Durante Alessandra Spada, Carvallo Renata Mota Mamede
Curso de Fonoaudiologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo.
Pro Fono. 2006 Jan-Apr;18(1):49-56. doi: 10.1590/s0104-56872006000100007.
It has been suggested that the function of the medial olivocochlear system (MOCS) can be evaluated by the suppression effect of the transient evoked otoacoustic emission (TEOAE). The competitive noise has an inhibitory effect on the functioning of the outer hair-cell, reducing the level of otoacoustic emissions. Despite the fact that there is no postnatal growth of the cochlea, middle ear growth and auditory processing development continue after birth.
To analyze age-related changes of MOCS using the TEOAE suppression in healthy infants.
25 full-term infants with no risk factors for hearing loss were evaluated in two moments: at birth and at the age of six months. At both ages TEOAE were recorded in the "Quickscreen" mode, nonlinear stimulation at 78dB peSPL, for both ears, with and without contralateral noise presented at 60dB SPL.
The data analyses, using ANOVA, revealed significant contralateral suppression of otoacoustic emissions in both groups, but the TEOAE levels and the amount of TEOAE contralateral suppression were smaller at six-month of age when compared to the neonatal period (p < 0.01). The TEOAE suppression effect for neonatals was 2.81dB (+/- 0.19dB) and at the age of six months was 1.41dB (+/- 0.29dB).
The amount of TEOAE suppression decreased from birth to six months of age. The association between contralateral acoustic stimulation and a commercially available rapid TEOAE measurement system enables a non-invasive monitoring of the auditory efferent mechanism and seems to be clinically feasible to evaluate cochlear status and auditory efferent function development in infants at risk.
有人提出,内侧橄榄耳蜗系统(MOCS)的功能可通过瞬态诱发耳声发射(TEOAE)的抑制效应来评估。竞争性噪声对外毛细胞功能有抑制作用,会降低耳声发射水平。尽管耳蜗出生后不再生长,但中耳生长和听觉处理发育在出生后仍会继续。
利用TEOAE抑制来分析健康婴儿中MOCS与年龄相关的变化。
对25名无听力损失风险因素的足月儿在两个时间点进行评估:出生时和6个月大时。在两个年龄段,均以“快速筛查”模式记录双耳的TEOAE,非线性刺激强度为78dB peSPL,分别记录有无60dB SPL对侧噪声时的情况。
使用方差分析进行数据分析发现,两组中对侧耳声发射均有显著抑制,但与新生儿期相比,6个月大时TEOAE水平和TEOAE对侧抑制量较小(p < 0.01)。新生儿的TEOAE抑制效应为2.81dB(±0.19dB),6个月大时为1.41dB(±0.29dB)。
从出生到6个月大,TEOAE抑制量减少。对侧声刺激与市售快速TEOAE测量系统之间的关联能够对听觉传出机制进行无创监测,并且在评估有风险婴儿的耳蜗状态和听觉传出功能发育方面似乎在临床上是可行的。