INTRODUÇÃO: Dentre as medidas da função coclear, a curva de crescimento das Emissões Otoacústicas por produto de distorção (CCEOA PD) permite o registro da amplitude da emissão em função do crescimento sistemático nos níveis de tons primários. A CCEOA PD fornece parâmetros específicos sobre o limiar e o comportamento não-linear das EOA PD, porém a variabilidade das respostas inter e intrasujeitos reduz a confiabilidade dessa medida na avaliação da robustez das respostas cocleares e a relação dessa robustez com os limiares auditivos. OBJETIVOS: Esta pesquisa estudou as interações entre as medidas timpanométricas da orelha média e as medidas de função coclear em adultos jovens sem queixas auditivas, de acordo com as variáveis: antecedentes de alterações de orelha média, sexo e orelha direita / esquerda. MÉTODOS: Participaram 69 indivíduos com audição normal e idades entre 18 e 34 anos, sendo 21 homens e 48 mulheres. A caracterização das condições de orelha média foi obtida pela anamnese, com a informação dos antecedentes de alterações de orelha média e pela timpanometria com sondas de admitância de 226 e 1000 Hz. A audiometria foi realizada com resolução de 01 dB NA, o que possibilitou comparações mais refinadas entre o limiar psicoacústico da audiometria tonal, a amplitude do DP-Gram e os limiares das CCEOA PD. Além dessas variáveis, a interferência dos fatores sexo e orelha foram testadas em todas as análises. RESULTADOS/DISCUSSÃO: Os resultados apontaram que as curvas de crescimento sofreram influência significativa das variáveis sexo, antecedentes de alterações de orelha média e orelha direita \\ esquerda, porém, apenas a interferência dos antecedentes foi constante e causou um padrão de modificação, ou seja, o grupo com antecedentes apresentou respostas aquém das respostas do grupo sem antecedentes. Os limiares audiométricos também apresentaram alta correlação com as amplitudes das EOA PD e com os limiares das CCEOA PD, quando identificadas as variáveis que interferiram nos resultados. Considerando que o ruído de fundo foi controlado nessa pesquisa, durante a avaliação das EOA PD e CCEOA PD, os resultados confirmaram a importância da consideração dessas variáveis na composição de grupos com audição normal em pesquisas com medidas de emissões otoacústicas. Ainda sobre os resultados, foi possível, por meio da medida da curva de crescimento (slope e limiar), demonstrar que o padrão de crescimento das CCEOA PD é diferente nos casos de modificação nas condições de orelha média e isso foi verificado tanto pelos antecedentes de alterações de orelha média quanto pelas medidas timpanométricas com sonda de admitância de 1000 Hz. CONCLUSÃO: O limiar das CCEOA - PD estudado nessa pesquisa apresentou correlação positiva com valores audiométricos e negativa com o DP-Gram. A inclinação da curva de crescimento (slope) também apresentou alta correlação com os antecedentes de alterações de orelha média, apontando o potencial valor desta medida no estudo da função coclear saudável e alterada e, conseqüentemente, sua possível utilização nas medidas prescritivas de amplificação / INTRODUCTION: The Distortion Product Otoacoustic Emissions Input/Output function (DPOAE I/O function) is a subdivision of DPOAE, where the response amplitude is recorded such as a systematic growth function in the primary tones. The DPOAE I/O function provides specific parameters about the DPOAEs threshold and non-linearity. However, the response variability reduces the measure reliability to evaluate the cochlear robustness and the relationship between robustness and hearing thresholds. OBJECTIVE: This research studied the interaction between the tympanometric measures and cochlear functions measures in young adults without hearing complaints, considering the variables: middle-ear alteration antecedents, gender and right / left ear. METHODS: 69 normal hearing subjects, aged from 18 to 34 years participated of the study. From the total, 21 were men and 48 women. To reach the proposed objectives, the middle ear conditions were assessed by anamneses and 226 and 1000 Hz admittance probe-tone tympanometry. The audiometric thresholds were searched with 01 dBHL resolution to enable refined comparisons among pure-tone audiometry and DP-Gram amplitude and DPOAE I/O function thresholds. The gender and ear interference were also evaluated in all analyses. RESULTS/DISCUSSION: The results showed that the variables gender, antecedents and ear affected the I/O functions responses, but only the middle-ear alterations antecedents presented a constant modification pattern. In other words, the group with antecedents presented mainly reduced responses in comparison with no antecedents group. The audiometric thresholds also presented high correlation with DPOAE amplitudes and DPOAE I/O functions thresholds, after the detection of the variables affecting the results. As the background noise was controlled during this study, the results confirmed the importance of monitoring these variables in the normal hearing group compositions to perform researches with DPOAE. Regarding the DPOAE I/O functions (slope and threshold), the growth pattern was modified according the middle ear conditions, verified by the antecedents of middle ear alterations and 1000 Hz admittance probe-tone tympanometry. CONCLUSION: The DPOAE I/O function threshold studied presented positive correlation with audiometric thresholds and negative correlation with DP-Gram. The DPOAE I/O functions slope also showed high correlation with antecedents of middle ear alterations, denoting the potential value of this measure in the study of the healthy and damaged cochlear function and, hence, it possible application in amplification prescriptive measures

Objective: To verify if the noise caused by sucking and swallowing mechanisms interferes in the quality of transient evoked otoacoustic emissions (TEOAE) in neonates with and without risk indicators for hearing loss by comparing the responses without sucking with situations of non-nutritive sucking, breast-feeding nutritive sucking and bottle-feeding nutritive sucking. Methods: a study carried out with 53 neonates (13 with risk indicators for hearing loss), evaluated with TEOAE, at rest and in three different cases: non-nutritive sucking, breast-feeding nutritive sucking and bottle-feeding nutritive sucking. Results: Studying the different types of sucking, it was found that the greater incidence of failure occurred at the frequency of 2000 Hz for all the three types of sucking. An increase in the noise intensity was observed in all frequencies during the capture of TEOAE in the left ear in all types of sucking studied. At 1400, 2000, 2800, and 4000 Hz, the signal to noise ratio decreased in the left ear during sucking. In breast-feeding nutritive sucking, the noise levels were lower at 1400 Hz and the signal to noise ratio was higher at the same frequency as well as at 2000 Hz. When neonates were compared regarding the presence or not of risk indicators for hearing loss, the seconds during non-sucking situation showed higher amplitude of TEOAE at the frequencies of 700, 1000, 2000, and 4000 Hz, and at 1000 and 4000 Hz during sucking. In both groups, a decrease in the amplitude of TEOAE and in the noise at 700 Hz during sucking was observed. At the other frequencies, the noise level increased in the sucking situation. There was no change in the signal to noise ratio between the conditions of sucking and nonsucking at 700 and 1000 Hz. At 1400 Hz, the sucking impaired the signal to noise ratio causing absence of response. At 2000, 2800, and 4000 Hz, the signal to noise ratio remained greater than 6 dB. Conclusions: The evaluation of TEOAE during sucking can be performed in neonates with and without risk indicators for hearing loss, since the criteria of presence/absence are achieved in at least three frequencies studied. / Objetivo:verificar se os ruídos provocados pelo mecanismo de sucção/deglutiçãointerferem na amplitude das Emissões Otoacústicas Evocadas Transientes(EOAETs) em neonatos com e sem indicadores de risco para perda auditiva, comparando as respostas sem sucção com as situações de sucção não nutritiva,sucção nutritiva no peito materno e em sucção nutritiva em mamadeira. Métodos:estudo realizado com 53 neonatos (13 com indicadores de risco para deficiência auditiva), avaliados com EOAETs, em repouso e em três situações de sucção:sucção não nutritiva, sucção nutritiva no peito materno e sucção nutritiva na mamadeira. Resultados: em 700, 1000, 2000 e 4000 Hz a amplitude foi maior no grupo sem indicadores de risco, e na situação de sucção, apenas em 1000 e 4000Hz. Em 700 Hz observou-se diminuição na amplitude das EOAETs e do ruído, quando mensuradas durante a sucção. O nível de ruído aumentou em sucção. Em 700 e 1000 Hz não houve variação da relação sinal/ruído entre as duas situações. Em 1400 Hz a sucção prejudicou a relação sinal/ruído, provocando ausência de respostas. Em 2000, 2800 e 4000 Hz a variável se manteve superior a seis dB. Constatou-se na freqüência de 2000 Hz maior ocorrência de falha durante a sucção. Analisando a variável ruído, em todas as freqüências houve aumento de sua intensidade durante a avaliação das EOAETs em sucção na orelha esquerda. Em 1400, 2000, 2800 e 4000 Hz houve interferência também na relação sinal/ruído, que diminuiu na orelha esquerda, durante a sucção. Encontrou-se níveis de ruído menores em 1400 Hz, durante a avaliação das EOAETs em sucção nutritiva no peito, e relação sinal/ruído maior na mesma freqüência e em 2000 Hz. Conclusões: A avaliação das EOAETs durante a sucção pode ser executada em neonatos com e sem indicadores de risco para deficiência auditiva, já que os critérios de presença/ausência são atingidos em pelo menos três freqüências analisadas e as alterações produzidas com esta estratégia não prejudicam as respostas ao ponto de evidenciar resultados falso/positivos.

Although the suppressive effect of the medial olivocochlear system (MOCS) on peripheral auditory active mechanisms is well documented in humans, the effect of efferent inhibition over prolonged periods of acoustic stimulation is less well documented, especially as observed in suppression of transient evoked otoacoustic emissions (TEOAE’s). The present study therefore evaluated the relationship between the duration of contralateral acoustic stimulation and the suppression of TEOAE’s in ten adults with normal hearing. TEOAE recordings with linear clicks (60 dB sound pressure level) were measured at four intervals during 15 minutes of continuous contralateral white noise (45 dB sound pressure level), followed by two post-noise recordings. An identical within-subject control condition was recorded without contralateral noise. Experimental and control measurements were repeated three times, on separate days. Results revealed significant and sustained TEOAE amplitude reduction for the entire duration of contralateral stimulation. Suppression increased across the duration of contralateral noise, but not sufficiently to be statistically significant. After noise termination, TEOAE amplitudes increased to values significantly above control recordings. The sustained suppression of TEOAE’s indicates continuous efferent inhibition over time in normal adults, with a significant increase in TEOAE amplitude after noise cessation possibly indicating increased outer hair cell responsiveness after prolonged contralateral noise. / Dissertation (MCommunication Pathology)--University of Pretoria, 2009. / Speech-Language Pathology and Audiology / Unrestricted

In the evaluation of special populations, such as neonates, infants and malingerers, audiologists have to rely heavily on objective measurements to assess hearing ability. Current objective audiological procedures such as tympanometry, the acoustic reflex, auditory brainstem response and transient evoked otoacoustic emissions, however, have certain limitations, contributing to the need of an objective, non-invasive, rapid, economic test of hearing that evaluate hearing ability in a wide range of frequencies. The purpose of this study was to investigate distortion product otoacoustic emissions (DPOAEs) as an objective test of hearing. The main aim was to improve prediction of pure tone thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz with DPOAEs and artificial neural networks (ANNs) in normal and hearing-impaired ears. Other studies that attempted to predict hearing ability with DPOAEs and conventional statistical methods were only able to distinguish between normal and impaired hearing. Back propagation neural networks were trained with the pattern of all present and absent DPOAE responses of 11 DPOAE frequencies of eight DP Grams and pure tone thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. The neural network used the learned correlation between these two data sets to predict hearing ability at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Hearing ability was not predicted as a decibel value, but into one of several categories spanning 1 OdB. Results for prediction accuracy of normal hearing improved from 92% to 94% at 500 Hz, 87% to 88% at 1000 Hz, 84% to 88% at 2000 Hz and 91% to 93% at 4000 Hz from the De Waal (1998) study to the present study. The improvement of prediction of normal hearing can be attributed to extensive experimentation with neural network topology and manipulation of input data to present information to the network optimally. The prediction of hearing-impaired categories was less satisfactory, due to insufficient data for the ANNs to train on. A prediction versus ear count correlation strongly suggested that the inaccurate predictions of hearing-impaired categories is not a result of an inability of DPOAEs to predict pure tone thresholds in hearing impaired ears, but a result of insufficient data for the neural network to train on. This research concluded that DPOAEs and ANNs can be used to accurately predict hearing ability within 10dB in normal and hearing-impaired ears from 500 Hz to 4000 Hz for hearing losses of up to 65dB HL. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted

Audiologists are challenged with various neurological diseases, such as Multiple Sclerosis. This disease causes demyelination of the white matter in the central nervous system resulting in desynchronisation of neural impulses. Despite controversy in the literature many studies illustrated some degree of auditory involvement associated with this disease. The auditory brainstem response has dominated the field during the assessment of the auditory system of patients with Multiple Sclerosis. Although this objective test procedure is useful during the assessment of the auditory nerve on a brainstem level, it reveals its own set of limitations when used in isolation as a single test procedure. A multiple test battery approach has shown promise in addressing the limitations of any single test procedure. This approach aims to assess the auditory nervous system of patients with Multiple Sclerosis on different levels (sensory and neural). The aim of the current study was to determine the effectiveness of a clinically appropriate battery of test procedures during the assessment of the auditory nervous system of 25 adult subjects with Multiple Sclerosis. The subjects were divided into two groups: Group 1 consisted of fifteen (15) subjects without a history of noise exposure, whereas the ten (10) subjects in Group 2 had previously been exposed to noise. A combined experimental-descriptive research design was selected in order to describe both the qualitative and quantitative results obtained during the study. The following test procedures were included in the test battery: • A self-assessment questionnaire allowing subjects to report on hearing abilities, related auditory-vestibular symptoms and communicative competence during every day life; • Puretone audiometry, distortion product otoacoustic emissions as well as the cochlear microphonic; and • Auditory brainstem response recording using both the rarefaction and condensation click polarities consecutively. The results indicated that a high percentage of subjects experienced vestibular symptoms such as dizziness and vertigo by the time the study was conducted. The presence of tinnitus and hearing difficulties were uncommon among subjects. Despite this, more than half of the subjects experienced difficulty with communication in the presence of background noise. Puretone audiometry demonstrated that some of the subjects presented with mild high-frequency hearing losses. However other configurations with impaired hearing thresholds were also observed. Most of the subjects’ auditory brainstem response recordings displayed abnormalities using either the rarefaction or condensation click polarity. The use of the condensation click polarity displayed more ABR abnormalities compared to the rarefaction click polarity. Several subjects displayed additional cochlear involvement while a smaller percentage of subjects presented only with neural involvement. / Dissertation (M (Communication Pathhology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / unrestricted

Orientadores: Jorge Humberto Nicola, Ester Maria Danielli Nicola / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T13:57:05Z (GMT). No. of bitstreams: 1 Ferreira_DeniseRezende_M.pdf: 701948 bytes, checksum: fc978779bb5a79b92989795b47d5a788 (MD5) Previous issue date: 2006 / Resumo: A orelha é o receptor de sons em nosso organismo. O som é captado e conduzido pela orelha externa, amplificado e modulado na orelha média e transformado em sinal elétrico (conhecido como transdução) na orelha interna. Entretanto, as emissões otoacústicas e o zumbido objetivo são exemplos de um processo inverso, onde a orelha se comporta como um emissor de sons. Visando entender alguns destes eventos em que a emissão de sons ocorre, revisou-se a literatura da fisiologia da audição e das bases físicas do percurso do som através do sistema auditivo. Utilizou-se como ferramenta principal, os artigos contidos no Web of Science, dos últimos 25 anos. A partir deste ponto, desenvolveu-se um modelo teórico do percurso do som gerado na cóclea que se propaga em direção à membrana timpânica. Foram realizados cálculos para a atenuação do som decorrente da existência de uma inércia mecânica da estrutura janela oval ¿ ossículos ¿ tímpano. Para isso, considerou-se a razão entre as áreas da janela oval e tímpano e as dimensões dos dois braços de alavanca formada pelos ossículos. Como conclusão, verificou-se que som gerado na cóclea pela eletromotilidade das células ciliadas externas, sofre uma atenuação da ordem de 20 vezes ao passar pela cadeia tímpano-ossicular no sentido inverso. Além disto, demonstrou-se que na interface perilinfa ¿ janela oval, assim como aquela da cadeia ossicular para a membrana timpânica, a transmissão do som é considerável (70%), pois não há grandes diferenças entre as impedâncias acústicas dos meios envolvidos (líquidos labirínticos e sistema tímpano-ossicular). Assim, foi explicado, fisicamente, como as emissões de sons através da orelha podem ter origem a partir de movimentos de muito baixa energia, como aqueles gerados pela contração das células ciliadas externas / Abstract: Ear is the sound receptor in our body. Sound is captured and driven through external ear, amplified and modulated in middle ear and transduced to electrical sign in internal ear. However, otoacoustic emissions and objective tinnitus are examples of an inverse process, where ear can be a sound emitter. Trying to understand some of theses events, in which sound emission occurs, the physiology of hearing and the physical basis to the sound propagation through the ear was revised. It was used as main tool, articles of Web of Science, from the last 25 years. From this point, it was developed a theoretical model to the way of sound, generated inside cochlea that propagates in tympanic membrane direction. It was performed mathematical calculations to sound attenuation, caused by the mechanical inertia of oval window - ossicles - tympanic membrane structure. For that, it was considered the area ratio between oval window and tympanum and the lever action ossicular chain. We concluded that sound generation by electromotility of outer hair cells inside cochlea, is attenuated in 20 times when it passes through ossicular chain in the inverse way. Besides this lost in sound energy, it was also demonstrated that in perilymph-oval window interface sound transmission is considerable (70%), because there are not big differences between the acoustic impedances of involved structures. Then, in physical basis, it was shown how ear can emit sound from contraction of outer hair cells / Mestrado / Otorrinolaringologia / Mestre em Ciências Médicas

Introdução: O fenômeno das Emissões Otoacústicas (EOA) é considerado como uma das grandes descobertas científicas na área da Audiologia. Seu exame possi-bilita avaliar a atividade motora da cóclea e traz novos conhecimentos sobre a fisiologia coclear. No entanto, tais registros trazem informações somente sobre o sistema auditivo aferente. Os estudos sobre a supressão das EOA contribuíram para a avaliação do sistema auditivo eferente. Atualmente, não são conhecidos outros testes audiológicos que possam avaliar a atividade eferente deste sistema olivococlear. Quando as EOA são registradas com apresentação de ruído, seja ele ipsilateral, contralateral ou bilateral, as vias eferentes do sistema olivococlear medial são ativadas, de forma a afetar o processo coclear. Tal fato pode ser observado com a redução no nível de respostas das EOA e é denominado de Efeito de Supressão das Emissões Otoacústicas. Tal teste avalia o efeito inibitório da função auditiva eferente (EIVE) sobre as células ciliadas externas (CCE). Objetivo: Este trabalho tem o objetivo de verificar a ocorrência do efeito inibitório da via eferente auditiva nas respostas de emissões otoacústicas por transientes, com diferentes estímulos supressores apresentados de forma contralateral: Ruído Branco, Ruído de fala (Talk Noise) e História Gravada. Método: A bateria de testes foi realizada em 30 indivíduos com idades entre 18 e 35 anos, com limiares auditivos em nível de intensidade inferior a 20 decibéis nível de audição (dBNA) nas frequências de 250 a 8.000 Hz. Foram realizadas seis provas, duas medidas iniciais de EOA Transiente sem ruído contralateral, seguida de três medidas de EOAT com diferentes estímulos contralaterais, ruído branco, ruído de fala e com história gravada. A sexta prova foi uma medida final de EOAT sem ruído contralateral. O efeito inibitório da via eferente foi investigado com o registro de EOAT obtidas com cliques lineares, e nível de intensidade do estimulo de aproximadamente 60dB NPS, em janela de análise de 4-20ms. O efeito inibitório foi quantificado pela variação do nível de resposta entre a apresentação do clique linear sem estímulo contralateral e, a apresentação do mesmo clique linear com cada um dos três estímulos contralaterais. Resultados: Não existe diferença média estatisticamente significante para as medidas de EOAT entre as orelhas em todas as variáveis. Houve uma média maior para os valores do EIVE na prova com o ruído contralateral do tipo Ruído Branco nas duas comparações, tanto com a primeira medida de EOAT sem ruído contralateral e na segunda medida de EOAT sem ruído contralateral. Existe diferença média estatisticamente significante entre Ruído Branco, Ruído de Fala e História Gravada somente para a orelha direita. Conclusão: O efeito inibitório da via eferente foi obtido com os três estímulos contralaterais estudados. Pode-se concluir que houve uma média maior nos valores de EIVE para a prova com o estímulo contralateral do tipo Ruído Branco. Todas as orelhas testadas, após a apresentação dos três estímulos contralaterais, apresentaram um valor de EOAT final sem ruído por volta dos valores encontrados inicialmente, o que nos mostra que assim que o ruído contralateral deixa de ser apresentado, a ativação do efeito inibitório da via eferente cessa instantaneamente e todo o sistema olivo coclear volta ao seu estado inicial / Introduction: The phenomenon of otoacoustic emissions (OAE) is considered as one of the greatest scientific discoveries in the field of Audiology. The exam provides the access to the motor activity of the cochlea and brings new knowledge about cochlear physiology. However, such records provide information only from the afferent auditory system. Studies on the suppression of the OAE contribute to the assessment of the efferent auditory system. Currently, there are known other audiologic tests that could evaluate the activity of the efferent olivocochlear system. When OAE are registered with noise presentation (whether ipsilateral, contralateral or bilateral), the efferent pathways of olivocochlear system are activated in order to affect the cochlear process. This fact can be observed with the reduction in the level of OAE responses and is called Effect Suppression of otoacoustic emissions. This test evaluates the inhibitory effect of efferent auditory function on the CCE. Objective: This study aims to establish the occurrence of the inhibitory effect of auditory efferent pathway in the responses of transient evoked otoacoustic emission, with different stimuli presented in contralateral suppressors: White Noise, Talk Noise and Recorded History. Method: The battery of tests was performed in 30 subjects aged between 18 and 35 years and auditory thresholds in intensity level less than 20 decibel hearing level (dB HL) at frequencies 250-8000 Hz. Were performed six tests, two initial measures OAE Transient without contralateral noise a measure of TOAE with white noise, a measure of TOAE with speech noise, a measure of TOAE with recorded history and finally a final measure of TOAE without contralateral noise. Results: There is no average difference statistically significant for measures of TOAE between the ears in all variables. The contralateral white noise showed the highest average in inhibitory effect of efferent auditory for the two situations without contralateral noise. There is a statistically significant difference between White Noise, Talk Noise and Recorded History only for the right ear. Conclusion: The inhibitory effect of the efferent pathway was observed in the three studied contralateral stimuli. It can be concluded that there was a greater mean values for inhibitory effect of efferent auditory in the condition with the contralateral white noise stimulus. All tested ears, after the presentation of the three contralateral stimuli, showed a value of TOAE end without noise around the values found initially, which shows us that once the contralateral noise is no longer displayed, the activation of the inhibitory effect of the efferent ceases instantly and all olivocochlear system back to its initial state

Recent advances in the field of audiology have indicated that there has been a growing concern regarding the potential damage to the hearing mechanism induced by recreational noise exposure from personal music devices (PMD). Regular PMD use may have a long-term damaging effect on the outer- and inner hair cells of the cochlea which may result in a progressive hearing loss. As PMDs have advanced to a stage where the memory of the devices are able to contain hours of listening content, the environments where these devices are being used are rapidly expanding. Many young adults tend to use their PMDs whilst exercising. Exercise in itself induces physiological and metabolic changes such as increased blood flow and oxygen levels within the structures of the cochlea. The purpose of this study was to determine the differential impact and short-term effects of simultaneous cardiovascular workout and personal music device (PMD) use on the otoacoustic emissions of young adults. Seven female and five male subjects completed three testing conditions: (i) one hour exposure to PMD use in isolation, (ii) one hour exposure to cardiovascular workout in isolation, and (iii) one hour simultaneous exposure to PMD use and cardiovascular workout. Distortion product otoacoustic emissions (DPOAEs) were conducted prior to, as well as directly following each testing condition, as primary indicator of cochlear responses emitted through a preset stimulus frequency sequence measuring the 2f₁ - f₂ (75 – 70 dB SPL) and constructing a plot of DPOAE levels as a function of frequency. While each of the testing conditions on its own did not result in statistically significant changes of the DPOAE response, a highly significant different profile in the DPOAE response level increase/decrease for the higher frequencies (6-8 kHz) was obtained when comparing the different sessions to each other. Where exposure to cardiovascular workout showed a clear trend of an increased DPOAE response level between the pre-exposure and post-exposure testing from 2 kHz to 8 kHz with a maximum increase at 6 kHz, both the music only condition and the combined condition where the cardiovascular workout was combined with music resulted in a significant different profile. During combined exposure a clear trend of decreased DPOAE response amplitudes between the pre-exposure and post-exposure testing were seen for the higher frequencies. These findings may support the notion of a clear effect of cardiovascular workout on the otoacoustic emissions at higher test frequencies, measured by DPOAEs when performed with and without music exposure. / Dissertation (MLOG)--University of Pretoria, 2014. / tm2015 / Speech-Language Pathology and Audiology / MLOG / Unrestricted

Objective: This study aimed to systematically review and analyse the available peer-reviewed literature reporting on the results of distortion product otoacoustic emissions (DPOAEs), transient evoked otoacoustic emissions (TEOAEs) and click auditory brainstem responses (c-ABRs) in adults with type 1 and type 2 diabetes mellitus (T1DM and T2DM). Method: A comprehensive literature search was conducted across three electronic databases to identify English; peer-reviewed articles that included results of OAEs (DPOAEs and TEOAEs) and c-ABR tests in adult subjects with DM. Articles were selected according to predetermined selection criteria and critically reviewed independently by two researchers. Results: 15 studies met the inclusion criteria for the systematic review while nine articles qualified for inclusion in the meta-analysis. DPOAE studies reported significantly reduced amplitudes with only one study reporting larger amplitudes. Abnormal TEOAEs were reported in all TEOAE studies, although these abnormalities were not always significant. Significantly delayed c-ABRs were reported in all ABR studies. Analysis of c-ABR mean wave latencies identified longer latencies for DM subjects, particularly for wave III and V, as well as for IPL I-III and I-V. Conclusions: Subjects with T1DM and T2DM may present with clinical or subclinical impairment of the cochlear outer hair cells and both the peripheral and central auditory pathway. / Dissertation (MA)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MA / Unrestricted

Hearing loss in early childhood and infancy often goes undetected because it exhibits no obvious indication and symptoms. The primary aim of newborn hearing screening is to detect permanent hearing loss. Since otoacoustic emissions (OAE) and automated auditory brainstem response (AABR) are sensitive to hearing loss, they are often used as screening tools. On the other hand, these screening tests can be affected by transient outer ear and middle ear conditions that are often present at birth. This is an especially characteristic state of affairs for NICU neonates. These false positive results may render screening programmes inefficient and can lead to increased parental anxiety. Wideband acoustic immittance (WAI) has shown potential for accurate assessment of middle ear function in neonates, and is therefore recommended as an adjunct tool for newborn hearing screening programmes. The main aim of the study was to determine the feasibility of using WAI in NICU neonates in terms of tone and click stimuli. Testing was conducted in the NICU units of three private hospitals in Pretoria. As part of the selection criteria all the neonates had to pass both DPOAE and AABR screenings before they were included in the study. In total, 56 NICU infants (106 ears) with a gestation age of between 32 and 37 weeks and a mean gestational age of 35.6 weeks who passed both DPOAE and AABR hearing screens in one or both ears were selected. For WAI measurements there were two measurements, one for each channel in the probe (chirp and tone stimuli). Normative regions were defined across the wideband reflective spectrum for both tone and chirp stimuli and for integrated frequency ranges. The chirps and tone stimuli compared relatively well with each other at the 90th percentile with the same amount of reflectance across all frequencies. The median reflectance reached a minimum of 0.67 at 1-2 kHz but increased to 0.7 below 1 kHz and 0.72 above 2 kHz for the tone stimuli. For chirp stimuli the median reflectance reached a minimum of 0.51 at 1-2 kHz but increased to 0.68 below 1 kHz and decreased to 0.5 above 2 kHz. Results of this study identified WAI patterns that had not previously been reported in the literature. High reflective values were obtained across all frequency ranges, especially in the frequency ranges below 3 kHz and above 4 kHz. The age of the neonates when tested (mean gestational age 35.6 weeks, with a standard deviation of 1.6) might have influenced the results. The neonates in this study were of a very young age compared to the ages of the infants in previous studies on WAI. Environmental noise in NICU might have influenced the results. Additional research is required to investigate WAI testing in ears with and without dysfunction. / Dissertation (M Communication Pathology)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / M Communication Pathology / Unrestricted