Rasetshwane Daniel M, Fultz Sara E, Kopun Judy G, Gorga Michael P, Neely Stephen T
1Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA; and 2Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Ear Hear. 2015 Jan;36(1):111-24. doi: 10.1097/AUD.0000000000000089.
Cochlear reflectance (CR) is the cochlear contribution to ear-canal reflectance. CR is equivalent to an otoacoustic emission (OAE) deconvolved by forward pressure in the ear canal. Similar to other OAE measures, CR level is related to cochlear status. When measured using wideband noise stimuli, potential advantages of CR over other types of OAEs include (1) the capability to cover a wider frequency range more efficiently by requiring fewer measurements, (2) minimal influence on the recorded emission from the measurement system and middle ear, (3) lack of entrainment of spontaneous OAEs, and (4) easier interpretation because of the existence of an equivalent linear model, which validates the application of linear systems theory. The purposes of this study were to evaluate the reliability, assess the accuracy in a clinical screening paradigm, and determine the relation of CR to audiometric thresholds. Thus, this study represents an initial assessment of the clinical utility of CR.
Data were collected from 32 normal-hearing and 58 hearing-impaired participants. A wideband noise stimulus presented at seven stimulus levels (10 to 70 dB SPL, 10 dB steps) was used to elicit the CR. Reliability of CR was assessed using Cronbach's α, standard error of measurement, and absolute differences between CR data from three separate test sessions. Test performance was evaluated using clinical decision theory. The ability of CR to predict audiometric thresholds was evaluated using regression analysis.
CR repeatability across test sessions was similar to that of other clinical measurements. However, both the accuracy with which CR distinguished normal-hearing from hearing-impaired ears and the accuracy with which CR predicted audiometric thresholds were less than those reported in previous studies using distortion-product OAE measurements.
CR measurements are repeatable between test sessions, can be used to predict auditory status, and are related to audiometric thresholds. However, under current conditions, CR does not perform as well as other OAE measurements. Further developments in CR measurement and analysis methods may improve performance. CR has theoretical advantages for cochlear modeling, which may lead to improved interpretation of cochlear status.
耳蜗反射率（CR）是耳蜗对耳道反射率的贡献。CR等同于由耳道中的正向压力解卷积的耳声发射（OAE）。与其他OAE测量方法类似，CR水平与耳蜗状态有关。当使用宽带噪声刺激进行测量时，CR相对于其他类型OAE的潜在优势包括：（1）通过较少的测量就能更有效地覆盖更宽的频率范围；（2）对测量系统和中耳记录的发射影响最小；（3）不会夹带自发性OAE；（4）由于存在等效线性模型，解释更容易，该模型验证了线性系统理论的应用。本研究的目的是评估可靠性，在临床筛查范式中评估准确性，并确定CR与听力阈值的关系。因此，本研究代表了对CR临床效用的初步评估。
从32名听力正常和58名听力受损的参与者中收集数据。使用在七个刺激水平（10至70 dB SPL，10 dB步长）呈现的宽带噪声刺激来诱发CR。使用克朗巴哈α系数、测量标准误差以及来自三个独立测试会话的CR数据之间的绝对差异来评估CR的可靠性。使用临床决策理论评估测试性能。使用回归分析评估CR预测听力阈值的能力。
跨测试会话的CR重复性与其他临床测量相似。然而，CR区分听力正常与听力受损耳朵的准确性以及CR预测听力阈值的准确性均低于先前使用畸变产物OAE测量的研究报告。
CR测量在测试会话之间是可重复的，可用于预测听觉状态，并且与听力阈值相关。然而，在当前条件下，CR的表现不如其他OAE测量。CR测量和分析方法的进一步发展可能会提高性能。CR在耳蜗建模方面具有理论优势，这可能会改善对耳蜗状态的解释。
