BACKGROUND AND OBJECTIVES: Transient evoked otoacoustic emissions (TEOAEs) have been used as a screening test for early detection of hearing loss in newborns and infants, because most of the normal hearing show TEOAEs. But the lack of understanding about the properties of spontaneous otoacoustic emissions (SOAEs) has limited their usefulness on the clinical basis. This study was designed with the purpose to find out the properties of SOAEs and their correlation with TEOAEs. MATERIALS AND METHODS: TEOAE and SOAE tests were performed in 95 neonates (190 ears, male:female=47:48) of well baby clinic in DKUH. RESULTS: 1) The prevalence of SOAEs were 86.8% (165/190 ears):87.2% (82/94 ears) in male and 86.5% (83/96 ears) in female, 91% (86/95 ears) in the right ears and 83% (75/95 ears) in the left ears. 2) The number of peaks in SOAEs was 4.14+/-1.92 overally, 4.38+/-2.01 in right ears, 3.87+/-1.79 in left ears, and 4.34+/-1.95 in males and 3.94+/-1.88 in females. There was a significant difference between the right and the left ears. 3) The level of SOAEs was -18.4 to 22.6 dB SPL. The highest amplitude of SOAEs in each subject was 3.69+/-8.87 dB SPL. 4) The SOAE frequency was mainly between 1000 Hz and 4000 Hz, and most frequently between 3000 Hz and 4000 Hz. The mean frequency of the highest amplitude of SOAE was 2907+/-1092 Hz. 5) The highest amplitude of SOAE was correlated with the overall response amplitude of TEOAE (r=0.619, p<0.01), but not the number of peaks (r=0.086, p=0.272). CONCLUSION: Neonates have robust SOAEs, which correlated with their TEOAEs.
Ear ; Female ; Hearing ; Hearing Loss ; Humans ; Infant ; Infant, Newborn* ; Male ; Mass Screening ; Otoacoustic Emissions, Spontaneous ; Prevalence

Distortion product otoacoustic emission (DPOAE) signal can be used for diagnosis of hearing loss so that it has an important clinical value. Continuously using sweeping primaries to measure DPOAE provides an efficient tool to record DPOAE data rapidly when DPOAE is measured in a large frequency range. In this paper, locally weighted least squares estimation (LWLSE) of 2f1-f2 DPOAE is presented based on least-squares-fit (LSF) algorithm, in which DPOAE is evoked by continuously sweeping tones. In our study, we used a weighted error function as the loss function and the weighting matrixes in the local sense to obtain a smaller estimated variance. Firstly, ordinary least squares estimation of the DPOAE parameters was obtained. Then the error vectors were grouped and the different local weighting matrixes were calculated in each group. And finally, the parameters of the DPOAE signal were estimated based on least squares estimation principle using the local weighting matrixes. The simulation results showed that the estimate variance and fluctuation errors were reduced, so the method estimates DPOAE and stimuli more accurately and stably, which facilitates extraction of clearer DPOAE fine structure.
Algorithms ; Hearing Loss ; diagnosis ; Humans ; Least-Squares Analysis ; Otoacoustic Emissions, Spontaneous ; Regression Analysis

OBJECTIVETo study how to perform the hearing screening on the infants in the rural area.

METHODSThree thousand nine hundreds and twenty-two infants, about 84% of them from rural, were born in the People Hospital of LaiZhou City from January to December in 2004. The infants were performed fast hearing screening by transient evoked otoacoustic emission (TEOAE) after the birth in 2-7 days. The fail cases were checked again after 4-6 weeks, and then were diagnosed if they still failed after following-up.

RESULTSThe infants (3612/3922, 92.1%) have been checked by TEOAE, and the examination was free in the poverty cases. The rate passed on the first check was 69.96% (2527/3922), but 1085 infants failed (30.4%), while 310 infants have not been checked (7.9%). In the 1085 cases that should be rechecked, there was only 633 cases (58.34%) accepted the check on time, while 452 cases (41.66%) missed. In the 163 cases with high-risk infants in 2004, 114 infants (69.96%) were checked, but 49 infants (29.04%) were not checked. Fourteen cases failed in the recheck, and 11 of them were checked by ABR. Two cases were found to be moderate and severe hearing loss in binaural respectively and 4 cases with mild hearing loss in monaural while 3 cases were normal.

CONCLUSIONSIt is necessary and viable for the infants on hearing screening in the rural area It should be set up and perfected the model for infants on hearing screening in rural area as soon as possible; it should be free for the poor infants to make sure everyone enjoy the health care.

China ; Hearing Tests ; Humans ; Infant, Newborn ; Neonatal Screening ; methods ; Otoacoustic Emissions, Spontaneous ; Rural Population

OBJECTIVE: To investigate the relationship between passing rate of otoacoustic emission (OAE) and pure tone thresholds. METHOD: OAE including both transient evoked otoacoustic emission (TEOAE) and distortion products otoacoustic emission (DPOAE) as well as pure tone thresholds were measured in subjects with normal hearing and sensory hearing loss. The passing rates of OAE were calculated in subjects with different age groups and different pure tone thresholds. RESULT: TEOAE can identify hearing loss at frequencies of 2 kHz and below. For TEOAE and 2 kHz DPOAE, passing rate has no difference between different age groups. For 4 kHz DPOAE, the passing rate in age over 50 years group is lower than other groups. The passing rate decreased as the pure tone threshold increased. When TEOAE and DPOAE suggest " pass", 70%, 81%, 79% subjects had pure tone threshold lower than 25 dB HL and 94%, 96%, 93% lower than 40 dB HL respectively. When they suggest "refer", 93%, 84%, 87% subjects had pure tone threshold higher than 25 dB HL and 71%, 58%, 68% higher than 40 dB HL respectively. CONCLUSION TEOAE is sensitive to hearing loss at middle and low frequencies but not at high frequencies. Measuring both TEOAE and DPOAE might provide more information of hearing loss at 0.5, 1.0, 2.0 and 4.0 kHz. It is worth noting that even OAE suggest "pass" or "refer", because there is still exist the possibility of hearing loss.
Audiometry, Pure-Tone ; Auditory Threshold ; Hearing Loss, Sensorineural ; diagnosis ; Humans ; Otoacoustic Emissions, Spontaneous

Child, Preschool ; Early Diagnosis ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; physiology ; Hearing Loss ; diagnosis ; Humans ; Infant ; Otoacoustic Emissions, Spontaneous

OBJECTIVETo study the significance of the second hearing screening in neonates who failed the first screening during their hospital stay.

METHODSScreening TEOAE tests were employed in 3849 neonates. The first screen was 3 days after birth. Those who failed were rescreened before discharge (5 - 7 days after birth). Neonates who failed the second screening would have a third screening in 30 - 42 days. Four types of rates were compared: pass rates of three times, rates of single ear fail and double ear fail, pass rates of left ear and right ear, pass rates of Caesarean birth and that of natural labor.

RESULTSThe difference between rates of first time and second time is statistically significant (χ(2) = 38.67, P < 0.01). There is no statistically difference between the total pass rate in ward and that of third time (χ(2) = 2.73, P > 0.05). The pass rate of single ear fail is higher than that of double ears (χ(2) = 34.34, P < 0.01, the difference has statistical significance). The pass rate of left ear is higher than that of right ear (χ(2) = 0.62, P > 0.05, the difference has not statistical significance). The first time screen result showed pass rates of natural labor is higher than that of Caesarean birth (χ(2) = 35.37, P < 0.05), but the differences of pass rates of the second and third time between two delivery method was no statistical significance (P > 0.05).

CONCLUSIONTwo times of screening in ward could decrease false negative and refer rate, thus relieve parent's mental burden.

False Negative Reactions ; Female ; Hearing Disorders ; diagnosis ; Hearing Tests ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; methods ; Otoacoustic Emissions, Spontaneous

OBJECTIVE: Tried to find the relationship between tinnitus and each testing method, provided information for objective diagnosis and treatment for tinnitus patients with sensorineural hearing loss. METHOD: The characteristics of audiology tests, including pure tone audiometric, acoustic immittance, middle ear muscle reflexes, matching test, distortion products otoacoustic emission(DPOAE) were compared in 79 ears of 69 tinnitus patients with sensorineural hearing loss. RESULT: The RI positive rate was higher in Convergence curve in tinnitus patients of sensorineural hearing loss, with the rate being 51.3%. The detection rates of DPOAE were 15.2% in patients of sensorineural hearing loss tinnitus groups, which were significant lower than those in control group. CONCLUSION Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, these data can help clinicians design needed based managements. DPOAE test is helpful for the diagnosis of lesions in some tinnitus patients.
Audiometry, Pure-Tone ; Hearing Loss, Sensorineural ; complications ; physiopathology ; Hearing Tests ; methods ; Humans ; Otoacoustic Emissions, Spontaneous ; Psychoacoustics ; Tinnitus ; complications ; physiopathology

OBJECTIVE: To explore the feasibility of distortion product otoacoustic emission (DPOAE) used for hearing monitoring in the oto-neurosurgery operation. METHOD: Twenty-four rabbits were equally divided into 3 groups: none operation (group A, n = 8); pressing the cerebella after the cerebellopontine angle was exposed (group B, n = 8); Blood flow of internal auditory artery were occlusion for 5 min after the facial-acoustic nerve complex was pressed(group C, n = 8). DPOAE value and histologic were observed. RESULT: In the state of pressing the cerebellar and blood flow of inner hearing artery were occlusion, DPOAE amplitude values changed, part of the frequencies could not be induced, DPOAE amplitude values of induced frequencies descend and nael significant difference (P < 0.05) to preoperation, as well as correspond to histology changes. CONCLUSION DPOAE could monitor the hearing loss effectively and would be one of ideal monitoring methods in the oto-neurosurgery operation.
Animals ; Disease Models, Animal ; Hearing Loss ; physiopathology ; surgery ; Hearing Tests ; methods ; Neurosurgery ; Otoacoustic Emissions, Spontaneous ; Otologic Surgical Procedures ; Rabbits

OBJECTIVE: To explore the risk factors of the newborns who failed initial hearing screening by analysing the distortion production otoacoustic emission (DPOAE) results of 1021 newborns with potential risk factors of hearing loss. METHOD: All newborns, who were born in obstetrical department and admitted in the neonatal department of the Nanfang Hospital during June 2009 to January 2012 and underwent initial hearing screening, were included in this study. Their clinical data and DPOAE results were analyzed retrospectively in order to identify the risk factors for failure of initial hearing screening in infants; cases who failed the DPOAE test were followed up by telephone interviews. RESULT: (1) One hundred and thirty-seven cases (13.42%) of the 1021 newborns did not pass the hearing screening. 51 cases (5.00%) did not pass the test in both ears. Meanwhile, left ear in 47 cases (4.60%) and right ear in another 39 cases (3.82%) failed the test respectively. (2) Univariate analysis showed that 14 factors had significant influence on the hearing screening results, such as birth weight, small for gestational age, multiple pregnancy, gestational age, delivery mode, oligohydramnion, oxytocin, blood sugar level of newborn, Apgar scores at 1 min, exposed prenatally to glucocorticoid, maxillofacial deformity, hypoxic-ischemic encephalopathy, neonatal respiratory distress syndrome and neonatal asphyxia (P < 0.01). (3) Multivariate Logistic regression analysis suggested that birthweight less than 1500 g, multiple pregnancy, Apgar scores of 0-4 at 1 min, exposed prenatally to glucocorticoid and maxillofacial deformity were risk factors for failure of initial hearing screening (OR were 3.132, 1.808, 2.615, 1.827 and 12.174 respectively; 95% CI were 1.466-6.691, 1.120-2.917, 1.317-5.336, 1.130-2.953 and 1.986-74.632 respectively). (4) Results of telephone interviews revealed that Apgar scores of 0-4 at 1 min would be a risk factor of language development. CONCLUSION Birthweight less than 1500 g, multiple pregnancy, Apgar scores of 0-4 at 1 min, exposed prenatally to glucocorticoid and maxillofacial deformity are risk factors of failure of initial hearing screening among newborns with potential hearing loss. Monitoring of the hearing condition of the infants at risk should be strengthened.
Deafness ; diagnosis ; Female ; Hearing Disorders ; diagnosis ; Hearing Tests ; Humans ; Infant, Newborn ; Neonatal Screening ; Otoacoustic Emissions, Spontaneous ; Pregnancy ; Risk Factors

OBJECTIVETo analyze the confusing factors and clinical and audiological characteristics in infants failed in hearing screening.

METHODSBetween August 2004 and January 2006, 166 infants (315 ears) with detailed birth record and hearing screening record were reviewed in the study. The age of this series ranged from 2 to 6 months. They were born in maternal and child health hospitals (MCH) in Guangzhou city and surrounding areas, and had hearing screened by otoacoustic emissions (OAE). However, they failed in the first and second hearing screening. The birth history, high-risk factors of hearing-impaired during newborn period and pregnancy history of subjects were fully detailed. Subjects were classified according to the age: 2 to 3 months old infants were considered as group 1, while 4 to 6 months old infants were considered as group 2. Auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following one to three months (before 6-month-old). The ABR results, DPOAE results and tympanic cavity pressure and static compliance value were compared between the two tests and then diagnosis was made.

RESULTS(1) Among the 166 cases, 34 (20.5%) cases were once suffered from hypercholesterolemia of newborn, and 10 cases (6.0%) had asphyxia and hypoxia history. (2) The proportion of presenting type B tympanogram in group 2 was higher than that of group 1 (chi2 = 26.22, P < 0.01). (3) The proportion of normal ABR in group 2 (37.2%) was significantly higher than that of in group 1 (23.4%, chi2 = 0.527, P < 0.05). Fifty-six percent of infants accepted twice ABR test had improving ABR results during the second test. (4) The proportion of normal DOPAE in group 2 (39.7%) was slightly lower than that of in group 1 (42.2%, chi2 = 0.14, P > 0.05). Among the infants who accepted twice DPOAE test, 32.0% had improving results in the second test. (5) Four cases (4 ears ) were diagnosed as auditory neuropathy.

CONCLUSIONSMiddle ear function and development of auditory system in infants may be confusing factors in hearing screening. The results of hearing screening should be interpreted appropriately.

Acoustic Impedance Tests ; Evoked Potentials, Auditory, Brain Stem ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Neonatal Screening ; Otoacoustic Emissions, Spontaneous