Audiology : official organ of the International Society of Audiology最新文献

This study examined the effects of tympanometric variables, stage of disease, hyperventilation, and seizures on the auditory brainstem response (ABR) in Rett syndrome (RS). Thirty-four female children with RS ranging in age from 2 years, 3 months to 15 years, 7 months participated in the study. ABRs and tympanograms were recorded from all of the subjects. When the ABR peaks were identifiable, interpeak latency intervals (IPLIs) for I-III, III-V, and I-V were computed for each waveform. The peaks (I, III, and V) and IPLIs were characterized as abnormal if either the peaks were absent or the latencies were greater than 2 SD from the normative data (obtained on female children). Analyses revealed significant prolongation of wave I latencies in Rett children with abnormal tympanograms. ABR wave III latencies were significantly affected by the presence of seizures and hyperventilation. The Pearson chi-square statistic revealed significant differences in the rate of wave III and V abnormalities due to the presence and degree of hyperventilation and the presence of seizures. Wave I abnormalities were also observed in the presence of normal middle ear function, suggesting the presence of sensorineural hearing impairment in some RS children. Clinical implications of these findings are discussed.

The purpose of this study was to compare multifrequency tympanometry and otoacoustic emissions (OAEs) in rhesus monkeys (Macaca mulatta) and humans. Tympanometry and OAEs can be recorded efficiently in Macaca mulatta to assess peripheral auditory function with results comparable to those in humans. Differences include (1) greater admittances and conductances in humans from 226 to 630 Hz, the frequency range validly assessed; (2) larger amplitude transient evoked OAEs (TEOAEs) and noise levels in humans; (3) larger amplitude monkey 2f(1)-f(2) distortion product OAEs (DPOAES) (f(2)s>2 kHz); (4) more prominent DPOAEs other than 2f(1)-f(2) in monkeys; (5) more narrowly tuned human f(2)/f(1) X 2f(1)-f(2) amplitude functions at the lower frequencies tested; and (6) lower 2f(1)-f(2) DPOAE thresholds at f(2)=0.5 kHz and > or = 8 kHz in monkeys.

Measuring the understanding of connected speech by hearing-impaired children is desirable if an appropriate rehabilitative or special educational program is to be implemented or monitored. This study was undertaken to explore the potential of a Cantonese version of the Helen sentence test as a measure of understanding connected speech by a group of 54 mildly to profoundly hearing-impaired children, and to compare the results from this sentence test with those achieved by the same children on a connected discourse test. The effects of two different hearing aid frequency responses and two noise conditions on the results from both tests were also examined. Findings from the present study revealed that the Helen sentence test could be successfully adapted for use with Cantonese-speaking hearing-impaired children in Hong Kong. When compared to the connected discourse test, the modified Helen test produced significantly higher scores and was more sensitive to changes in noise level, especially for the severely and profoundly hearing-impaired children.

Tinnitus is one of the consequences of cisplatin chemotherapy, but its underlying mechanisms are not well understood. Since it has been shown that cisplatin causes outer hair cell loss, it is possible that loss of these cells might induce tinnitus by increasing spontaneous activity in the central auditory system. To test this possibility, the present study examined the effects of cisplatin treatment on cochlear hair cells and on spontaneous neural activity in the dorsal cochlear nucleus of hamsters. Recordings, carried out approximately 1 month after cisplatin treatment, demonstrated significant increases in spontaneous activity across broad regions of the dorsal cochlear nucleus relative to levels in saline-treated controls. Histological results showed that cisplatin-treated animals also displayed dramatic loss of outer hair cells over most of the basal turn of the cochlea. Inner hair cells remained intact, although some evidence of damage to their stereocilia was evident. These findings indicate that cisplatin treatment causes abnormalities in spontaneous activity in the dorsal cochlear nucleus that are associated with widespread damage to outer hair cells. However, since some damage to inner hair cells was also observed, the role of inner hair cell injury in contributing to higher spontaneous activity cannot be ruled out.

This study evaluated the characteristics of transient evoked otoacoustic emission (TEOAE) time-frequency (TF) representations from normal and hearing-impaired ears. Linear and non-linear TEOAE recordings from normally-hearing subjects (40) and non-linear recordings from patients with sensorineural hearing loss (SNHL) (40) were analysed using the short-time-Fourier-transform spectrogram, the Gabor spectrogram, and the adaptive spectrogram. The TF representations of the TEOAE recordings indicated a considerable dispersion of energy across frequencies and TEOAE time segments >4.0 ms. The linear and non-linear recordings from the normal subjects showed common frequency peaks. The TF representations from the patients with SNHL indicated that the significantly reduced energy in the mid-to-high TEOAE frequencies did not correlate closely with the threshold elevation. As in the recordings from the normal subjects, a high percentage of the TEOAE cumulative energy was found within a short TEOAE segment (4-14 ms).

The estimation of the maximum comfort loudness levels (MCL) by measurements of the electrically elicited stapedius reflex was examined in six experienced cochlear implant users supplied with the COMBI 40 implant system. The stapedius reflex was tested and loudness scaling was performed simultaneously using an up/down stimulation protocol close to the reflex threshold with automated recording of both test procedures. The electrical stapedius reflex threshold (ESRT) and loudness scaling were evaluated separately. Scaling at the reflex threshold ranged between normal and loud. The range of stimulus intensities corresponding to ESRT is much smaller than that at a particular loudness category. The overall correlation between ESRT and MCL was high (r=0.92), with a similar dependence of ESRT and MCL on the channel stimulated. Thus, when the stapedius reflex can be detected post-operatively, the ESRT can be applied successfully for the fitting procedure of the speech processor. Simultaneous loudness scaling during the entire reflex test showed that overstimulation via the implant can be avoided effectively.

To determine the nature of sensorineural hearing loss in the middle-frequency range (U-shaped audiogram), we compared the differences in electrocochleographic findings for 15 ears with vestibular schwannomas and 10 ears without tumours. Short-tone bursts of 0.5, 1, 2, and 4 kHz were used to evoke cochlear microphonics (CM). Ears with tumours had normal or lower CM detection thresholds than ears without tumours. Input-output curves for 1-kHz frequency were normal in 10 ears with tumours and in 1 ear without tumours. These indicate that tumour ears have no or mild cochlear dysfunction. In addition, CM detection thresholds of ears with tumours were lower than audiometric thresholds, particularly at the 1- and 2-kHz region. These findings suggest that the loss seen by audiometry in ears with vestibular schwannomas was from a retrocochlear component.

This contribution forms part of the HEAR project. It describes some phenotypes of inherited low-frequency sensorineural hearing impairment (LFSHI) and estimates the prevalence of this inherited hearing impairment (HI) based on a clinical series. During a 10-year period (1987-1996), 418 subjects (134 males and 284 females), with a median age of 68 years (range 4-98), had been examined with LFSHI, defined as hearing loss most pronounced in the low frequencies (i.e., 250 and 500 Hz > 20 dB HL with better hearing, i.e., > or =15-dB difference at 1 and/or 2 and/or 4 kHz with an air-bone gap <15 dB for the average of 0.5, 1, and 2 kHz). The 418 subjects comprising 0.6 per cent of the total number of subjects examined (N=69,309) were subdivided into four categories: category I positive genetic subjects (N=69); category II, probably genetic (N=339); category III, uncertain genetic (N=6); and category IV, subjects with contradictory audiological findings (N=4). The phenotype in category I demonstrated a symmetrical LFSHI, with a pattern of progression showing a slow deterioration in the high frequencies (i.e., 2, 4, and 8 kHz as a function of age)--the progression comprising 40-45 dB. In the low frequencies (i.e., 250, 500, and 1,000 Hz), a deterioration of 15-25 dB could be demonstrated from the youngest to the oldest age group. In category II, a symmetrical LFSHI was found in 179 subjects, showing the same pattern of progression as in category I. However, in the age group 20-39 years, a significantly poorer hearing was found in the low frequencies compared to category I, implying that several phenotypes may be present in LFSHI. A subgroup (A) in category II exhibited normal hearing in one ear with LFSHI in the opposite ear with the same pattern of progression as in category I. Three other subgroups with LFSHI and flat/sloping audiogram in the opposite ear and asymmetrical LFSHI also showed the same type of progression in the ear with LFSHI as in category I. A prevalence of 0.18/1,000 (95 per cent CI 0.13-0.22) of LFSHI was estimated based on the background population with a fairly constant prevalence throughout life. It is concluded that inherited nonsyndromal LFSHI is a rare disease and that the many different phenotypes of LFSHI probably are associated with pronounced genetic heterogeneity.

We have used positron emission tomography (PET) to test a specific hypothesis of a neural system subserving auditory temporal processing (acoustical stimulus duration discrimination). Maps of the cerebral blood flow distribution during specific stimulations were obtained from five normally-hearing and otherwise healthy subjects. The auditory stimuli consisted of sounds of varying duration and of auditorily presented words in which the duration of the initial phoneme was manipulated. All stimuli alternated with conditions of silence in a subtraction paradigm. The blood flow distribution was mapped with O-15-labelled water. The results demonstrated that stimuli requiring recognizing, memorizing, or attending to specific target sounds during temporal processing generally resulted in significant activation of both frontal lobes and the parietal lobe in the right hemisphere. Based on these results, we hypothesise that a network consisting of anterior and posterior auditory attention and short-term memory sites subserves acoustical stimulus duration perception and analysis (auditory temporal processing).

The working hypothesis of an ongoing study is that the quick and reliable procedure of acoustic reflex threshold (ART) determination in conjunction with measurements of HTL may yield accurate estimates of loudness. The aim of this study was to investigate whether differences in loudness in normally-hearing subjects are reflected in the ARTs and to collect normal material with respect to pure-tone elicited ART and loudness categories. Categorical loudness scaling (CLS) and ART measurements were performed at frequencies of 0.5, 1, 2 and 4 kHz in 60 normally-hearing subjects (HTL<20 dB HL, 26 males, 34 females, aged 21-63 years) with no history or sequelae of middle ear disease. Subjects reporting disturbing tinnitus were excluded. The results show that the ART is not a predictor of individual loudness perception for normally-hearing subjects. Using a numerical scale (HTL=0, 'very soft'=5, 'soft'=15, 'OK'=25, 'loud'=35, 'very loud'=45 and 'too loud'=50) loudness for pure tones grows almost linearly at approximately 0.4 arbitrary loudness units per dB below the 'loud' category. Above the 'loud' category the slope is around 1 unit per dB. The median ART was 85 dB HL at frequencies of 0.5, 1, 2 and 4 kHz. No differences in loudness perception across frequencies were found.