Home About us Contact | |||
Otoacoustic Emissions Testing (otoacoustic_emission + testing)
Selected AbstractsEvidence for surviving outer hair cell function in congenitally deaf ears,THE LARYNGOSCOPE, Issue 11 2003FRCS (London), FRCS (ORL-HNS), Peter A. Rea MA Abstract Objective/Hypothesis: The hypotheses of the study were that congenital hearing impairment in infants can result from the isolated loss of inner hair cells of the cochlea and that this is shown by the presence of abnormal positive summating potentials on round window electrocochleography. The objectives were to establish the proportion of infants with hearing loss affected, the nature of the cochlear lesion, and its etiology. And to highlight the important implications for otoacoustic emissions testing and universal neonatal screening. Study Design: A prospectively conducted consecutive cohort study with supplemental review of notes was performed. Methods: Four hundred sixty-four children underwent round window electrocochleography and auditory brainstem response testing under general anesthesia to assess suspected hearing loss. The presence of abnormal positive potentials was recorded. Otoacoustic emissions data were collected separately and retrospectively. Results: Three hundred forty-two children had significant bilateral congenital hearing loss. All results were from hearing-impaired children. Abnormal positive potentials were recorded in 73 of 342 children (21%). Eighty-three percent of children with otoacoustic emissions also had abnormal positive potentials, but only 14% of children without otoacoustic emissions had abnormal positive potentials (P < .001). In the neonatal intensive care unit setting, 43% of infants were found to have abnormal positive potentials, whereas only 10% had abnormal positive potentials if not in the neonatal intensive care unit setting (P < .001). Abnormal positive potentials were present in 63% of infants born before 30 weeks gestation and in 14% of infants born at term (P < .001). Abnormal positive potentials were identified in 57% of infants with documented hypoxia and 11% of children with no episodes (P < .001). Otoacoustic emissions were present in 48% of infants from the neonatal intensive care unit, despite their hearing loss. Conclusion: Both otoacoustic emissions and abnormal positive potentials may originate from outer hair cell activity following inner hair cell loss. This may occur in more than 40% of hearing-impaired children in the neonatal intensive care unit setting. Chronic hypoxia is the most likely cause. Otoacoustic emissions testing may not be a suitable screening tool for such infants. [source] Alternative indications for laser-assisted tympanic membrane fenestrationLASERS IN SURGERY AND MEDICINE, Issue 4 2001Steven P. Cook MD Abstract Background and Objective To assess the utility of the CO2 Flashscanner laser for treatment of selected middle ear diseases other than otitis media with effusion (OME) and acute otitis media (AOM). Study Design/Materials and Methods A retrospective review of the records of 144 patients treated with the OtoLAM® device, a Flashscanner laser, between July 1, 1998, and February 29, 2000. Patients treated for AOM or OME were excluded. Results Data are presented on 11 patients (17 ears). Four indications were identified: Elimination of middle ear fluid before auditory brainstem response with or without otoacoustic emission testing (ABR,±,OAE), barotrauma, eustachian tube obstruction, tympanocentesis when a culture of middle ear fluid was deemed necessary. All tympanic membranes (TM) healed. Conclusions Fenestration of the TM can be accomplished for both diagnostic and therapeutic purposes. Laser assisted tympanic membrane fenestration seems to be effective in the management of middle ear fluid before ABR,±,OAE, barotrauma, eustachian tube dysfunction, and for tympanocentesis. Lasers Surg. Med. 28:320,323, 2001. © 2001 Wiley-Liss, Inc. [source] Evidence for surviving outer hair cell function in congenitally deaf ears,THE LARYNGOSCOPE, Issue 11 2003FRCS (London), FRCS (ORL-HNS), Peter A. Rea MA Abstract Objective/Hypothesis: The hypotheses of the study were that congenital hearing impairment in infants can result from the isolated loss of inner hair cells of the cochlea and that this is shown by the presence of abnormal positive summating potentials on round window electrocochleography. The objectives were to establish the proportion of infants with hearing loss affected, the nature of the cochlear lesion, and its etiology. And to highlight the important implications for otoacoustic emissions testing and universal neonatal screening. Study Design: A prospectively conducted consecutive cohort study with supplemental review of notes was performed. Methods: Four hundred sixty-four children underwent round window electrocochleography and auditory brainstem response testing under general anesthesia to assess suspected hearing loss. The presence of abnormal positive potentials was recorded. Otoacoustic emissions data were collected separately and retrospectively. Results: Three hundred forty-two children had significant bilateral congenital hearing loss. All results were from hearing-impaired children. Abnormal positive potentials were recorded in 73 of 342 children (21%). Eighty-three percent of children with otoacoustic emissions also had abnormal positive potentials, but only 14% of children without otoacoustic emissions had abnormal positive potentials (P < .001). In the neonatal intensive care unit setting, 43% of infants were found to have abnormal positive potentials, whereas only 10% had abnormal positive potentials if not in the neonatal intensive care unit setting (P < .001). Abnormal positive potentials were present in 63% of infants born before 30 weeks gestation and in 14% of infants born at term (P < .001). Abnormal positive potentials were identified in 57% of infants with documented hypoxia and 11% of children with no episodes (P < .001). Otoacoustic emissions were present in 48% of infants from the neonatal intensive care unit, despite their hearing loss. Conclusion: Both otoacoustic emissions and abnormal positive potentials may originate from outer hair cell activity following inner hair cell loss. This may occur in more than 40% of hearing-impaired children in the neonatal intensive care unit setting. Chronic hypoxia is the most likely cause. Otoacoustic emissions testing may not be a suitable screening tool for such infants. [source] Candidate's Thesis: Universal Newborn Hearing Screening in an Inner-City, Managed Care Environment ,THE LARYNGOSCOPE, Issue 6 2000Glenn Isaacson MD Abstract Objectives/Hypothesis Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations. As larger states attempt to implement such programs, important obstacles have arisen, particularly in sparsely populated rural environments and in the inner city, where poverty, unstable living situations, and inadequate access to health care make follow-up of infants failing initial testing difficult. Study Design We performed a prospective longitudinal study e-amining the effects of increasingly comple- and e-pensive interventions designed to ensure that children failing initial hearing screening returned for complete evaluation and habilitation. Methods A UNHS program based on transient evoked otoacoustic emissions testing was implemented at Temple University Hospital, with 2,000 births per year. At 6 months into the program, efficacy was assessed and modifications in follow-up methodology were made in an attempt to improved rate of return of infants failing newborn screening. The effect of these interventions was reassessed 6 months later. Results In its first 12 months, the Temple University Infant and Young Child Hearing Intervention Initiative successfully screened 95% (2,031) of all newborns using transient evoked otoacoustic emissions. Collecting a complete database profile for each newborn, establishing rapport with the family, and offering immediate follow-up appointments yielded a 61% return rate after discharge. The addition of a dedicated project secretary, free day-care for siblings, and cab vouchers for transportation and the elimination of a requirement for health maintenance organization referrals increased follow-up yield to 75%. Conclusion Given adequate resources and planning, UNHS can be successful, even in economically depressed environments. [source] |