In der veterinärmedizinischen Wissenschaft spielt das equine akustische Organ sowie dessen Erkrankungen und Funktionsstörungen bislang eine stark untergeordnete Rolle. Mangelnde Visualisierungs- und Untersuchungsmöglichkeiten, geringe Patienten- Compliance sowie fehlende Referenzen erschweren die Diagnose aurikulärer Erkrankungen (SARGENT et al. 2006; SOMMERAUER et al. 2012). Das übergeordnete langfristige Ziel dieser Forschungsarbeit ist es, humanmedizinische objektive audiometrische Messtechnik an das Pferdeohr anzupassen. Von speziellem Interesse ist dabei die Messung otoakustischer Emissionen zur objektiven Überprüfung der Innenohrfunktion. Die grundlegende Voraussetzung jeglicher Messungen und Adaptierungen ist zunächst die otoskopische Kontrolle des externen Gehörkanales und Trommelfelles. So können die Messung behindernde Faktoren, beispielsweise ein hoher Verschmutzungsgrad oder Fremdkörper im externen Gehörkanal, ausgeschlossen werden. Mit Hilfe herkömmlicher Videobronchoskope oder Videogastroskope (Durchmesser von 7 mm bzw. 9 mm) und der Anwendung eines standardisierten Protokolls konnten im Rahmen der Basisstudie die externen Gehörkanäle und Trommelfelle von 38 sedierten Pferden bilateral endoskopisch untersucht werden. Aus praktischer Sicht ist dabei hervorzuheben, dass die bislang obligatorische Leitungsanästhesie der Ohrnerven und das damit verbundene Risiko einer Fazialisparese vollständig umgangen werden konnte. Im Zuge dieses optimierten Verfahrens wurden physiologische und pathologische endoskopische Referenzen des externen Gehörkanales und Trommelfelles erstellt. Pathologische otoskopische Befunde (z.B. Tympanosklerose) sowie mangelnde veterinärmedizinische Fachliteratur verdeutlichen den Bedarf der histologischen Aufarbeitung des equinen akustischen Organs. Im Rahmen der Folgestudie wurden die Ohren von zehn Schlachtpferden für die detaillierte histologische Aufarbeitung herangezogen. Die Ergebnissedieser Arbeit beschreiben und verbildlichen erstmalig das vollständige equine akustische Organ. Im Folgenden sind nun die wesentlichen Ergebnisse der Basis- und Folgestudie zusammengefasst. Der physiologische kartilaginöse externe Gehörkanal ist pigmentiert, mit Haaren sowie mit cerumenproduzierenden Talg- und Schweißdrüsen ausgekleidet. Im Vergleich zum ossären externen Gehörkanal weist der kartilaginöse Anteil einen deutlich höheren Verschmutzungsgrad auf. Der Übergang zwischen dem kartilaginösen und ossären äußeren Gehörgang ist histologisch gekennzeichnet durch einen abrupten Wechsel zu einem unpigmentierten, haarlosen und drüsenfreien mehrschichtig verhornten Epithel. Endoskopisch ist dieser Übergang anhand kranzartig angeordneter beigefarbener Keratinschuppen erkennbar, welche Produkte des Selbstreinigungsmechanismus des knöchernen Gehörganges darstellen. Letzterer besitzt eine rund-ovale Form, ein trockenes zartrosafarbenes Epithel mit konzentrischen Keratinringen und schwach durchscheinender Gefäßzeichnung. Das physiologische equine Trommelfell stellt sich endoskopisch als eine klar in ihre Bestandteile (Pars tensa, Pars flaccida, Stria mallearis) differenzierte semitransparente Membran ohne positiven Lichtreflex dar. Auf der Grundlage der etablierten physiologischen Referenzen konnten pathologische Befunde bei sieben Pferden (vier Pferde mit Aural Plaques, drei Pferde mit Otitis externa) nachgewiesen werden. Zu den typischen Kennzeichen einer Otitis externa zählen die Schwellung und Rötung des ossären Epithels, das Verstreichen der konzentrischen Keratinringe und/oder die Ablösung der schützenden Keratinschicht im ossären Gehörkanal sowie ein positiver Lichtreflex im Bereich des Trommelfelles. Bei einem der an Otitis externa erkrankten Pferde konnte ein möglicher Zusammenhang zu einer Temporohyoidosteoarthropathie (THO) hergestellt werden. Darüber hinaus konnte bei zwei weiteren Pferden erstmalig eine Tympanosklerose diagnostiziert werden. Die Resultate dieser Dissertation liefern die Grundlage für weitere Forschungsansätze auf dem Gebiet des equinen akustischen Organs. Die Ohrendoskopie am stehenden sedierten Pferd ist eine praktikable, schonende sowie diagnostisch wertvolle Untersuchungsmöglichkeit. Sie sollte insbesondere bei der Abklärung einer THO, Fazialisparese, Vestibularsyndrom, Headshaking, Kopfscheue, parasitären Infektionen oder bei Kopftraumata zum Einsatz kommen. Die Ohrendoskopie ist zudem der Ausgangspunkt für die Anpassung und Anwendung humanmedizinischer audiometrischer Messsonden an das Pferdeohr. Die gewonnenen histologischen Erkenntnisse bilden die Basis für weiterführende Untersuchungen hinsichtlich angeborener oder erworbener Mittel- und Innenohrerkrankungen, welche Einfluss auf die Messung der otoakustischen Emissionen haben. / The equine acoustic organ, including its diseases and disorders, still plays a minor role in veterinary science. Due to insufficient visualization and examination equipment, little patient compliance and sparse references the diagnosis of auricular diseases is rather difficult (SARGENT et al. 2006; SOMMERAUER et al. 2012). The overall aim of this research project is to adapt human objective audiometric testing devices onto the equine acoustic organ. Particularly, the measurement of so-called otoacoustic emissions is of importance for an objective evaluation of the inner ear function. The otoscopic examination of the external ear canal and tympanic membrane is the fundamental precondition for the adaption of probes and every audiometric testing. Circumstances that may prevent us from having successful measurements, like a high degree of ceruminous and cellular debris or even foreign bodies within the external ear canal, can be identified and eliminated by otoscopy. By the use of common veterinary videobronchoscopes or videogastroscopes (calibre 7 mm/9 mm) the external ear canal and tympanic membrane of 38 standing sedated horses were bilaterally examined following a standardized protocol. Special emphasis should be placed on the fact that the obligatory local nerve block anaesthesia of the auricular nerves and the associated risk of a facial nerve paralysis were completely eliminated. With the help of this simplified procedure physiological and pathological references could be established. Pathological findings and a lack of relevant veterinary literature prompted us to take a closer look at histological aspects of the equine acoustic organ. In this context, the ears of ten slaughter horses were histologically examined in detail. The results of this follow-up study describe and illustrate the complete histology of the equine acoustic organ for the first time. In the following the essential results of the basic- and follow-up study are summarized. The physiological cartilaginous external ear canal is pigmented and contains hair, as well as ceruminous and sebaceous glands. In comparison to the osseous external ear canal, the cartilaginous part has higher degree of ceruminous and cellular debris. The intersection between both- the cartilaginous and osseous portion- is histologically characterized by an abrupt change to a non-pigmented, hairless, aglandular keratinized stratified squamous epithelium. Endoscopically, the intersection can be identified by a rim of beige keratin scales, which are products of the self-cleaning mechanism of the osseous epithelium. The osseous ear canal is round to oval shaped and lined with pale pink coloured epithelium that contains concentric keratin formations and visible capillary drawing. The physiological equine tympanic membrane is endoscopically characterized by a well-differentiated semi- transparent membrane, which shows no positive light reflex. On basis of the established physiological references pathological changes were found in seven horses (four horses with aural plaques, three horses with otitis externa). Typical sings of otitis externa were swelling and reddening of the osseous epithelium, the loss of the concentric keratin layer formation and/or detachment of the protective osseous keratin layer, as well as a positive light reflex on the tympanic membrane. In one diseased horse a possible correlation between the Otitis externa and severe temporohyoid osteoarthropathy (THO) could be revealed. Additionally, tympanosclerotic changes within two equine eardrums could be visualized for the first time. The results of this study provide a basis for further research on the equine acoustic organ. The otoscopic examination in standing sedated horses is a viable, safe, easy and quick to perform beneficial diagnostic procedure for a complete work-up of ear-related diseases, such as THO, facial nerve paralysis, vestibular disease, head shaking, parasitic infections or head trauma. In addition, the otoscopic examination is a basic requirement for the adaption and the use of human audiometric measuring probes in equine ears. The results obtained in the histological study can be employed as references for further research on equine congenital and acquired middle and inner ear diseases, which can influence the measurement results of otoacoustic emissions.

[Truncated abstract] The cochlea presumably possesses a number of regulatory mechanisms to maintain cochlear sensitivity in the face of disturbances to its function. Evidence for such mechanisms can be found in the time-course of the recovery of CAP thresholds during experimental manipulations, and in observations of slow oscillations in cochlear micromechanics following exposure to low-frequency tones (the “bounce phenomenon”) and other perturbations. To increase our understanding of these oscillatory processes within the cochlea, and OHCs in particular, investigations into cochlear regulation were carried out using a combination of mathematical modelling of the ionic and mechanical interactions likely to exist within the OHCs, and electrophysiological experiments conducted in guinea pigs. The electrophysiological experiments consisted of electrocochleographic recordings and, in some cases, measurement of otoacoustic emissions, during a variety of experimental perturbations, including the application of force to the cochlear wall, exposure to very-low-frequency tones, injection of direct current into scala tympani, and intracochlear perfusions of artificial perilymph containing altered concentrations of potassium, sodium, and sucrose. To obtain a panoramic view of cochlear regulation under these conditions, software was written to enable the interleaved and near-simultaneous measurement of multiple indicators of cochlear function, including the compound action potential (CAP) threshold, amplitude and waveshape at multiple frequencies, the OHC transfer curves derived from low-frequency cochlear microphonic (CM) waveforms, distortion-product otoacoustic emissions (DPOAEs), the spectrum of the round-window neural noise (SNN), and the endocochlear potential (EP). ... The mathematical model we have developed provided a physiologically-plausible and internally-consistent explanation for the time-courses of the cochlear changes observed during a number of different perturbations. We show that much of the oscillatory behaviour within the cochlea is consistent with underlying oscillations in cytosolic calcium concentration. We conclude that a number of the discrepancies between the simulation results and the experimental data can be resolved if the cytosolic calcium functions as two distinct pools: one which controls basolateral permeability and one which controls slow motility. This two-calcium-pool model is discussed.

Thesis (Ph.D.)--James Madison University, 2010. / Includes bibliographical references.

INTRODUÇÃO: O processamento da informação sonora depende da integridade das vias auditivas. O sistema auditivo eferente pode ser avaliado por meio de dois métodos objetivos e não-invasivos: a obtenção dos limiares dos reflexos acústicos, e a supressão das emissões otoacústicas. OBJETIVO: Verificar a atividade do sistema auditivo eferente, por meio da supressão das emissões otoacústicas por transientes (EOAT) e da sensibilização do reflexo acústico em indivíduos com alteração de processamento auditivo. MÉTODO: Foram avaliadas 50 crianças com alteração de processamento auditivo (grupo estudo) e 38 crianças sem alteração de processamento auditivo (grupo controle), por meio das EOAT evocadas por \"clicks\" na ausência e na presença de ruído ipsilateral e contralateral, e por \" tone bursts\", nas freqüências de 1000, 2000 e 4000 Hz na ausência e na presença de ruído contralateral, e de reflexo acústico nas freqüências de 500, 1000, 2000 e 4000 Hz na ausência e na presença de estímulo facilitador ipsi e contralateral. RESULTADOS: O valor da média de EOAT evocadas por \"clicks\" com estímulo supressor foi de até 1,50 dB para o grupo controle e de até 1,26 dB para o grupo estudo. Para as EOAT evocadas por \"tone bursts\" com estímulo supressor, os valores médios foram de até 2,69 dB para o grupo controle e de até 2,79 dB para o grupo estudo. Foi observado efeito de sensibilização do reflexo acústico com redução média de até 18,17 dB para o grupo estudo e de até 17,38 dB para o grupo controle. Não foi observada diferença estatisticamente significante entre as respostas do grupo controle e do grupo estudo, para supressão de EOAT (exceto na freqüência de 2000 Hz - \"tone burst\"), e para sensibilização do reflexo acústico. CONCLUSÕES: O grupo estudo apresentou valores reduzidos na pesquisa de supressão das EOAT e valores aumentados na sensibilização do reflexo acústico, em relação ao grupo controle. / INTRODUCTION: Auditory processing depends on the auditory pathways integrity. Efferent auditory system may be assessed in humans by two non-invasive and objective methods: acoustic reflex and otoacoustic emissions suppression. OBJECTIVE: Analyze efferent auditory system activity by otoacoustic emissions suppression and acoustic reflex sensitization in human subjects with auditory processing disorders. METHOD: Fifty children with auditory processing disorders (study group) and thirty-eight children without auditory processing disorders (control group) have being evaluated using clicks otoacoustic emission suppression with and without ipsilateral and contralateral white noise; tone bursts otoacoustic emission suppression in 1000, 2000 and 4000 Hz with and without contralateral white noise and acoustic reflex in 500, 1000, 2000 and 4000 Hz with and without ipsilateral and contralateral facilitator. RESULTS: The higher clicks otoacoustic emission suppression was up to 1.50 dB for the control group and up to 1.26 dB for the study group. The higher tone burst otoacoustic emission was up to 2.69 dB for the control group and up to 2.79 dB for the study group. The higher acoustical reflex sensitization was up to 18.17 dB for the study group and up to 17.38 dB for the control group. There was no significant statistical difference between results for control group and study group to otoacoustic emission suppression (except for 2000 Hz) and acoustical reflex sensitization. CONCLUSION: Study group presented smaller otoacoustic emission suppression than control group and study group presented higher acoustical reflex sensitization than control group.

O objetivo do presente estudo foi estimar a especificidade e taxa de falso-positivo de protocolos de triagem auditiva neonatal (TAN), realizados com os procedimentos emissões otoacústicas evocadas transientes-módulo triagem (EOAet) e potenciais evocados auditivos de tronco encefálico automático (PEATEa), de forma isolada ou combinada, aplicados em uma ou duas etapas. Participaram deste estudo 200 recém-nascidos, selecionados aleatoriamente, submetidos à triagem auditiva, no período entre Março/2006 e Julho/2006. A estimativa da taxa de falso-positivo e da especificidade foi realizada com a TAN em uma etapa e com três protocolos: protocolo 1, TAN realizada em duas etapas com EOAet; protocolo 2, TAN realizada em duas etapas com PEATEa; e protocolo 3, TAN realizada em uma etapa com dois procedimentos - teste com EOAet seguido de reteste com PEATEa para os recém-nascidos que não passaram no primeiro procedimento. Os resultados mostraram alta taxa de falso-positivo na triagem auditiva realizada em uma etapa para ambos os procedimentos. Apesar de não ter havido diferença estatisticamente significante quando comparadas as taxas de encaminhamento para diagnóstico audiológico obtidos nos protocolos com EOAet e com PEATEa, o protocolo com EOAet encaminhou 4 vezes mais recém-nascidos. O protocolo com EOAet e PEATEa apresentou a maior taxa de encaminhamento (6%), com diferença estatisticamente significante ao ser comparado com os protocolos 1 (EOAet) e 2 (PEATEa). Concluiu-se que a triagem auditiva neonatal deve ser realizada em duas etapas (teste-reteste), a fim de reduzir a taxa de falso-positivo e de encaminhamento, aumentando a especificidade; a taxa de falso-positivo e conseqüentemente a especificidade foram melhores no protocolo com PEATEa, seguido dos protocolos com EOAet e com EOAet e PEATEa. / O objetivo do presente estudo foi estimar a especificidade e taxa de falso-positivo de protocolos de triagem auditiva neonatal (TAN), realizados com os procedimentos emissões otoacústicas evocadas transientes-módulo triagem (EOAet) e potenciais evocados auditivos de tronco encefálico automático (PEATEa), de forma isolada ou combinada, aplicados em uma ou duas etapas. Participaram deste estudo 200 recém-nascidos, selecionados aleatoriamente, submetidos à triagem auditiva, no período entre Março/2006 e Julho/2006. A estimativa da taxa de falso-positivo e da especificidade foi realizada com a TAN em uma etapa e com três protocolos: protocolo 1, TAN realizada em duas etapas com EOAet; protocolo 2, TAN realizada em duas etapas com PEATEa; e protocolo 3, TAN realizada em uma etapa com dois procedimentos - teste com EOAet seguido de reteste com PEATEa para os recém-nascidos que não passaram no primeiro procedimento. Os resultados mostraram alta taxa de falso-positivo na triagem auditiva realizada em uma etapa para ambos os procedimentos. Apesar de não ter havido diferença estatisticamente significante quando comparadas as taxas de encaminhamento para diagnóstico audiológico obtidos nos protocolos com EOAet e com PEATEa, o protocolo com EOAet encaminhou 4 vezes mais recém-nascidos. O protocolo com EOAet e PEATEa apresentou a maior taxa de encaminhamento (6%), com diferença estatisticamente significante ao ser comparado com os protocolos 1 (EOAet) e 2 (PEATEa). Concluiu-se que a triagem auditiva neonatal deve ser realizada em duas etapas (teste-reteste), a fim de reduzir a taxa de falso-positivo e de encaminhamento, aumentando a especificidade; a taxa de falso-positivo e conseqüentemente a especificidade foram melhores no protocolo com PEATEa, seguido dos protocolos com EOAet e com EOAet e PEATEa.

The aim of my thesis is to summarize all the information regarding newborn and infant hearing screening programmes, to find out about the awareness of mothers-to-be and to give account on the possibilites of the further professional development of the infant hearing screening. The theoretical part consists of the definitions of terminology relating to this topic, the historical development of the hearing screening and the latest findings and current level of knowledge of the issue both in the Czech Republic and abroad. The practical part of my master's thesis aspires to detect the awareness of expecting mothers and non-professionals through a questionnaire survey. Apart from the results of the survey the practical part also contains an interview with a specialist. Besides the research analysis, I have also focused on informing the target group about the prospects and significance of the newborn and infant hearing screening tests as this is a current issue now. KEYWORDS: Newborn Otoacoustic emissions Hearing screening Hearing loss Early detection

This study aimed to investigate the effectiveness of the Quiet earplug noise protectors worn by a group of South African industrial workers exposed to excessive noise in the workplace. This was achieved by investigating the prevalence and amplitudes of distortion product otoacoustic emissions (DPOAEs), as they have been found to be sensitive to the effects of noise on the cochlea (Vinck, Van Cauwenberge, Leroy,&Corthals, 1999, p. 52). DPOAEs were recorded before and after noise exposure and were compared in order to determine whether the earplugs are providing sufficient protection against cochlear damage. DPOAEs were recorded using a test protocol where the primaries are fixed at L1 = 60dB SPL and L2 = 35dB SPL (L1 - L2 = 25dB) with an f2/f1 ratio of 1.18. The f2 frequencies were selected to correspond closely to the audiometric test frequencies of 2000Hz, 3000Hz, 4000Hz, 6000Hz and 8000Hz. The study found the prevalence of DPOAEs to be statistically stable and repeatable. This was true for DPOAEs measured successively during the same test sitting, as well as comparing prevalence determined before and after exposure to eight hours of noise. DPOAE prevalence alone was therefore not found to be a good indication of the temporary threshold shift (TTS) associated with the effects of noise on the cochlea. However, a significant finding of the study was that normal DPOAEs were recorded in only six right ears (24%) and seven left ears (28%) before noise exposure, even though all the subjects presented with hearing thresholds better than 25dB SPL. This may mean that cochlear pathology is already evident in some of the subjects tested. Further results of the study showed DPOAE amplitudes to be sensitive to the negative effects of excessive noise, as there was a significant difference between DPOAE amplitudes measured before and after the noise exposure. DPOAE amplitudes, specifically in the frequencies that are known to be affected by noise such as 4000Hz and 6000Hz, measured after the work-shift were significantly smaller than those measured before exposure to noise. Although correct usage of the earplugs could not be controlled for the duration of the noise exposure, each subject was instructed on the correct usage of the hearing protection before entering the noise zone. Bearing this limitation of the study in mind, because DPOAE amplitudes were reduced the implication is that the Quiet earplugs are not providing sufficient protection against the harmful effects of noise. / Dissertation (M (Communication Pathology))--University of Pretoria, 2005. / Speech-Language Pathology and Audiology / Unrestricted

Grâce à la miniaturisation de la technologie ainsi qu'a l'augmentation constante des capacités de calcul numérique, les méthodes objectives et les appareils de mesures de la physiologie auditive évoluent. C'est dans l'optique de créer de nouveaux outils diagnostics que la société Echodia a été créée en 2009. Celle-ci finance aujourd'hui mes recherches sous convention CIFRE.Les présents travaux proposent, dans une première partie, de présenter comment deux méthodes de mesures non invasives ont été mises en oeuvre pour être applicables au diagnostic de l'hydrops cochléaire. Les méthodes sont basées sur le fait que les réponses des cellules ciliées de la cochlée à des stimuli sonores dépendent de la position au repos de leur touffe de stéréocils. Or, l'hydrops cochléaire, l'une des principales caractéristiques de la maladie de Menière, est susceptible de venir perturber cet environnement. Une variation chimique ou mécanique de celui-ci peut ainsi être mise en évidence par différentes méthodes d'exploration objectives. La première est basée sur un enregistrement électrophysiologique. En étudiant le Potentiel de sommation (SP) de l'ÉlectroCochléoGraphie (ECochG), nous allons recueillir une image du tour basal de la cochlée. La deuxième méthode est basée sur un enregistrement acoustique dans le méat acoustique externe. En monitorant le déphasage des Produits de distorsion desoto-émissions acoustiques (DPOAE), nous allons enregistrer les réponses du tour apical de la cochlée.La deuxième partie est consacrée à une étude au cours de laquelle nous avons enregistré de manière concomitante le SP (basal) ainsi que le DPOAE (apical) chez 73 patients souffrant de vertiges de Menière, à proximité d'une attaque (n = 40) ou entre les attaques, sans symptômes cliniques (n = 33). Dans le cas des DPOAE, c'est la phase du produit de distorsion (PDA) à 2*f1-f2 qui a été étudiée en réponse à des sons stimulants de fréquence f1 = 1 kHz et f2 = 1,2 kHz. La puissance des deux fondamentaux a été fixée entre 70 et 75dB SPL en fonction du niveau du DPOAE. Le rapport entre SP et le Potentiel d’action global (AP) a, quant à lui, été mesuré de manière extra-tympanique en réponse à des clics de 95dB nHL. Ces deux mesures ont été effectuées plusieurs fois pendant un test de posture afin d'évaluer leur stabilité.Les limites normales de déphasage du DPOAE en réponse à la posture [-18 °, +38 °] ont été dépassées chez 75% des patients étant venus consulter à proximité d'une crise. Sur ces mêmes sujets, l'étude du ratio entre SP et AP a dépassé la valeur normale (<0,40) dans 60% des cas. De plus, chez les patients à proximité d'une crise de vertige, les deux types de mesures révèlent des fluctuations entre deux répétitions. Ces écarts mettent en évidence combien l'hydrops entrave le bon fonctionnement de la mécanique cochléaire. Le fait de constater des variations sur des échelles de temps aussi courtes pourrait expliquer la sensibilité imparfaite des tests diagnostics. En effet, les protocoles de mesure du SP ou des DPOAE nécessitent un moyennage des acquisitions qui, par définition, a tendance à niveler les fluctuations transitoires. / Thanks to technology miniaturization as well as digital computing abilities steadily increasing, objective measurement methods and their related devices evolve. Echodia company was created in 2009 with the goal to create new diagnostic tools. The company currently supports my research work through a CIFRE convention.The first part of this thesis presents two non-invasive measurement methods that have been implemented to the diagnosis of cochlear hydrops. The methods are based on the responses of cochlear hair cells to sound stimuli, depending themselves on the resting position of their stereocilia bundles. Cochlear hydrops, a hallmark of Meniere's disease, is likely to disturb this environment. A chemical or mechanical variation of this environment may be observed by various objective exploration methods. The first method is based on an electrophysiological recording. By studying the Summating Potential (SP) of the Electrocochleography (ECOG) we will register activity in the basal part of the cochlea. The second method is based on a sound recording in the external acoustic meatus. By monitoring the phase shifts of Distortion-Product OtoAcoustic Emissions (DPOAE), we will record the apical responses of the cochlea.The second part of this thesis focuses on a study in which we recorded concomitantly the SP (basal) and the DPOAE (apical) in 73 patients with Menière's disease, close to an attack (n = 40) or between attacks without clinical symptoms (n = 33). In the case of DPOAE, the phase at 2*f1-f2 has been studied in response to pure sinusoidal sounds at frequency f1 = 1 kHz and f2 = 1,2 kHz. The power of the two primary was set between 70 and 75dB SPL based on the level of the DPOAE. The SP to Action Potential (AP) ratio has been measured by extra-tympanic electrode in response to 95dB nHL clicks. These two measurements were performed several times during a postural test to evaluate their stability.The normal limit of the phase shift of the DPOAE during a postural test [-18 °, +38 °] was exceeded in 75% of patients near an attack. On these subjects, the study of the SP/AP ratio exceeded the normal value (<0.40) in 60% of cases. In addition, the two types of measurements made on patients near a vertigo attack reveal fluctuations between reiteration. These differences highlight how hydrops hinders the proper functioning of the cochlear mechanics. This short time scales fluctuations might explain the imperfect diagnostic sensitivity of SP and DPOAE tests, as averaging procedures would tend to level out transient fluctuations characteristic of hydrops.

Background: Iron deficiency, anemia, and iron excess have been associated with altered hearing functions in children and adults. Animal studies suggest that iron deficiency during pregnancy negatively affect fetal auditory development. The relationship between maternal iron status and auditory functions in healthy term newborns has not been clearly elucidated among humans. The goal of this pilot study was to determine the relationship between markers of iron status during pregnancy and brainstem auditory function in healthy neonates. Methods: Pregnant women who gave birth at the Montfort Hospital were recruited to take part in this study (n=6). Within two weeks after birth, their newborn’s hearing function was assessed by wave amplitude, latency and inter-latency from the Auditory Brainstem Response (ABR) test. Markers of iron status, namely hemoglobin (Hb) and mean corpuscular volume (MCV), were collected retrospectively for the first and second trimester from the women’s medical chart. Results: Overall, no significant relationship was observed between maternal Hb and MCV concentrations and newborns auditory function. Although two significant Spearman correlations were observed (MCV and inter-latency I-V; r=0.87; p=0.005 and Hb and amplitude V; r=0.89; p=0.04), these findings may be due to chance because of multiple testing and the small sample size. Conclusion: Although iron is a key nutrient involved in the brain and auditory system development, we were not able to demonstrate a relationship between iron status during pregnancy and newborn hearing function. Prospective or intervention studies with a larger sample size and with more specific iron markers (ex. ferritin) are required to confirm these findings.

BACKGROUND: The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. MATERIAL/METHODS: Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. RESULTS: The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. CONCLUSIONS: Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.