Dalhoff E, Vetesník A, Turcanu D, Gummer A W
HNO-Klinik Tübingen, Deutschland.
HNO. 2010 Jun;58(6):543-55. doi: 10.1007/s00106-010-2104-z.
Recent publications show that DPOAE measurements can generate a more accurate diagnosis, if (1) their fine structure is suppressed, and (2) if the calibration of the sound field is improved. Reduction of the fine structure is particularly important in the frequency range below 4 kHz in subjects with intact cochlear amplifier and can reduce the standard deviation of threshold estimations based on DPOAE-input/output functions from 11 dB to 6 dB. Improving the sound-field calibration has most impact in the frequency range above 4 kHz. Threshold estimations based on laserinterferometrically measured DPOAE input-output functions where the sound field was calibrated close to the tympanic membrane have been shown to reduce the standard deviation down to 8.6 dB in humans and 6.5 dB in guinea pigs. Compared with conventional DPOAE measures, such as amplitude or signal-to-noise ratio, threshold estimation based on DPOAE-I/O functions has the advantage that its slope provides additional information about the middle-ear; however, its specificity is limited. In the future, combined methods such as acoustic reflectance or laser vibrometry on the umbo promise a reliable assessment of the middle-ear contribution to DPOAE.
最近的出版物表明，如果满足以下两个条件，畸变产物耳声发射（DPOAE）测量能够实现更准确的诊断：（1）抑制其精细结构；（2）改善声场校准。对于具有完整耳蜗放大器的受试者，在4kHz以下的频率范围内，降低精细结构尤为重要，这可以将基于DPOAE输入/输出函数的阈值估计标准差从11dB降低到6dB。改善声场校准在4kHz以上的频率范围内影响最大。基于激光干涉测量的DPOAE输入/输出函数（声场在鼓膜附近进行校准）的阈值估计已被证明，在人类中可将标准差降低至8.6dB，在豚鼠中降低至6.5dB。与传统的DPOAE测量方法（如幅度或信噪比）相比，基于DPOAE输入/输出函数的阈值估计的优势在于其斜率能提供有关中耳的额外信息；然而，其特异性有限。未来，诸如对鼓膜脐部进行声反射或激光振动测量等联合方法有望对中耳对DPOAE的贡献进行可靠评估。
