Ear-canal acoustic admittance and reflectance effects in human neonates. I. Predictions of otoacoustic emission and auditory brainstem responses

Abstract

This report describes the extent to which ear-canal acoustic admittance and energy reflectance (YR) in human neonates (1) predict otoacoustic emission (OAE) levels and auditory brainstem response (ABR) latencies, and (2) classify OAE and ABR responses as present or absent. Analyses are reported on a subset of ears in which hearing screening measurements were obtained previously [Norton et al., Ear. Hear. 21, 348-356 (2000a)]. Tests on 1405 ears included YR, distortion-product OAEs, transient-evoked OAEs, and ABR. Principal components analysis reduced the 33 YR variables to 5-7 factors. OAE levels decreased and ABR latencies increased with increasing high-frequency energy reflectance. Up to 28% of the variance in OAE levels and 12% of the variance in ABR wave-V latencies were explained by these factors. Thus, the YR response indirectly encodes information on inter-ear variations in forward and reverse middle-ear transmission. The YR factors classify OAEs with an area under the relative operating characteristic (ROC) curve as high as 0.79, suggesting that middle-ear dysfunction is partly responsible for the inability to record OAEs in some ears. The YR factors classified ABR responses less well, with ROC areas of 0.64 for predicting wave-V latency and 0.56 for predicting Fsp.

High frequency immittance for neonates: a normative study

“…Newborns and infants with mild conductive hearing loss often refer hearing screenings resulting in higher false positive rates that lead to added expenses, decreased programme efficacy, and increased chances of anxiety for parents 1, 2. Even though significant efforts have been made to reduce the number of false positive results by comprehensive screening protocols, the question of compromised middle ear functioning due to otitis media with effusion, a transient middle ear effusion, or middle ear cavities containing mesenchyme and not fully pneumatized at birth, has not yet been addressed sufficiently 3 . Middle ear fluid or middle ear effusion is a common diagnosis among newborns and infants, with infants in neonatal intensive care units (NICUs) especially prone to the condition 4,5 .…”

“…The effect of sound transmission through the neonatal ear canal to the middle ear and cochlea has not been described sufficiently and is therefore not clearly understood 3 . Conventional immittance evaluations of middle ear functioning with a 226 Hz probe tone have been demonstrated to be unreliable for accurate assessment of middle ear status in infants younger than 7 months of age [11][12][13] .…”

“…An alternative technique suggested for possible neonatal middle ear assessment has been the acoustical admittance and reflectance (YR) response 3 . Initial results have indicated promise that the YR response is sensitive to both forward and reverse sound transmission through the ear canal and middle ear 3 .…”

Avaliação da onda V da audiometria de tronco cerebral de crianças reprovadas na triagem auditiva neonatal

“…Após a triagem auditiva, realizada ainda na maternidade, é necessária a realização de diagnóstico nos casos de falha. É imprescindível que outros exames, como a audiometria de tronco cerebral, imitanciometria e observação do comportamento auditivo, sejam incorporados ao de emissões otoacústicas para que o diagnóstico de deficiência auditiva seja realmente concluído 16,28 .…”

“…As EOA têm sido largamente indicadas para programas de triagem por ser um exame rápido, de fácil aplicação e poder atingir um grande número de sujeitos em um curto espaço de tempo 1,6,10,12,16,17 .…”