Assessment of Peripheral and Central Auditory Function.ppt

SP/AP Ratio Abnormal ratio is defined as more than 50% for canal electrode type More than 40% for tympanic membrane electrode More than 30% for transtympanic needle electrode Meniere Disease Tympanic membrane electrode technique Sensitivity is 57% for endolymphatic hydrops but 94% specificity Otoacoustic Emissions Low intensity sounds produced by the cochlea either spontaneously or in response to stimulus Outer hair cell motility affects basilar membrane and the result is a form of intracochlear energy amplification and cochlear tuning for precise frequency resolution. Mechanical energy is propagated outward though middle ear. Vibration of TM produces an acoustic signal (the OAE), detected by a sensitive microphone. 2 Broad Classes of OAE Spontaneous OAE (SOAE) Evoked OAE SOAE Only occur in approximately 60% of persons with normal hearing, without any external sound stimulation A marked sex effect been confirmed Man : Woman = 1: 2 Evoked OAE Elicited by 50 ~ 80 dB SPL in EEC Stimulus-frequency OAE (SFOAE) is technically difficult to record and least studied. Distortion-product OAE (DPOAE) Transiently evoked OAE (TEOAE) DPOAE Produced when 2 pure tone stimuli (f1 and f2) are presented to ear simultaneously. DPOAE is determined by the equation 2f1-f2. The actual cochlear frequency region assessed with DPOAE is between f1 and f2. Probably close to the f2 stimulus. TEOAE Transient stimuli, clicks, evoke emissions from a large portion of the cochlea. Generally present when hearing thresholds are below 35dB. Advantages Reliable separate normal from abnormal at 20-30dB Fast Disadvantages Poor at higher frequencies Damage to Outer Hair Cells To mild cochlear dysfunction, OAE can be recorded but amplitudes are below normal limits Tinnitus: OAE provide information at far more frequencies (up to 20 per octave) than does an audiogram Up to 30% of a population of outer hair cells can be damaged without substantially affecting a simple audiogram Clinical Applications of OAE Child