Dille Marilyn, Glattke Theodore J, Earl Brian R
Listen for Life Center, Virginia Mason Medical Center, Seattle, WA, United States.
Int J Pediatr Otorhinolaryngol. 2007 Nov;71(11):1789-95. doi: 10.1016/j.ijporl.2007.08.003. Epub 2007 Sep 17.
The first purpose of this study was to compare transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) to determine if they resulted in equivalent signal-to-noise ratios (SNRs) when used for hearing screening in a preschool population in a community setting. The second purpose was to determine if the OAE methods would result in equivalent pass/refer rates. The third purpose was to determine the agreement between the pass/refer rates from a tympanometric screening and the pass/refer rates from each OAE method.
Thirty-three preschool children ages 4 months to 4 years, 4 months were tested using DPOAE and TEOAE. The frequencies 800-4000Hz were compared. The tympanometric gradient was obtained from a tympanogram done on each ear. A multivariate statistic was used to compare the emission SNR from both methods. A chi(2) statistic was used to compare the pass/refer rates from both methods. The agreement between the pass/refer rates from the OAE screens and from the tympanometric gradient were compared.
TEOAE and DPOAE SNRs were significantly different in the low frequency however, there were no significant differences found in the high frequencies. There were no significant pass/refer differences found between the methods at any frequency. When comparing the agreement between the OAE methods with the tympanometry, both methods produced nearly equivalent agreement with tympanometric gradient. However, the overall correspondence between OAE findings and tympanometry was not perfect.
Both methods are effective and especially equivalent in the high frequencies and can be recommended for use in a preschool population in the field. Tympanometric gradient disagreed with both OAE screening results about 25% of the time. Finally, our study also found that higher refer rates can be expected when young (<3 years) preschool children are included in the screen.
本研究的首要目的是比较瞬态诱发耳声发射（TEOAE）和畸变产物耳声发射（DPOAE），以确定在社区环境中对学龄前儿童进行听力筛查时，它们是否能产生等效的信噪比（SNR）。第二个目的是确定耳声发射方法是否会产生等效的通过/转诊率。第三个目的是确定鼓室图筛查的通过/转诊率与每种耳声发射方法的通过/转诊率之间的一致性。
对33名年龄在4个月至4岁4个月的学龄前儿童进行了DPOAE和TEOAE测试。比较了800 - 4000Hz的频率。通过对每只耳朵进行鼓室图检查获得鼓室图梯度。使用多变量统计来比较两种方法的发射SNR。使用卡方统计来比较两种方法的通过/转诊率。比较了耳声发射筛查的通过/转诊率与鼓室图梯度之间的一致性。
TEOAE和DPOAE的SNR在低频时有显著差异，然而在高频时未发现显著差异。在任何频率下，两种方法之间的通过/转诊差异均不显著。当比较耳声发射方法与鼓室图之间的一致性时，两种方法与鼓室图梯度的一致性几乎相同。然而，耳声发射结果与鼓室图之间的总体对应并不完美。
两种方法都有效，尤其是在高频时等效，可推荐用于该领域的学龄前儿童。鼓室图梯度与两种耳声发射筛查结果约25%的时间不一致。最后，我们的研究还发现，当将年龄较小（<3岁）的学龄前儿童纳入筛查时，预计转诊率会更高。
