正常新生儿瞬态诱发耳声发射

本文对20名正常新生儿在出生后1～5天每天进行一次瞬态诱发耳声发射(Transientevoked otoacoustic emissions,TEOAE)测试.结果表明,随着新生儿天龄的增加,其TEOAE检出率及反应幅值逐步提高.新生儿1～2天的检出率显著低于后几天,至出生后第3天,TEOAE检出率可达97.4%,反应幅值也趋于稳定,提示应用TEOAE进行新生儿听力筛选时,其天龄至少应在3天或3天以上.对第5天的TEOAE反应进行统计,发现其频谱范围主要在1～4kHz,反应幅值显著高于正常听力青年人,性别差异对新生儿TEOAE无显著性影响.     

正常出生新生儿瞬态诱发耳声发射与畸变产物耳声发射听力筛查结果比较

目的 探讨瞬态诱发耳声发射(transient evoked otoacoustic emissions,TEOAE)和畸变产物耳声发射(distortion products otoacoustic emissions,DPOAE)用于新生儿听力筛查特点,为正常出生新生儿听力筛查方法的选择提供参考.方法 于出生后48~72小时,对1 062例正常出生的新生儿分别使用TEOAE和DPOAE进行听力初筛,其中135例未通过初筛者,在42天龄左右,同时进行TEOAE和DPOAE复筛;复筛未通过者3月龄左右进行诊断型听性脑干反应测试. 结果 1 062例新生儿中TEOAE初筛未通过率为11.02%(117/1 062),DPOAE未通过率为13.65%(145/1 062);135例进行了复筛,TEOAE和DPOAE未通过率分别为17.78%(24/135)和20.74%(28/135),DPOAE初、复筛未通过率均高于TEOAE,差异均有统计学意义(P<0.001);TEOAE和DPOAE在初筛和复筛中的一致率分别为96.04%和95.56%,kappa值分别为0.817和0.857.在初筛中TEOAE每耳的平均测试时间为24±25 s,DPOAE为40±34 s;在复筛中TEOAE为52±41 s,DPOAE为73±62 s,配对样本t检验显示两种方法的测试时间差异有统计学意义(P=0.000).复筛的135例中,共有7例(10耳)最终被诊断为不同程度的传导性听力损失(9耳)及感音神经性听力损失(1耳),这10耳TEOAE和DPOAE初、复筛均未通过. 结论 作为正常出生新生儿的听力筛查方法,TEOAE较DPOAE未通过率低,耗时少;作为新生儿听力筛查工具,TEOAE可能比DPOAE有优势.     

瞬态诱发耳声发射用于黄疸新生儿的听力筛查

目的：探讨瞬态诱发耳声发射（transient evoked otoacoustic emission,TEOAE)应用于新生儿黄疸听力筛查的可行性及临床意义。方法：采用前瞻性队列研究的方法对新生儿病房277例黄疸新生儿及50例健康新生儿应用CELESTA503耳声发射仪进行TEOAE检测，出院前和3个月后复查。结果：初查时黄疸新生儿TEOAE通过率为64．23％，健康新生儿TEOAE通过率为96％，两组检出率经统计学分析，有非常显著差异（P＜0．01）。第一次复查黄疸新生儿TEOAE通过率为88％，第二次复查黄疸新生儿TEOAE通过率为100％。结论：TEOAE是快速可行的高危新生儿听力筛查方法；新生儿测试耳TEOAE的通过率与黄疸严重程度有关；黄疸对耳蜗的影响是可逆的。     

9971例新生儿瞬态诱发性耳声发射听力筛查结果分析

目的 分析瞬态诱发性耳声发射(transient evoked otoacoustic emission,TEOAE)进行新生儿听力筛查通过率的影响因素及听力障碍的检出情况.方法 采用瞬态诱发性耳声发射在生后2～5天对2006年10月～2009年3月出生正常新生儿8 319例(正常组)和因各种疾病转入新生儿科治疗者1 652例(高危组)进行听力筛查,初筛未通过者,生后42天复筛,复筛未通过者,3个月左右行听性脑干反应(ABR)诊断性检查.结果 可筛总数10 523例,实际筛查9 971例,初筛率94.75%;初筛未通过790例,阳性率7.92%(790/9 971),初筛通过率女婴高于男婴,右耳高于左耳,正常组高于高危组;实际复筛290例,复筛率36.71%(290/790);复筛未通过57例,阳性率19.66%(57/290);实际接受诊断性ABR检查46例,确诊听力障碍人数35例,其中双耳听力损失22人,单耳听力损失13人;重度听力损失者6例.高危儿先天性听力损失检出率6.05‰(10/1 652)明显高于正常新生儿(3.01‰,25/8 319).结论 应用TEOAE进行新生儿听力初筛的通过率与性别、耳别、高危因素等有关,本组新生儿先天性听力损失的检出率约为3.51‰(35/9 971).     

瞬态诱发耳声发射测试结果分析

目的：为取得听功能正常耳瞬态耳声发射测试结果的正常值敏感参数,为临床应用提供诊断依据。方法：采用ＩＬＯ－８８耳动态分析仪对听功能正常的６０耳进行测试。短声声刺激强度为８０ｄＢ ＳＰＬ,刺激方式为非线性模式。结果：对稳定性、Ａ－Ｂ差值、反应幅值、波重复性、频带重复性及信噪比、主频等分别进行分析,得出了正常值。结论：频谱分析、反应幅值及重复性三者综合分析为判断听力正常与否的主要敏感参数。     

正常新生儿瞬态诱发性耳声发射测试结果报告

本文对22例（44耳）正常新生儿行瞬态诱发性耳声发射（TEOAE）测试，并与ABR对照结果表明：当ABR波V阈值≤50dBHL,TEOAE出现率93．2％。TEOAE能否出现与ABR波V阈值密切相关。测试TEOAE方法较ABR快速、方便、不失为筛查新生儿听力障碍的首选法。     

正常新生儿畸变产物耳声发射

目的研究新生儿畸变产物耳声发射（ＤＰＯＡＥ）听力筛选的最佳时机,了解正常新生儿ＤＰＯＡＥ的基本特征;方法应用Ｃｅｌｅｓｔａ５０３型耳声发射分析仪对２０名正常新生儿出生后１～５天逐日进行ＤＰＯＡＥ测试。结果随新生儿天龄的增加,ＤＰＯＡＥ的检出率及反应幅值逐渐提高。ｆ０为０．５ｋＨｚ时,ＤＰＯＡＥ的检出率较低,且反应不稳定。ｆ０≥０．７５ｋＨｚ时,ＤＰＯＡＥ的检出率迅速接近或达到１００％,大部分测试频率在出生１～２天的反应幅值显著低于后几天,至出生后第３天,ＤＰＯＡＥ的检出率及反应幅值均趋于稳定;结论新生儿ＤＰＯＡＥ听力筛选的适宜天龄应在其出生后３天或３天以上。０．５ｋＨｚ不宜作为新生儿ＤＰＯＡＥ的听力筛选频率。ＴＥＯＡＥ和ＤＰＯＡＥ相应频谱的反应幅值有显著相关性。两种耳声发射在新生儿听力筛选中各有优缺点     

缺氧缺血性脑病新生儿瞬态诱发耳声发射测试

目的了解应用瞬态诱发性耳声发射（ｔｒａｎｓｉｅｎｔｅｖｏｋｅｄｏｔｏａｃｏｕｓｔｉｃｅｍｉｓｉｏｎｓ,ＴＥＯＡＥ）对正常新生儿高危新生儿行听力筛查的可行性。方法采用ＳＦ－Ⅰ型耳声发射接受器与ＣｏｍｐａｃｔＡｕｄｉｔｏｒｙＴＩＰ－３００电反应测听仪联合记录,对２０名正常新生儿及３６名缺氧缺血性脑病（ｈｙｐｏｘｉａ－ｉｓｃｈｅｍｉｃｅｎｃｅｐｈａｌｏｐａｔｈｙ,ＨＩＥ）新生儿进行ＴＥＯＡＥ和ＡＢＲ测试。结果ＨＩＥ患儿ＴＥＯＡＥ多表现为阈值升高或波缺失,ＴＥＡＯＥ能否出现与ＡＢＲ之Ｖ波阈值密切相关,重度ＨＩＥ的ＴＥＯＡＥ出波率较轻度者明显减低。结论ＴＥＯＡＥ可早期发现缺氧等高危因素所致听力损伤,因此有可能成为早期监测新生儿及高危儿听力的一种方法。     

新生儿高胆红素血症的瞬态诱发性耳声发射测试

高胆红素血症是新生儿多种疾病的重要症状,重者可导致脑神经系统损害,常留有语言、智能及听力发育障碍。７０年代后国内外学者用听性脑干电反应测听（ＡＢＲ）监测高危儿听力,近几年国外学者又用瞬态诱发性耳声发射（ＴＥＯＡＥ）进行监测,为探讨其临床应用价值,对２...     

正常听力青年人诱发性耳声发射测试

本文利用耳声发射分析仪ＣＥＬＥＳＴＡ５０３对２０名正常听力青年人进行了ＤＰＯＡＥ和ＴＥＯＡＥ测试，结果发现平均ＤＰＯＡＥ图中有两个反应高峰，分别位于１ｋＨｚ和６ｋＨｚ附近，两峰之间于３ｋＨｚ左右有一反应低谷。左右耳及性别差异对ＤＰＯＡＥ无显著性影响。ＤＰＯＡＥ的反应幅值随两个初始纯音强度的增加而升高，平均检测阈值在３０～４５ｄＢＳＰＬ之间。当初始音强度≤７０ｄＢＳＰＬ时，平均Ｉ／Ｏ函数曲线未见明显饱和现象。若采用不等强度的初始纯音（Ｌ１＝７０ｄＢＳＰＬ，Ｌ１－Ｌ２＝５ｄＢ）刺激，在中频部分（１．５～４ｋＨｚ）可获得较等强度初始纯音刺激时高的ＤＰＯＡＥ反应。由８０ｄＢｐｅＳＰＬ短声诱发的ＴＥＯＡＥ检出率为１００％，平均幅值４．１１±３．９９ｄＢＳＰＬ（ｘ±ｓ）。两种耳声发射之间有显著相关性。     

足月新生儿瞬态诱发性耳声发射能量谱分析

本文对115例足月新生儿,230耳,以瞬态诱发性耳声发射的快速筛查方法进行测试。分析500～5657Hz的各半倍频程的反应和噪声的能量谱,结果显示反应能量和检出率最高的四个频带为1 414Hz、2 000Hz、2 828Hz、4 000Hz,检出率最低的频带为500Hz与707Hz,反应能量最低的三个频带为5 657Hz、707Hz和500Hz;噪声水平最高的三个频带依次为500Hz、1000Hz与707Hz。左右耳的反应能量在1 000Hz、1 414Hz、2 000Hz与2 828Hz等频带有显著性差异。除2 000Hz外,各频带反应能量不存在性别差异。     

畸变产物耳声发射与瞬态诱发耳声发射的相关性观察

目的：探讨畸变产物耳声发射（DPOAE)和瞬态诱发耳声发射(TEOAE)的特点和相关性。方法：以20例（40耳）耳科正常青年人观察噪声暴露前后在无对侧抑制（NCS)状态下和有对侧抑制（CS)状态下TEOAE的频带信噪比、频带反应幅值，与DPOAE的2f1-f2幅值、信噪比相互间的相关性。结果：DPOAE与TEOAE虽由不同的刺激声所引出，有各自的图形特征，但在绝大多数相近频率点上，其测量值有较好的相关性，形成一定的数量关系。结论：TEOAE测试较为快捷并有中频优势，而DPOAE则有很好的频率特异性和高频优势。二者幅值及信噪比间有良好的相关性，可得出有统计意义的线性回归方程参数，听觉损害，噪声性。     

Influence of a 6–8 kHz audiometric notch on transient evoked otoacoustic emissions

Thirty-eight patients with known unilateral cochlear hearing loss at 6 and/or 8 kHz were examined for transient evoked otoacoustic emisssions (TEOAEs). These findings were compared with those of the contralateral “normal hearing” ear. Statistically significant lower values of echo reproducibility and amplitude were recorded in hearing-impaired ears, together with a more narrow TEOAE spectrum. In addition to these findings, a globally reduced amplitude of the cochlear response was found that was unrelated to the frequency impaired in pure-tone audiometry (6, 8, or 6–8 kHz). Since patients’ audiometric thresholds at such frequencies could influence test results, findings could possibly be due to an altered echo travelling wave across the most basal part of the cochlea or to coexisting damage in the rest of Corti’s organ that were undetectable with standard audiometry. A significant overlap was found between the results from hearing-impaired ears and those from normally hearing ones. Although TEOAEs were not helpful in the present study in identifying patients with a unilateral hearing loss at 6 and/ or 8 kHz when compared to normal contralateral ears, they are still considered to play an important role in the follow-up of subjects at risk for hearing damage. Received: 22 December 1997 / Accepted: 14 May 1998     

Comparison of two-step transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR) for universal newborn hearing screening programs

OBJECTIVE: Both transitory auditory otoemissions (TEOAE) and automated auditory brainstem responses (AABR) are considered adequate methods for universal hearing screening. The goal of this study was to compare the results obtained with each device, applying the same screening procedure. MATERIALS AND METHODS: From 2001 to 2003, all the newborns in our health area (2454 infants) were evaluated with TEOAE (ILO92, otodynamics) and all those born from 2004 to 2006 (3117) were evaluated with AABR (AccuScreen, Fischer-Zoth). The population studied included all well newborns and those admitted to neonatal intensive care units (NICU). The first screening was normally undertaken with well babies during the first 48h of life, before hospital discharge. Infants referred from this first step underwent a second screening after hospital discharge, before they were a month old. RESULTS: The results from each study group were compared and analyzed for significant differences. TEOAE screening yielded 10.2% fail results from the first screening step; AABR gave 2.6%. In the second screening step, 2% of the newborns screened with TEOAE were referred, whereas 0.32% of those screened with AABR were referred. These differences are statistically significant. CONCLUSIONS: Although AABR screening tests involve a slightly higher cost in time and money than TEOAE, the results obtained compensate this difference. AABR gives fewer false positives and a lower referral rate; the percent of infants lost during follow-up is consequently smaller. Therefore, in our environment, universal newborn auditory screening with AABR is more effective than that with TEOAE.     

瞬态诱发耳声发射频域分析的临床意义

目的：确定瞬态诱发耳声发射（ＴＥＯＡＥ）频域分析的应用价值。方法：对正常耳,噪声暴露耳,梅尼埃病耳,中耳病变耳及对侧抑制耳,进行ＴＥＯＡＥ频域测试。结果（１）噪声暴露耳,一些频率带的频信噪比降低,主频出现移动变化;（２）梅尼埃病一些甘油摄入后,频带信噪比增高,未引出ＴＥＯＡＥ的部分耳出现ＴＥＯＡＥ,主频也有移动变化;（３）中耳病变耳,不同的鼓室病变耳的频带信噪比降低,程度各异,其变化与声导纳改变有     

Transient evoked otoacoustic emissions in hearing screening programs: protocol for developing countries

OBJECTIVES: To formulate a protocol for infant hearing screening in developing countries enabling it to be later incorporated into their national deafness screening programs. The screening tool should be sensitive in detecting hearing loss in infants with high specificity. METHODS: 2659 infants in the age range of 0-3 months who reported to the Department of Otolaryngology were included in the study. As 537 children were lost to follow up after the first screening, the remaining 2122 infants only were considered for the statistical analysis. These were divided into 3 groups with age range between 0-1, 1-2 and 2-3 months of age. All were subjected to transient evoked otoacoustic emission (TEOAE) for hearing screening. Those who failed first screening were followed up after 1-month. Pass rate for TEOAE was calculated for each. Infants who had failed the second screening underwent Brainstem Evoked Response Audiometry (BERA). The data collected was statistically analyzed. RESULTS: 77.5% of infants in 0-1-month age group passed the screening test whereas 83.4% and 92.8% of infants passed the screening test in 1-2 months and 2-3 month age groups, respectively. On the first follow up, the pass percentage of the infants who had failed screening earlier rose significantly high up to age of 3 months. Those who had failed the follow up were scheduled for Brainstem Evoked Auditory testing. CONCLUSION: The concept of this delayed hearing screening at 3 months of age would considerably decrease the number of false positive cases undergoing unnecessary investigations and wastage of resources making the universal neonatal hearing screening within 48 h of life impractical for developing countries. Combining this delayed hearing screening with the 3rd dose of universal immunization program would constitute a viable, feasible and universal hearing screening program, which can be drafted into national deafness programs of the developing countries.     

Transient evoked and distortion product otoacoustic emissions following successful stapes surgery

Background: The effect of stapes surgery on the recording of otoacoustic emissions is unknown. The aim of the present study was to evaluate the success of stapes surgery by using acoustically evoked otoacoustic emissions as an objective and fast method for postoperative hearing evaluation. Methods: Transient evoked (TEOAE) and distortion product otoacoustic emissions (DPOAE) were measured consecutively in otosclerosis patients before as well as 3 and 6 months after stapes surgery. Results: Air-bone gaps in the pure-tone audiograms were significantly reduced in all patients. TEOAEs and DPOAEs were not measurable preoperatively and were only evident in one patient postoperatively with low amplitudes in a narrow frequency range. Conclusions: Despite a subjective hearing improvement and a significant reduction of the conductive loss, otoacoustic emissions are only rarely evident after successful stapes surgery. Received: 26 September 2000 / Accepted: 30 November 2000     

Comparison of hearing screening programs between one step with transient evoked otoacoustic emissions (TEOAE) and two steps with TEOAE and automated auditory brainstem response

OBJECTIVE: To compare the efficacy between one step with transient evoked otoacoustic emissions (TEOAE) and two steps with TEOAE and automated auditory brainstem response (AABR) in a newborn hearing screening program. We investigated their differences in referral rate, the accurate identification rate of congenital hearing loss (HL), and cost effectiveness. METHOD: From November 1998 to December 2004, a total of 21,273 healthy newborns were screened for HL in Mackay Memorial Hospital, Taipei. In the periods from November 1998 to January 2004 and from February 2004 to December 2004, the screening tools used were TEOAE alone (n = 18,260) and TEOAE plus AABR (n = 3,013), respectively. RESULTS: A statistically significant decrease of referral rate was achieved in the group using TEOAE and AABR as screening tools when compared with TEOAE alone (1.8% vs. 5.8%). The accurate identification rate of congenital HL was 0.45% in TEOAE protocol and 0.3% in TEOAE and AABR protocol, which was not statistically significant. The total direct costs per screening were 10.1 U.S. dollars for the program using TEOAE alone and 8.9 U.S. dollars for the TEOAE plus AABR program. The intangible cost, however, was much higher in the earlier program because of the higher referral rate. CONCLUSION: In terms of the efficacy of a hearing screening program using the one step TEOAE and two step TEOAE and AABR programs, the later significantly decreased the referral rate from 5.8% to 1.8%. No significant difference was noted between the accurate identification rates of congenital HL. The total costs, including expenditures and intangible cost, were lower in the protocol with TEOAE plus AABR.     

The effects of crossed olivocochlear bundle section on transient evoked otoacoustic emissions

The purpose of this study was to investigate the effect of sectioning the crossed olivocochlear bundle (COCB) on transient evoked otoacoustic emissions (TEOAEs) in anesthetized adult chinchillas. Of particular interest is the role of cochlear efferents to the outer haircells (OHCs) and how they control mechanisms responsible for otoacoustic emissions. Specifically the experiment addressed whether a tonic level of inhibitory control is reduced by COCB section. The nonlinear component of TEOAEs was measured before and after COCB section. Analysis was made of the 1, 2, 3, 4, and 5 kHz frequency components and of the total emission, as quantified by fast Fourier transform (FFT) of the raw (time domain) response. After COCB section, the amplitude of the total response and of the 2, 3, 4, and 5 kHz components increased whereas the amplitude of the 1 kHz component decreased. The results indicate that COCB section reduces inhibitory control of the OHC mechanisms responsible for nonlinear TEOAE generation. It is not clear whether the nerve section eliminates a spontaneous level of activity in COCB efferents, or whether it results in the interruption of a stimulus-evoked feedback loop.     

对侧抑制对噪声暴露后的瞬态诱发耳声发射的影响

目的 :了解对侧抑制对噪声暴露前后瞬态耳声发射 (TEOAE)的影响。方法 :观察对侧抑制 (6 0dBSPL宽带噪声 )对噪声暴露前后TEOAE反应幅值、波重复率、频带信噪比、频带重复率等指标的变化。结果 :短时噪声暴露后 ,TEOAE各指标的数值都有所下降 ,敏感地反映出噪声暴露对耳蜗功能的影响。对侧抑制在噪声暴露前可引起较小的下降 ,部分指标有显著性改变。暴露后 ,对侧抑制使TEOAE指标下降更明显。结论 :噪声暴露可对耳蜗功能状态产生明显影响 ,降低耳声发射的测值。对侧抑制对耳蜗进行负反馈调节 ,可明显提高TEOAE测试检出噪声暴露所引起改变的敏感度。