Usefulness of Otoacoustic Emissions in Diagnosis of Pseudohypacusis with Organic Hearing Loss; A Report of Two Cases
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We report two cases of pseudohypacusis with organic hearing loss in which useful diagnostic information could be obtained from otoacoustic emission (OAE) testing.Case 1 was a 12-year-old female who had complained of fluctuating hearing loss for a few years. Although her initial pure-tone audiogram indicated moderate hearing loss in both ears, speech audiometry strongly suggested that the hearing of her left ear was considerably better than anticipated based on the pure-tone testing. Since the wave V thresholds of auditory brainstem response (ABR) were 70 and 20dBnHL in the right and left ear, respectively, it was suspected that she had moderate hearing loss in the right ear and normal hearing sensitivity in the left ear. However, OAE testing subsequently performed revealed moderate to severe hearing loss in all frequency regions except between 1.5 and 5kHz in her left ear, and this finding was also confirmed by follow-up pure-tone audiometry.Case 2 was a 54-year-old male whose complaints were left-sided hearing loss and tinnitus developing after a traffic accident. His initial pure-tone audiogram showed moderate to severe hearing loss in the left ear. However, his speech discrimination score for the left ear suggested much better hearing than expected from the pure-tone testing results, and mild hearing loss in the left ear was suspected based on ABR examined later. OAE testing was subsequently performed and revealed moderate to severe hearing loss in the frequency region above 3kHz in the left ear, a finding subsequently confirmed by pure-tone audiometry.The diagnosis of pseudohypacusis is sometimes difficult in patients with organic hearing loss, as in the two cases presented here. In such cases, frequency-specific information about cochlear function provided by OAE might be helpful for assessment of true hearing loss. From this perspective, OAE testing is considered useful as a diagnostic tool for pseudohypacusis.Keywords:
Audiogram
Pure tone audiometry
Otoacoustic emission
Auditory brainstem response
Hearing test
Unilateral hearing loss
Objective To compare the effect of distortion product otoacoustic emission(DPOAE) and pure tone audiometry(PTA) in the evaluation of sudden deafness.Methods 60 patients(64 ears) with sudden deafness admitted in our hospital from 2009 to 2011 were selected and enrolled in this study.All the 60 patients received DPOAE test and PTA test before and after treatment.The results of the two kinds of tests were compared.Results After treatment,the results of DPOAE test and PTA test were all significantly better than that before treatment(P0.05).After treatment,DPOAE test was found to be significantly more sensitive than PTA test(P0.05).With the improvement of the hearing,the patients' hearing threshold recovery rate,DPOAE amplitude were gradually increased,but the change is not synchronous(P0.05).Conclusion DPOAE test can reveal the cochlear hearing function and hair functional status,which is non-invasive,fast,comprehensive and specific.
Otoacoustic emission
Pure tone audiometry
Pure tone
Tone (literature)
Hearing test
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Correlations between spectrum analysis of evoked otoacoustic emissions (EOAEs) and hearing losses have been calculated in 150 patients with pure sensorineural hearing loss. Significant correlations were found. The greater the high-frequency spectral components of the EOAE, the better the high-frequency hearing. However the relationship is complex, and it does not seem possible to establish an audiogram knowing only the spectrum analysis of EOAEs.
Audiogram
Otoacoustic emission
Spectral Analysis
Frequency spectrum
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In this study, the parameters of notches in the Audioscan have been compared with the distortion product otoacoustic emission (DPOAE) findings in 100 subjects with normal hearing, including 55 normal controls and 45 patients with King-Kopetzky syndrome. Of those, 35 subjects had Audioscan notches (11 controls and 24 patients), 96 per cent (53 out of 55 notches) of which were associated with notches in DPOAEs. Analyses showed that the notch centre frequencies obtained in the Audioscan test correlated significantly with those of the notches found on the distortion product audiogram (DP-gram). In addition, the width of notches of the two procedures was also significantly correlated. It is likely, therefore, that such notches on Audioscan and DPOAE testing reflect localized areas of impaired cochlear function.
Audiogram
Otoacoustic emission
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Objectives The purpose of this study was to give a brief review of the effectiveness of otoacoustic emissions for getting frequency-specific information about a hearing-loss problem in newborns after hearing screening. Especially, the advantages of distortion-product otoacoustic emissions (DPOAE) over transiently evoked otoacoustic emissions (TEOAEs) are described. Data Sources Approximately 186 ears of 104 children aged between 76 days and 15 years and 436 ears of adults with normal hearing and sensory hearing loss. Methods Extrapolated DPOAE I/O-functions at frequencies between 1.5 and 6 kHz were obtained in the children for assessing the hearing loss and for differentiating between a transitory sound-conductive hearing loss and a persisting cochlear hearing loss. For getting information on the test time needed, measurements were performed in the adult patients. Results DPOAE thresholds derived from extrapolated DPOAE I/O-functions (DPOAE audiograms) are closely related to behavior audiometric thresholds and can be used for determining characteristic quantities of the cochlear-impaired ear. A DPOAE audiogram can be obtained in a couple of minutes. DPOAE audiograms are able to reveal a transitory sound-conductive hearing loss because of Eustachian tube dysfunction and/or amniotic fluid in the tympanic cavity or to confirm a persisting cochlear hearing loss because of outer hair cell impairment in babies with a reference result in newborn hearing screening. Conclusion DPOAE audiograms provide a tool for a fast automated frequency-specific and quantitative evaluation of a mild or moderate hearing in follow-up diagnosis.
Audiogram
Otoacoustic emission
Conductive hearing loss
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We report two cases of pseudohypacusis with organic hearing loss in which useful diagnostic information could be obtained from otoacoustic emission (OAE) testing.Case 1 was a 12-year-old female who had complained of fluctuating hearing loss for a few years. Although her initial pure-tone audiogram indicated moderate hearing loss in both ears, speech audiometry strongly suggested that the hearing of her left ear was considerably better than anticipated based on the pure-tone testing. Since the wave V thresholds of auditory brainstem response (ABR) were 70 and 20dBnHL in the right and left ear, respectively, it was suspected that she had moderate hearing loss in the right ear and normal hearing sensitivity in the left ear. However, OAE testing subsequently performed revealed moderate to severe hearing loss in all frequency regions except between 1.5 and 5kHz in her left ear, and this finding was also confirmed by follow-up pure-tone audiometry.Case 2 was a 54-year-old male whose complaints were left-sided hearing loss and tinnitus developing after a traffic accident. His initial pure-tone audiogram showed moderate to severe hearing loss in the left ear. However, his speech discrimination score for the left ear suggested much better hearing than expected from the pure-tone testing results, and mild hearing loss in the left ear was suspected based on ABR examined later. OAE testing was subsequently performed and revealed moderate to severe hearing loss in the frequency region above 3kHz in the left ear, a finding subsequently confirmed by pure-tone audiometry.The diagnosis of pseudohypacusis is sometimes difficult in patients with organic hearing loss, as in the two cases presented here. In such cases, frequency-specific information about cochlear function provided by OAE might be helpful for assessment of true hearing loss. From this perspective, OAE testing is considered useful as a diagnostic tool for pseudohypacusis.
Audiogram
Pure tone audiometry
Otoacoustic emission
Auditory brainstem response
Hearing test
Unilateral hearing loss
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Distortion product otoacoustic emission (DPOAE) growth functions reflect the active nonlinear cochlear sound processing when using a primary-tone setting which accounts for the different compressions of the two primaries at the DPOAE generation site and hence provide a measure for objectively assessing cochlear sensitivity and compression. DPOAE thresholds can be derived from extrapolated DPOAE input/output (I/O) functions independently of the noise floor and consequently can serve as a unique measure for reading DPOAE measurements. The thus-estimated DPOAE thresholds exhibit a close correspondence to behavior audiometric thresholds and thus can be used for reconstructing an audiogram, i.e., a DPOAE audiogram. The DPOAE I/O functions’ slope increases with cochlear hearing loss and thus provides a measure for assessing recruitment. Hence, DPOAE I/O functions can give more information for diagnostic purposes than those of DP grams, transiently evoked OAEs (TEOAEs), or auditory brain stem responses (ABRs). DPOAE audiograms can be applied in pediatric audiology to assess cochlear dysfunction in a couple of minutes. In newborn hearing screening, they are able to detect transitory sound-conductive hearing loss and thus can help to reduce the rate of false-positive TEOAE responses in the early postnatal period. Since DPOAE I/O functions are correlated with loudness functions, DPOAEs offer the possibility of basic hearing aid adjustments, especially in infants and children. Extrapolated DPOAE I/O functions provide a tool for a fast automated frequency-specific and quantitative evaluation of hearing loss.
Distortion (music)
Otoacoustic emission
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To study the value of distortion product otoacoustic emission(DPOAE) audiogram on examining the radioation injury to the cochlea after radiotherapy for nasopharyngeal carcinoma(NPC). DPOAE and pure audiometry were detected for 40 ears of NPC patients at regular intervals radiotherapy, (before, during, at the end 6 and 12 months after radiotherapy). The different intervals' data were collected and analyzed with statistic methods. Compared with DPOAE audiogram before radiation[1 0 kHz was (9 9±4 9) dB,2 0 kHz was (-0 7±8 6)dB,4 0 kHz was (2 9±6 2) dB,6 0 kHz was (1 4±7 4dB)],DPOAE audiogram of the different intervals were not the same,but there were on significant after difference(P0 05). The value of DPOAE was similar with the audiometric threshold of bone conduction.[Conclusion] DPOAE can be used in detecting the radiation injuries to the cochlea after radiotherapy. It is simple, objective, sensitive and unwounded.
Audiogram
Otoacoustic emission
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Previous research has reported reduced otoacoustic emission amplitude as a function of age. In each study, however, interpretation of findings was confounded by age-related hearing loss. The present study was designed to re-evaluate the contribution of age and peripheral hearing loss on the prevalence and amplitude of distortion-product otoacoustic emissions (DPOAEs) by controlling for degree of peripheral hearing loss. Twenty subjects were divided into four age ranges. All subjects in each group had 15 dB HL or better thresholds from 0.25 through 8 kHz and normal immittance findings. DPOAE audiograms recorded at three intensity levels and input/output functions recorded at six discrete frequencies showed no significant differences in amplitude or noise level between age groups. Findings indicate that when the degree of peripheral hearing loss is adequately controlled, there is no direct effect of advanced age on DPOAE measures. Clinical implications are discussed.
Audiogram
Otoacoustic emission
Immittance
Noise-induced hearing loss
Age groups
Presbycusis
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Abstract Objectives/Hypothesis: To detect subtle hearing changes by measuring otoacoustic emissions in patients treated with a first dose of cisplatin. Study Design: Prospective study. Methods: We recruited 26 patients (mean age at treatment, 11.3 years) into this prospective study conducted at a tertiary academic referral center. Audiograms and transient‐evoked otoacoustic emissions (TEOAEs) and distortion‐product otoacoustic emissions (DPOAEs) were measured before and after the first dose of cisplatin. Results: Baseline readings were compared with those recorded after the administration of the first dose of cisplatin. Two patients showed a loss of TEOAEs at high frequencies above 4 kHz, and this was consistent with the 25‐dB hearing loss of the high frequencies detected in their audiograms; there was a significant threshold shift for DPOAEs at a frequency >3 to 4 kHz ( P <.05). Conclusions: DPOAE testing appears to be a more sensitive method to detect cochlear damage than conventional pure‐tone audiometry. Our results suggest that the measurement of DPOAE thresholds is a useful approach to detect the early auditory changes induced by cisplatin therapy.
Audiogram
Otoacoustic emission
Ototoxicity
Pure tone audiometry
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