RESUMEN
Our objectives were 1) to determine whether transiently evoked otoacoustic emissions (TEOAEs) are affected by the status of the tympanic membrane (TM) and middle ear (ME) as determined by clinical examinations and tympanograms; 2) to determine the efficacy of TEOAEs in detecting hearing loss; and 3) to determine the relative effects of the ME status and hearing loss on TEOAEs. In a prospective observational study in a tertiary care children's hospital, 89 patients (169 ears; 9 ears eliminated from analyses) were examined by 2 attending pediatric otolaryngologists for otologic conditions and underwent audiologic evaluations including TEOAEs from August 1994 through May 1995. The main outcome measures were presence or absence of TEOAE whole reproducibility (WR) and reproducibility (R) at 2 kHz. Statistical analyses showed that of the 8 ME and TM conditions evaluated (normal, TM perforation, pressure equalization [PE] tube, TM retraction, tympanosclerosis, TM atrophy, ME effusion, surgery other than PE tube insertion), only the presence of ME effusion and normal examination findings had a significant effect on the results of WR and R at 2 kHz. Of the 6 different types of tympanograms evaluated (A, B, C, AD, As, B with large volume), type A, B, and C tympanograms had a significant effect on WR and types A and B had a significant effect on R at 2 kHz. Hearing losses > or = 25 dB hearing level (HL) at any of the 5 frequencies (0.25, 0.5, 1, 2, and 4 kHz) were well predicted by the absence of WR and R at 2 kHz. When clinical examination and impedance data were evaluated simultaneously with hearing status, hearing status had a greater effect on WR and R at 2 kHz. We conclude that type B and C tympanograms and the presence of ME effusion (which reflect abnormal ME status) have an adverse effect on TEOAEs. However, the presence of hearing loss is the most significant predictor of TEOAE results. The TEOAE WR and R at 2 kHz are effective in identifying patients with normal hearing and with hearing losses > or = 25 dB HL.
Asunto(s)
Enfermedades del Oído/diagnóstico , Trastornos de la Audición/diagnóstico , Pruebas de Impedancia Acústica , Estimulación Acústica , Preescolar , Oído Medio/fisiopatología , Humanos , Emisiones Otoacústicas Espontáneas/fisiología , Estudios Prospectivos , Reproducibilidad de los ResultadosRESUMEN
Measures of transient evoked otoacoustic emission (TEOAE) reproducibility were obtained for 506 ears of 260 children and young adults. Frequency-specific and whole reproducibility data were obtained using ILO88 hardware and software (version 3.92), and were analyzed with respect to pure tone threshold and emmittance data for the same ears. The 2,000-Hz reproducibility score was the most efficient of all measurements (0.85-0.91) in separating normal and hearing-impaired ears, regardless of the frequencies at which the hearing loss occurred. TEOAE reproducibility measures may be very useful in screening for hearing loss in babies, leading to the earliest identification of children with hearing loss.
Asunto(s)
Estimulación Acústica , Cóclea , Trastornos de la Audición/diagnóstico , Adolescente , Adulto , Umbral Auditivo , Niño , Preescolar , Femenino , Humanos , Lactante , MasculinoRESUMEN
The purpose of this study was to discover whether sensorineural hearing loss was a significant complication in survivors of persistent fetal circulation. Eleven patients were followed to 36 months. Hearing assessments were performed on at least two occasions using brain stem auditory evoked response testing and behavioral audiometry. Three of 11 babies had bilateral, progressive sensorineural hearing loss. No clear relationship could be found between hearing loss and any of the clinical variables examined in this study.
Asunto(s)
Pérdida Auditiva Sensorineural/etiología , Síndrome de Circulación Fetal Persistente/complicaciones , Audiometría de Respuesta Evocada , Preescolar , Femenino , Pérdida Auditiva Sensorineural/diagnóstico , Pruebas Auditivas , Humanos , Lactante , Recién Nacido , Desarrollo del Lenguaje , MasculinoRESUMEN
The present investigation examined the effects of sickle cell anemia on threshold hearing. The study included 43 homozygous sickle cell anemia patients, ages 7-18 years, and 23 age-matched controls with documented normal hemoglobin. Both the study and control groups received otologic and audiologic examinations. Bilaterally normal hearing was found in 88% of the sickle cell subjects. Unilateral or bilateral mild high frequency sensorineural hearing loss was demonstrated in 12% (5 of 43). The control subjects revealed no hearing loss. The sickle cell group, therefore, exhibited a higher than usual incidence of hearing loss. Further, three of the five subjects with hearing loss evidenced central nervous system involvement, resulting in a probability of < 0.025 that this relation might occur by chance. Periodic hearing evaluations of children with sickle cell anemia should be performed to identify those with auditory complications and those who possibly may have CNS involvement.