The influence of pressure compensation in the middle ear on the detection of distortion product otoacoustic emissions

Abstract

Cilj ovog rada bio je utvrđivanje uticaja kompenzacije pritiska u srednjem uvu na veličinu odgovora distorzionih otoakustičkih emisija (DPOAE) na frekvencijama od 1 do 6 kHz. Ispitivanje je obavljeno na 150 pacijenata, unutar pola i tri starosne grupe (2-15; 16-40; 41-71 godine). Pritisak u srednjem uvu je varirao od negativnog do pozitivnog (-329 do 195 daPa). Povećanje pritiska pri kompenzaciji za 1 daPa dovelo je do povećanja amplituda pri frekvencijama od 1.0, 1.3 i 1.6 kHz za 0,02, 0,03 i 0,02 dB SPL (decibel nivoa zvučnog pritiska), a nivoa buke pri frekvencijama od 1.0 do 2.0 kHz, uslovljavajući povećanje od 0,02 do 0,03 dB SPL. Kompenzacioni tretman je doveo do povećanja odgovora DPOAE (amplitude i nivoa buke). Povećanje amplituda je bilo najveće na frekvencijama manjim od 2 kHz unutar nivoa oba ispitivana uticaja. Kompenzacija pritiska uticala je stimulativno na detektabilnost DPOAE, čime se povećava pouzdanost 1 Rad je proistekao iz projekta "Uticaj kohlearne implantacije na edukaciju gluvih i nagluvih osoba" ON 179055, čiju realizaciju finansira Ministarstvo prosvete, nauke i tehnološkog razvoja Republike Srbije.2

Contrasting Effects of Pressure Compensation on TEOAE and DPOAE in Children With Negative Middle Ear Pressure

“…Although the trans-tympanic pressure difference is corrected in compensation, an abnormal pressure difference still exists at the oval window. Our results on DPA and noise changes on pressure compensation were only partly similar to those of Karić et al. (2016) on 50 child participants; they found modest enhancement of DPA in low frequency bands (1.0, 1.6, and 2.0 kHz) but surprisingly increased noise in mid-frequency bands (2–4 kHz) which we did not.…”

“…Compensation effects are smaller in ears with actual NMEP than in ears with artificially induced NMEP ( Marshall, Heller, & Westhusin, 1997 ). In exhaustive literature searches (Cochrane, Embase, and Google Scholar), we found 35 studies combining middle ear dysfunction and DPOAE response in children, but within these, there were only 4 studies on pressure in children ( Hof, Anteunis, et al., 2005 ; Hof et al., 2012 ; Hof, Dijk, et al., 2005 ), 3 using TEOAEs, and only 1 using DPOAEs ( Karić, Djoković, Dimić, Slavnić, & Savić, 2016 ). The latter authors included 50 children aged 2 to 15 years and compared amplitude (distortion product amplitude [DPA]) and noise levels before and after pressure compensation; however, they did not report the analysis parameter of signal-to-noise ratio (SNR).…”