Subclinical conductive hearing loss significantly reduces otoacoustic emission amplitude: Implications for test performance

Kreitmayer, Christoph; Marcrum, Steven C.; Picou, Erin M.; Steffens, Thomas; Kummer, Peter

doi:10.1016/j.ijporl.2019.05.025

Cited by 7 publications

(1 citation statement)

References 36 publications

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“…Otoacoustic emissions have low diagnostic value, the presence of conductive hearing loss is sufficient to reduce the clinical utility of distortion product otoacoustic (DPOAE). But, through a strategic modification of primary tone levels, the clinician can improve the measurement of DPOAE [11].…”

Section: Discussionmentioning

confidence: 99%

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Mallouk¹,

Halily²,

Hammouda³

et al. 2020

IJO

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Objective: Our study aims to analyze the epidemiological, clinical, radiological, and etiological aspects of this disease. Methods: We reviewed data from patients who consulted the same seigneur for hearing loss and in whom the otoscopic examination was normal with a conductive hearing loss objectively confirmed on tonal audiometry, for a period of one year (from October 2018 to October 2019). Epidemiological, clinical and paraclinical data were collected and recorded onfarm records. Results: The average age is 36 years. The M/F sex ratio was 1.5 in favor of the men. None of our patients reported a personal otologic history. Three patients reported a notion of head trauma and a similar case in the family was found in four patients. Hearing loss is the most frequent reason for consultation. Otoscopic examination shows a normal tympanic membrane without perforation in all patients. CT scan of the temporal bone was performed in all patients (100%); it was normal in 4 cases (17%), which required surgical exploration. However, he showed images of otosclerosis in 15 cases (65%), an image of congenital cholesteatoma in a single patient, tympanic glomus in a single patient, an incudo-malleolar dislocation in a single patient (4.5%), and an incudo-stapedial dislocation in a single patient (4.5%). Conclusion: Conductive hearing loss (CHL) is a diagnostic challenge for the physician that requires a schematic approach. The diagnosis is based on a combination of clinical and paraclinical arguments.

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Section: Discussionmentioning

confidence: 99%

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Mallouk¹,

Halily²,

Hammouda³

et al. 2020

IJO

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Gepulste DPOAE in Verlaufsmessungen

Bader,

Zelle,

Gummer

et al. 2024

HNO

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Zusammenfassung Hintergrund Bisher gibt es keinen Konsens darüber, wie Ototoxizität in Verlaufsmessungen standardisiert zu erfassen ist. Für die Diagnostik von Schädigungen des cochleären Verstärkers sind Messverfahren notwendig, die eine möglichst hohe Test-Retest-Zuverlässigkeit und eine hohe Aussagekraft hinsichtlich persistierender Schädigungen aufweisen. Hörschwellenschätzungen auf der Grundlage von Kurzpuls-DPOAE-Pegelkarten („estimated distortion-product thresholds“, LEDPT) berücksichtigen individuell optimale DPOAE-Anregungspegel und erlauben eine zuverlässige quantitative Schätzung des cochleär bedingten Hörverlusts. Methodik Hörschwellen wurden mithilfe von LEDPT objektiv geschätzt und mit einer modifizierten Békésy-Tracking-Audiometrie (LTA) subjektiv erfasst. Die Messungen wurden siebenmal innerhalb von drei Monaten bei 14 Frequenzen (f2 = 1–14 kHz) in 20 Ohren (PTA4 (0,5–4 kHz) < 20 dB HL) durchgeführt. Die Rekonstruktion des DPOAE-Wachstumsverhaltens in Abhängigkeit von den Anregungspegeln L1,L2 erfolgte auf der Grundlage von 21 DPOAE-Amplituden und ermöglichte mithilfe einer numerischen Anpassung einer nichtlinearen mathematischen Funktion die Berechnung eines LEDPT für jede Anregungsfrequenz. Für die gleichzeitige kombinierte Betrachtung wurden Verteilungen der Hörschwellen (LTA, LEDPT), der DPOAE-Pegel (LDP) und Kombinationen davon ermittelt. Ergebnisse Einzeln betrachtet wiesen LTA und LEDPT jeweils eine Test-Retest-Zuverlässigkeit mit einem Median der absoluten Differenzen (AD) von 3,2 dB bzw. 3,3 dB auf, der sich durch Anwendung eines kombinierten Analyseparadigmas aus LEDPT, LDP und LTA auf 2,0 dB signifikant reduzieren ließ. Schlussfolgerung Es ist zu erwarten, dass ein auf einer Kombination von LEDPT, überschwelligen LDP, und feinstrukturreduzierter LTA basierendes Analyseparadigma eine höhere Güte (Sensitivität und Spezifität) des Tests erzielt, um pathologische oder auch regenerative Veränderungen der äußeren Haarsinneszellen zuverlässig zu detektieren.

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Pulsed DPOAEs in serial measurements

Bader,

Zelle,

Gummer

et al. 2024

HNO

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Background To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (LEDPT) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss. Materials and methods Hearing thresholds were estimated objectively using LEDPT and subjectively using modified Békésy tracking audiometry (LTA). Recordings were performed seven times within three months at 14 frequencies (f2 = 1–14 kHz) in 20 ears (PTA4(0.5–4 kHz) < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L1, L2 was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded LEDPT for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (LTA, LEDPT), DPOAE levels (LDP), and combinations thereof were determined. Results LTA and LEDPT each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining LEDPT, LDP, and LTA into a single parameter yielded a significantly smaller median AD of 2.0 dB. Conclusion It is expected that an analysis paradigm based on a combination of LEDPT, suprathreshold LDP, and fine-structure-reduced LTA would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.

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Subclinical conductive hearing loss significantly reduces otoacoustic emission amplitude: Implications for test performance

Cited by 7 publications

References 36 publications

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Gepulste DPOAE in Verlaufsmessungen

Pulsed DPOAEs in serial measurements

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