Zelle D, Dalhoff E, Gummer A W
Section of Physiological Acoustics and Communication, Department of Otolaryngology, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany.
HNO. 2017 Aug;65(Suppl 2):122-129. doi: 10.1007/s00106-016-0267-y.
Distortion product otoacoustic emissions (DPOAEs) and transient-evoked otoacoustic emissions (TEOAEs) are sound waves generated as byproducts of the cochlear amplifier. These are measurable in the auditory canal and represent an objective method for diagnosing functional disorders of the inner ear. Conventional DPOAE and TEOAE methods permit detection of hearing impairment, but with less than desirable accuracy.
By accounting for DPOAE generation mechanisms, the aim is to improve the accuracy of inner-ear diagnosis.
DPOAEs consist of two components, which emerge at different positions along the cochlea and which may cause artifacts due to mutual interference. Here, the two components are separated in the time domain using short stimulus pulses. Optimized stimulus levels facilitate the acquisition of DPOAEs with maximum amplitudes. DPOAE and Békésy audiograms were recorded from 41 subjects in a clinically relevant frequency range of 1.5-6 kHz.
The short stimulus pulses allowed artifact-free measurement of DPOAEs. Semilogarithmic input-output functions yielded estimated distortion product thresholds, which were significantly correlated with the subjectively acquired Békésy thresholds. In addition, they allowed detection of hearing impairment from 20 dB HL, with 95% sensitivity and only a 5% false-positive rate. This accuracy was achieved with a measurement time of about 1-2 min per frequency.
Compared to conventional DPOAE and TEOAE methods, separation of DPOAE components using short-pulse DPOAEs in combination with optimized stimulus parameters considerably enhances the accuracy of DPOAEs for diagnosing impairment of the cochlear amplifier.
畸变产物耳声发射（DPOAE）和瞬态诱发耳声发射（TEOAEs）是作为耳蜗放大器副产品产生的声波。这些可在耳道中测量，并代表一种诊断内耳功能障碍的客观方法。传统的DPOAE和TEOAEs方法可检测听力损伤，但准确性不尽人意。
通过考虑DPOAE的产生机制，旨在提高内耳诊断的准确性。
DPOAE由两个成分组成，它们沿耳蜗出现在不同位置，并且可能由于相互干扰而产生伪迹。在此，使用短刺激脉冲在时域中将这两个成分分离。优化的刺激水平有助于获取具有最大幅度的DPOAE。在1.5 - 6kHz的临床相关频率范围内，从41名受试者记录了DPOAE和贝凯西听力图。
短刺激脉冲允许对DPOAE进行无伪迹测量。半对数输入 - 输出函数产生估计的畸变产物阈值，其与主观获得的贝凯西阈值显著相关。此外，它们能够检测出20dB HL以上的听力损伤，灵敏度为95%，假阳性率仅为5%。每个频率的测量时间约为1 - 2分钟即可达到这种准确性。
与传统的DPOAE和TEOAEs方法相比，使用短脉冲DPOAE结合优化的刺激参数分离DPOAE成分，可显著提高DPOAE诊断耳蜗放大器损伤的准确性。
