temporal resolution for deterministic stimuli is similar for normally hearing and hearing-impaired listeners.  相似文献   

7.
Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. The standard procedure consists of recording the 2f1-f2 DPOAE amplitude as a function of the f2 frequency, using a fixed f2/f1 ratio (DPOAE-gram), close to 1.20. DPOAE amplitude, as recorded in the DPOAE-gram, shows a wide range of values in normal-hearing subjects, which can impair the predictive value of the DPOAE-gram for hearing thresholds. This study is aimed at comparing intersubject variability in 2f1-f2 DPOAE amplitude according to three paradigms: a fixed f2/f1 ratio, such as the DPOAE-gram, a variable ratio DPOAE-gram (f2/f1 adapted to frequency) and an "optimum" DPOAE-gram, where the f2/f1 is adapted both to subject and frequency. The 2f1-f2 DPOAE amplitude has been investigated on 18 normally hearing subjects at ten different f2 frequencies (from 0.75 to 6 kHz), using an f2 fixed, f1 sweep paradigm, and allowed to define, for each frequency, the f2/f1 ratio giving the greatest 2f1-f2 DPOAE amplitude (or optimum ratio). Results showed a large intersubject variability of the optimum ratio, especially at frequencies below 1.5 kHz, and a significant decrease of the optimum ratio with frequency. The optimum DPOAE-gram was underestimated by up to 5.8 dB on average (up to 14.9 dB for an individual subject) by the fixed ratio DPOAE-gram, and by up to 3 dB on average (up to 10.6 dB for an individual subject) by the variable ratio DPOAE-gram. Intersubject variability was slightly but significantly reduced in the optimum DPOAE-gram versus the fixed-ratio DPOAE-gram. Lastly, correlations between tone-burst evoked otoacoustic emission (TBOAE) amplitudes and maximum DPOAE amplitudes were significantly greater than correlations between TBOAE amplitudes and fixed-ratio DPOAE amplitudes.  相似文献   

8.
Both distortion product otoacoustic emissions (DPOAEs) and auditory steady-state responses (ASSRs) provide frequency-specific assessment of hearing. However, each method suffers from some restrictions. Hearing losses above 50 dB HL are not quantifiable using DPOAEs and their performance at frequencies below 1 kHz is limited, but their recording time is short. In contrast, ASSRs are a time-consuming method but have the ability to determine hearing thresholds in a wider range of frequencies and hearing losses. Thus, recording DPOAEs and ASSRs simultaneously at their adequate frequencies and levels could decrease the overall test time considerably. The goal of the present study was to develop a parameter-setting and test-protocol to measure DPOAEs and ASSRs binaurally and simultaneously at multiple frequencies. Ten normal-hearing and 23 hearing-impaired subjects participated in the study. The interaction of both responses when stimulated simultaneously at frequencies between 0.25 and 6 kHz was examined. Two limiting factors need to be kept. Frequency distance between ASSR carrier frequency f(c) and DPOAE primary tone f(2) needs to be at least 1.5 octaves, and DPOAEs may not be measured if the ASSR stimulus level is 70 dB SPL or above. There was a significant correlation between pure-tone and DPOAE/ASSR-thresholds in sensorineural hearing loss ears.  相似文献   

9.
The aim of this study was to examine susceptibility to noise-induced hearing loss in animals with and without age-related hearing loss (AHL), using cubic distortion product otoacoustic emissions (CDPs) to assess the functional status of the outer hair cell (OHC) system. Subjects were young (< or = 3-yr-old) and aged (10- to 15-yr-old) chinchillas. CDP thresholds and input/output (I/O) functions were measured before and after exposure to 95 dB or 106 dB SPL low-frequency noise. The results indicate that (a) aging in the chinchilla is associated with significant elevations of CDP thresholds and depression of CDP I/O functions, (b) noise exposures cause equivalent CDP threshold elevations and amplitude reductions in young animals with normal hearing and older animals with AHL, and (c) CDP threshold and amplitude measures provide information that complements evoked potentials measured from the auditory midbrain.  相似文献   

10.
Frequency resolution (viz., masking by low-pass-filtered noise and broadband noise) and temporal resolution (viz., masking by interrupted noise) were compared with hearing thresholds and acoustic reflex thresholds for four normally hearing and 13 cochlearly impaired subjects. Two models, one for frequency resolution (model I) and one for temporal resolution (model II), were introduced, and these provided a means of predicting individual frequency and temporal resolution from hearing thresholds for both normal-hearing and hearing-impaired listeners. Model I is based on the assumption that the upward spread of masking increases in cochlearly impaired hearing with an amount proportional to the hearing threshold in dB HL. Model II is based on the assumption that the poststimulatory masked thresholds return to the level of the hearing threshold within a duration of 200 ms, independent of the level of the masker and the amount of cochlear hearing loss. Model parameters were determined from results from other studies. Although some discrepancies between measured and predicted values were observed, the model predictions generally agree with measurements. Thus, to a first-order approximation, it seems possible to predict individual frequency and temporal resolution of cochlearly hearing-impaired listeners solely on the basis of their hearing thresholds.  相似文献   

11.
Many hearing-impaired listeners suffer from distorted auditory processing capabilities. This study examines which aspects of auditory coding (i.e., intensity, time, or frequency) are distorted and how this affects speech perception. The distortion-sensitivity model is used: The effect of distorted auditory coding of a speech signal is simulated by an artificial distortion, and the sensitivity of speech intelligibility to this artificial distortion is compared for normal-hearing and hearing-impaired listeners. Stimuli (speech plus noise) are wavelet coded using a complex sinusoidal carrier with a Gaussian envelope (1/4 octave bandwidth). Intensity information is distorted by multiplying the modulus of each wavelet coefficient by a random factor. Temporal and spectral information are distorted by randomly shifting the wavelet positions along the temporal or spectral axis, respectively. Measured were (1) detection thresholds for each type of distortion, and (2) speech-reception thresholds for various degrees of distortion. For spectral distortion, hearing-impaired listeners showed increased detection thresholds and were also less sensitive to the distortion with respect to speech perception. For intensity and temporal distortion, this was not observed. Results indicate that a distorted coding of spectral information may be an important factor underlying reduced speech intelligibility for the hearing impaired.  相似文献   

12.
Otoacoustic emissions are typically reduced in amplitude when broadband noise is presented to the contralateral ear. This contralateral suppression is attributed to activation of the medial olivocochlear system, which has an inhibitory effect on outer hair-cell activity. By studying the effects of contralateral noise on cochlear output at different stages of auditory maturation in human neonates, it is possible to describe the timecourse for development of medial efferent system function in humans. The present study recorded 2 f1-f2 distortion product otoacoustic emissions (DPOAE) in human adults, term and premature neonates at three f2 frequencies: 1500, 3000, and 6000 Hz, using fixed primary tone frequency ratio (f2/f1 = 1.2) and level separation (10 dB, L1 > L2). Average DPOAE growth functions were recorded with and without contralateral broadband noise. Results indicate that contralateral suppression of DPOAEs is absent at 6000 Hz, but present at 1500 and 3000 Hz for all ages. However, DPOAE amplitude from premature neonates was not altered by noise in an adult-like manner; in this age group, DPOAE amplitude was equally likely to by suppressed or enhanced by noise presented contralaterally. Contralateral enhancement may reflect a temporary stage of immaturity in outer hair cell-medial efferent fiber synapses just prior to term birth.  相似文献   

13.
Distortion product otoacoustic emissions (DPOAE) were recorded from eight human subjects with mild to moderate cochlear hearing loss, using a frequency spacing of 48 primary pairs per octave and at a level L1 = L2 = 60 dBSPL and with a fixed ratio f2/f1. Subjects with different shapes of hearing thresholds were selected. They included subjects with near-normal hearing within only a limited frequency range, subjects with a notch in the audiogram, and subjects with a mild to moderate high-frequency loss. If the primaries were located in a region of normal or near-normal hearing, but DP frequencies were located in a region of raised thresholds, the distortion product 2 f1-f2 was still observable, but the DP fine structure disappeared. If the DP frequencies fell into a region of normal thresholds, fine structure was preserved as long as DPOAE were generated, even in cases of mild hearing loss in the region of the primaries. These experimental results give further strong evidence that, in addition to the initial source in the primary region, there is a second source at the characteristic place of fDP. Simulations in a nonlinear and active computer model for DPOAE generation indicate different generation mechanisms for the two components. The disappearance of DPOAE fine structure might serve as a more sensitive indicator of hearing impairment than the consideration of DP level alone.  相似文献   

14.
Distortion product otoacoustic emission (DPOAE) ipsilateral suppression has been applied to study cochlear function and maturation in laboratory animals and humans. Although DPOAE suppression appears to be sensitive to regions of specialized cochlear function and to cochlear immaturity, it is not known whether it reflects permanent cochlear damage, i.e., sensorineural hearing loss (SNHL), in a reliable and systematic manner in humans. Eight school-aged children with mild-moderate SNHL and 20 normal-hearing children served as subjects in this study. DPOAE (2f1-f2) suppression data were collected at four f2 frequencies (1500, 3000, 4000, and 6000 Hz) using moderate-level primary tones. Features of the DPOAE iso-suppression tuning curves and suppression growth were analyzed for both subject groups. Results show that DPOAE suppression tuning curves from hearing-impaired subjects can be reliably recorded. DPOAE suppression tuning curves were generally normal in appearance and shape for six out of eight hearing-impaired subjects but showed subtle abnormalities in at least one feature. There was not one single trend or pattern of abnormality that characterized all hearing-impaired subjects. The most prominent patterns of abnormality included: broadened tuning, elevated tip, and downward shift of tip frequency. The unique patterns of atypical DPOAE suppression in subjects with similar audiograms may suggest different patterns of underlying sensory cell damage. This speculation warrants further investigation.  相似文献   

15.
Data are reported for seven cats with a total of 29 electrodes permanently placed in or near the cochlear nucleus, the superior olivary complex, the nucleus of the inferior colliculus, and the medial geniculate body. Detection thresholds for pulsate electrical stimuli were measured using an operant behavioral procedure. Electrical stimulation thresholds were measured prior to and following bilateral destruction of the cochleas in all animals. In addition, four of the animals were tested using a site-of-stimulation discrimination prior to and following the cochlear lesion. Finally, hearing loss was evaluated in all cats after the completion of the experiments. Electrical stimulation thresholds showed a mean reduction of 7.9 dB throughout the brain stem auditory system fater cochlear destruction. The ability of the animals to perform the site-of-stimulation discrimination was not permanently impaired by the cochlear lesion. The data indicated the presence of increased sensitivity to electrical stimulation in most regions of the subcortical auditory system, although a lesser effect was found at the thalamic level. It was concluded that stimulation threshold provides an index relevant to the state of auditory neurons proximal to the electrode tip.  相似文献   

16.
Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. It is well known that 2f1-f2 DPOAE amplitude increases as the f2/f1 ratio increases from 1.0 to about 1.20, and then decreases as the f2/f1 ratio increases above 1.20, showing an amplitude ratio function, which is thought to be related to cochlear filtering properties. Different lower sideband DPOAEs are believed to show the same amplitude ratio functions as the 2f1-f2 DPOAE, with a magnitude peak situated at a constant DPOAE frequency relative to f2. More recently, several studies have suggested the involvement of a DPOAE component coming from its own distortion product place as well as the DPOAE component coming from the f2 place. To investigate DPOAE generation sites and the importance of the DPOAE frequency place, amplitude ratio functions of 2f1-f2, 3f1-2f2, 4f1-3f2 and 2f2-f1, 3f2-2f1, 4f2-3f1 DPOAE components have been systematically studied in 18 normally hearing subjects, using an f2 fixed, f1 sweep method, and an f1 fixed, f2 sweep method, at ten different f2 frequencies. Results show a dependency of the distortion magnitude peak on f2 frequency for each lower sideband DPOAE, and a small frequency shift of the distortion peak for the high order lower sideband DPOAE components. Strong correlation between the different lower sideband DPOAE amplitude were obtained, whether they were recorded with the same f1 (and a different f2) or with the same f2 (and a different f1), suggesting that lower side-band DPOAE amplitude does not depend on small variations in the f2 frequency. Moreover, correlations between DPOAE amplitude and tone-burst evoked otoacoustic emissions (TBOAEs) are highly significant for TBOAEs centered at the f2 frequency and at 1/2 octave below the f2 frequency, suggesting some degree of importance of the cochlear status at frequencies below f2 in DPOAE amplitude. Subjects presenting spontaneous otoacoustic emissions showed a greater lower sideband DPOAE amplitude recorded for low f2/f1 ratios, and a distortion magnitude peak shifted towards higher frequencies. The best correlation between upper sideband DPOAE amplitude and lower sideband DPOAE amplitude occurred for lower sideband DPOAEs generated by an f2 frequency 1/2 octave to 1 octave below the primaries used to generate upper sideband DPOAEs, suggesting a site of generation basal to f2 for the upper sideband DPOAEs. Correlations between TBOAE amplitude and upper sideband DPOAE amplitude agreed with a site of upper sideband DPOAE generation basal to f2, and which would move with the DPOAE frequency itself.  相似文献   

17.
Distortion product otoacoustic emissions (DPOAEs) evoked by low-level tones are a sensitive indicator of outer hair cell (OHC) function. High-level DPOAEs are less vulnerable to cochlear insult, and their dependence on the OHC function is more controversial. Here, the mechanism underlying high-level DPOAE generation is addressed using a mutant mouse line lacking prestin, the molecular motor driving OHC somatic motility, required for cochlear amplification. With prestin deletion, attenuated DPOAEs were measurable at high sound levels. DPOAE thresholds were shifted by approximately 50 dB, matching the loss of cochlear amplifier gain measured in compound action potentials. In contrast, at high sound levels, distortion products in the cochlear microphonic (CM) of mutants were not decreased re wildtypes (expressed re CM at the primaries). Distortion products in both CM and otoacoustic emissions disappeared rapidly after death. The results show that OHC somatic motility is not necessary for the production of DPOAEs at high SPLs. They also suggest that the small, physiologically vulnerable DPOAE that remains without prestin-based motility is due directly to the mechanical nonlinearity associated with stereociliary transduction, and that this stereocilia mechanical nonlinearity is robustly coupled to the motion of the cochlear partition to the extent that it can drive the middle ear.  相似文献   

18.
The acoustic intermodulation distortion product 2f1-f2 (ADP) was measured in human subjects to investigate (1) the dependence of ADP level on stimulus parameters and (2) the relationship between ADP level and auditory sensitivity. The frequency ratio (f2/f1), at which ADP level is maximal, varies only slightly across frequency and subjects. The average optimal ratio is 1.225. Beyond the maximum, the ADP level declines with increasing f2/f1 ratio, at rates of up to 250 dB/oct. As the level of one stimulus is increased relative to the other, the ADP grows, saturates, and in most cases shows a bendover. Maximum distortion is generated when L 1 exceeds L 2. Growth rate and saturation point are dependent on which stimulus is incremented and on the level of the stationary stimulus. With optimal stimulus parameters (levels below 60 dB SPL; L 1 greater than L 2 by 15 dB; f2/f1 = 1.225), ADP levels are commonly 30 dB below L 2. Patterns of ADP level across frequency vary between subjects, but are repeatable within each subject. As the frequency of one or both of the stimuli is varied, changes in ADP level exhibit a broadly featured pattern with a fine structure superimposed upon it. This fine structure was compared with the features in the stimulus frequency emission spectrum in one subject. With appropriate stimulus parameters, half of our subjects show a statistically significant correlation across frequency, between ADP level and auditory sensitivity at the corresponding f1 frequency. Our results suggest that, with low levels of stimulation, ADP measurements could form the basis of an objective measure of cochlear function in human subjects.  相似文献   

19.
The temporal behavior of the 2f1-f2 distortion product otoacoustic emission is theoretically investigated for the case in which the lower frequency (f1) primary tone is on continuously, and the higher frequency (f2) one is pulsed on and off [e.g., Talmadge et al., J. Acoust. Soc. Am. 105, 275-292 (1999)]. On physical grounds, this behavior is expected to be characterized by various group delays associated with the propagation of (1) the f2 cochlear primary wave between the cochlear base and the primary distortion product generation region around x2 (the f2 tonotopic place), and (2) the 2f1-f2 cochlear distortion product (DP) waves between the cochlear base, the primary generation region of the distortion product, and the region around the 2f1-f2 tonotopic place where the generated apical moving DP wave is reflected toward the cochlear base [e.g., Talmadge et al., J. Acoust. Soc. Am. 104, 1517-1543 (1998)]. An approximate analytic expression is obtained for this behavior from the analysis of the Fourier integral representation of the auditory peripheral response to the primary stimuli. This expression also approximately describes the transient build-up of the components of different latencies in terms of the damping properties of the cochlear partition. It is shown that considerable caution must be applied in attempting to relate phase derivatives of the distortion product otoacoustic emissions for steady state stimuli and the physical time delays which are associated with the temporal behavior of a distortion product emission in the case of a pulsed primary.  相似文献   

20.
The objective of this study was to determine whether distortion product otoacoustic emission (DPOAE) test performance, defined as its ability to distinguish normal-hearing ears from those with hearing loss, can be improved by examining response and noise amplitudes at 2 f1-f2 and 2f2-f1 simultaneously. In addition, there was interest in knowing whether measurements at both DPs and for several primary frequency pairs can be used in a multivariate analysis to further optimize test performance. DPOAE and noise amplitudes were measured at 2f1-f2 and 2 f2-f1 for 12 primary levels (L2 from 10 to 65 dB SPL in 5-dB steps) and 9 pairs of primary frequencies (0.5 to 8 kHz in 1/2-octave steps). All data were collected in a sound-treated room from 70 subjects with normal hearing and 80 subjects with hearing loss. Subjects had normal middle-ear function at the time of the DPOAE test, based on standard tympanometric measurements. Measurement-based stopping rules were used such that the test terminated when the noise floor around the 2 f1-f2 DP was < or = -30 dB SPL or after 32 s of artifact-free averaging, whichever occurred first. Data were analyzed using clinical decision theory in which relative operating characteristics (ROC) curves were constructed and areas under the ROC curves were estimated. In addition, test performance was assessed by selecting the criterion value that resulted in a sensitivity of 90% and determining the specificity at that criterion value. Data were analyzed using traditional univariate comparisons, in which predictions about auditory status were based only on data obtained when f2 = audiometric frequency. In addition, multivariate analysis techniques were used to determine whether test performance can be optimized by using many variables to predict auditory status. As expected, DPOAEs were larger for 2f1-f2 compared to 2 f2-f1 in subjects with normal hearing. However, noise amplitudes were smaller for 2f2-f1, but this effect was restricted to the lowest f2 frequencies. A comparison of signal-to-noise ratios (SNR) within normal-hearing ears showed that the 2f1-f2 DP was more frequently characterized by larger SNRs compared to 2f2-f1. However, there were several subjects in whom 2f2-f1 produced a larger SNR. ROC curve areas and specificities for a fixed sensitivity increased only slightly when data from both DPs were used to predict auditory status. Multivariate analyses, in which the inputs included both DPs for several primary frequency pairs surrounding each audiometric frequency, produced the highest areas and specificities. Thus, DPOAE test performance was improved slightly by examining data at two DP frequencies simultaneously. This improvement was achieved at no additional cost in terms of test time. When measurements at both DPs were combined with data obtained for several primary frequency pairs and then analyzed in a multivariate context, the best test performance was achieved. Excellent test performance (ROC) curve areas >0.95% and specificities >92% at all frequencies, including 500 Hz, were achieved for these conditions. Although the results described should be validated on an independent set of data, they suggest that the accuracy with which DPOAE measurements identify auditory status can be improved with multivariate analyses and measurements at multiple DPs.  相似文献   

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