School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California, USA.
Ear Hear. 2018 Jan/Feb;39(1):85-100. doi: 10.1097/AUD.0000000000000465.
Distortion-product otoacoustic emissions (DPOAEs) are repeatable over time at lower frequencies (≤8 kHz) and higher frequencies (>8 kHz) in healthy, normal-hearing subjects. The purpose of this study was to examine the repeatability of DPOAEs measured with high-frequency (HF) stimuli in a patient population. It was hypothesized that HF DPOAEs would be repeatable over four trials.
DPOAEs were measured in 40 cystic fibrosis (CF) patients (17 females and 23 males) with measurable behavioral thresholds and present DPOAEs for at least 2 of the high frequencies tested (8 to 16 kHz). A depth-compensated simulator sound pressure level (SPL) method of calibration was utilized. Each patient attended four trials, in which a complete set of data were collected. At each trial, three different DPOAE paradigms were completed. First, a discrete frequency sweep was measured between 8 and 16 kHz with a ratio (f2/f1) of 1.2 and levels of 65/50 dB SPL for L1/L2. Next, ratio and level sweeps were obtained at the two highest frequencies with a present DPOAE determined from the discrete frequency sweep, and the results were used to calculate DPOAE group delay and DPOAE detection thresholds, respectively. Ratio sweeps were collected with f2/f1 varied from 1.1 to 1.3 and stimulus levels of 60/45 dB SPL (L1/L2). Level sweeps were collected with an f2/f1 of 1.22 and L2 = 50 and L1 varied between 20 and 70 dB SPL. Differences and correlations between trials, SE of the measurement, and confidence intervals were calculated, as well as a repeated-measures analysis of variance.
DPOAE response and behavioral threshold variability in CF patients were not significantly different across four trials. It can be expected in 95% of CF patients that differences between trials of DPOAE levels, group delay, and detection thresholds and behavioral thresholds are less than 6.26 dB, 0.87 msec, 9.34 dB, and 9.60 dB, respectively.
HF DPOAEs were repeatable across four test trials for all three paradigms measured in a group of CF patients. These results are encouraging for the measurement of HF DPOAEs to be monitored in those exposed to ototoxic agents.
在健康、正常听力受试者中，低频（≤8 kHz）和高频（>8 kHz）的失真产物耳声发射（DPOAEs）随时间具有可重复性。本研究的目的是检查在患者人群中使用高频（HF）刺激测量的 DPOAE 的可重复性。假设 HF DPOAEs 将在四个试验中具有可重复性。
在 40 名囊性纤维化（CF）患者（17 名女性和 23 名男性）中测量 DPOAE，这些患者具有可测量的行为阈值，并且至少有 2 个测试的高频（8 至 16 kHz）存在 DPOAE。使用深度补偿模拟器声压级（SPL）校准方法。每位患者参加了四次试验，在每次试验中都收集了完整的数据。在每次试验中，都完成了三种不同的 DPOAE 模式。首先，在 8 至 16 kHz 之间测量离散频率扫描，比率（f2/f1）为 1.2，L1/L2 的水平为 65/50 dB SPL。接下来，在两个最高频率上获得比率和电平扫描，使用来自离散频率扫描的存在 DPOAE 来确定结果，分别用于计算 DPOAE 群延迟和 DPOAE 检测阈值。比率扫描的收集范围为 f2/f1 从 1.1 到 1.3，刺激水平为 60/45 dB SPL（L1/L2）。电平扫描的收集范围为 f2/f1 为 1.22，L2 = 50，L1 介于 20 至 70 dB SPL 之间。计算了试验之间的差异和相关性、测量的标准误差以及置信区间，并进行了重复测量方差分析。
在四个试验中，CF 患者的 DPOAE 反应和行为阈值变异性没有显著差异。可以预期，在 95%的 CF 患者中，试验之间的 DPOAE 水平、群延迟和检测阈值以及行为阈值的差异小于 6.26 dB、0.87 msec、9.34 dB 和 9.60 dB。
在一组 CF 患者中，对三种测量模式的高频 DPOAE 在四个测试试验中均具有可重复性。这些结果令人鼓舞，因为可以监测接触耳毒性药物的人群中的高频 DPOAE。
