Chirp-Evoked Otoacoustic Emissions and Middle Ear Absorbance for Monitoring Ototoxicity in Cystic Fibrosis Patients

Garinis, Angela C.; Keefe, Douglas H.; Hunter, Lisa L.; Fitzpatrick, Denis; Putterman, Daniel; McMillan, Garnett P.; Gold, Jeffrey A.; Feeney, M. Patrick

doi:10.1097/aud.0000000000000464

Cited by 7 publications

(3 citation statements)

References 70 publications

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“…In tandem with other studies (Putterman et al, 2017;Garinis et al, 2017) using the present measurements system, the present work extended pressurized measurements of TEOAEs in adult ears up to a stimulus frequency of 8 kHz, which allowed the study of pressurization effects at higher frequencies compared to previous studies (as reviewed in Sec. I, previous studies extended to 5 kHz).…”

Section: Teoae Methodsmentioning

confidence: 65%

“…The inclusion criteria for their study was based on ages between 18 and 89 yrs, normal otoscopy, normal 226 Hz tympanometry including a TPP within 6100 daPa, and air-bone gaps of 10 dB or less between 0.5 and 4 kHz. Garinis et al (2017) reported that TEOAEs recorded at ambient and TPP had a generally similar performance in classifying ears as having normal hearing or a sensorineural hearing loss in a group of cystic fibrosis patients who had received ototoxic drugs.…”

Section: Discussionmentioning

confidence: 99%

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Pressurized transient otoacoustic emissions measured using click and chirp stimuli

Keefe

Feeney

Hunter

et al. 2018

The Journal of the Acoustical Society of America

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Transient-evoked otoacoustic emission (TEOAE) responses were measured in normal-hearing adult ears over frequencies from 0.7 to 8 kHz, and analyzed with reflectance/admittance data to measure absorbed sound power and the tympanometric peak pressure (TPP). The mean TPP was close to ambient. TEOAEs were measured in the ear canal at ambient pressure, TPP, and fixed air pressures from 150 to -200 daPa. Both click and chirp stimuli were used to elicit TEOAEs, in which the incident sound pressure level was constant across frequency. TEOAE levels were similar at ambient and TPP, and for frequencies from 0.7 to 2.8 kHz decreased with increasing positive and negative pressures. At 4-8 kHz, TEOAE levels were larger at positive pressures. This asymmetry is possibly related to changes in mechanical transmission through the ossicular chain. The mean TEOAE group delay did not change with pressure, although small changes were observed in the mean instantaneous frequency and group spread. Chirp TEOAEs measured in an adult ear with Eustachian tube dysfunction and TPP of -165 daPa were more robust at TPP than at ambient. Overall, results demonstrate the feasibility and clinical potential of measuring TEOAEs at fixed pressures in the ear canal, which provide additional information relative to TEOAEs measured at ambient pressure.

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Section: Teoae Methodsmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Pressurized transient otoacoustic emissions measured using click and chirp stimuli

Keefe

Feeney

Hunter

et al. 2018

The Journal of the Acoustical Society of America

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“…The damage from these ototoxic drugs appears first at the basal end of the cochlea tuned to high frequencies, and includes damage to outer hair cells whose functioning is assessed via OAEs. Previous work demonstrated the potential value of TEOAEs to detect ototoxic SNHL in CF patients (Garinis et al, 2017b), but the upper TEOAE test frequency in that study was 8 kHz. This suggests the use of HF TEOAEs above 8 kHz as a potentially more sensitive diagnostic test for early identification of ototoxicity in CF patients.…”

Section: Methodsmentioning

confidence: 80%

High frequency transient-evoked otoacoustic emission measurements using chirp and click stimuli

Keefe¹,

Feeney

Hunter

et al. 2019

Hearing Research

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Transient-evoked otoacoustic emissions (TEOAEs) at high frequencies are a non-invasive physiological test of basilar membrane mechanics at the basal end, and have clinical potential to detect risk of hearing loss related to outer-hair-cell dysfunction. Using stimuli with constant incident pressure across frequency, TEOAEs were measured in experiment 1 at low frequencies (0.7–8 kHz) and high frequencies (7.1–14.7 kHz) in adults with normal hearing up to 8 kHz and varying hearing levels from 9 to 16 kHz. In combination with click stimuli, chirp stimuli were used with slow, medium and fast sweep rates for which the local frequency increased or decreased with time. Chirp TEOAEs were transformed into equivalent click TEOAEs by inverse filtering out chirp stimulus phase, and analyzed similarly to click TEOAEs. To improve detection above 8 kHz, TEOAEs were measured in experiment 2 with higher-level stimuli and longer averaging times. These changes increased the TEOAE signal-to-noise ratio (SNR) by 10 dB. Slower sweep rates were investigated but the elicited TEOAEs were detected in fewer ears compared to faster rates. Data were acquired in adults and children (age 11–17 y.), including children with cystic fibrosis (CF) treated with ototoxic antibiotics. Test-retest measurements revealed satisfactory repeatability of high-frequency TEOAE SNR (median of 1.3 dB) and coherence synchrony measure, despite small test-retest differences related to changes in forward and reverse transmission in the ear canal. The results suggest the potential use of such tests to screen for sensorineural hearing loss, including ototoxic loss. Experiment 2 was a feasibility study to explore TEOAE test parameters that might be used in a full-scale study to screen CF patients for risk of ototoxic hearing loss.

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Amikacin/tobramycin

2019

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Chirp-Evoked Otoacoustic Emissions and Middle Ear Absorbance for Monitoring Ototoxicity in Cystic Fibrosis Patients

Cited by 7 publications

References 70 publications

Pressurized transient otoacoustic emissions measured using click and chirp stimuli

Pressurized transient otoacoustic emissions measured using click and chirp stimuli

High frequency transient-evoked otoacoustic emission measurements using chirp and click stimuli

Amikacin/tobramycin

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