Contralateral Ear Occlusion for Improving the Reliability of Otoacoustic Emission Screening Tests

Overview

Journal Int J Otolaryngol

Specialty Otorhinolaryngology

Date 2014 Mar 28

PMID 24672553

Authors

Emily Papsin

Adrienne L Harrison

Mattia Carraro

Robert V Harrison

Affiliations

Soon will be listed here.

Abstract

Newborn hearing screening is an established healthcare standard in many countries and testing is feasible using otoacoustic emission (OAE) recording. It is well documented that OAEs can be suppressed by acoustic stimulation of the ear contralateral to the test ear. In clinical otoacoustic emission testing carried out in a sound attenuating booth, ambient noise levels are low such that the efferent system is not activated. However in newborn hearing screening, OAEs are often recorded in hospital or clinic environments, where ambient noise levels can be 60-70 dB SPL. Thus, results in the test ear can be influenced by ambient noise stimulating the opposite ear. Surprisingly, in hearing screening protocols there are no recommendations for avoiding contralateral suppression, that is, protecting the opposite ear from noise by blocking the ear canal. In the present study we have compared transient evoked and distortion product OAEs measured with and without contralateral ear plugging, in environmental settings with ambient noise levels <25 dB SPL, 45 dB SPL, and 55 dB SPL. We found out that without contralateral ear occlusion, ambient noise levels above 55 dB SPL can significantly attenuate OAE signals. We strongly suggest contralateral ear occlusion in OAE based hearing screening in noisy environments.

References

Foust T, Eiserman W, Shisler L, Geroso A . Using otoacoustic emissions to screen young children for hearing loss in primary care settings. Pediatrics. 2013; 132(1):118-23. DOI: 10.1542/peds.2012-3868. View

Kemp D . Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am. 1978; 64(5):1386-91. DOI: 10.1121/1.382104. View

Ptok M . [Fundamentals of hearing screening in neonates (standard of care)]. Z Geburtshilfe Neonatol. 2003; 207(5):194-6. DOI: 10.1055/s-2003-43421. View

Puel J, Rebillard G . Effect of contralateral sound stimulation on the distortion product 2F1-F2: evidence that the medial efferent system is involved. J Acoust Soc Am. 1990; 87(4):1630-5. DOI: 10.1121/1.399410. View

Hatzopoulos S, Petruccelli J, Ciorba A, Martini A . Optimizing otoacoustic emission protocols for a UNHS program. Audiol Neurootol. 2008; 14(1):7-16. DOI: 10.1159/000148205. View

Simmons D . Development of the inner ear efferent system across vertebrate species. J Neurobiol. 2002; 53(2):228-50. DOI: 10.1002/neu.10130. View

James A, Mount R, Harrison R . Contralateral suppression of DPOAE measured in real time. Clin Otolaryngol Allied Sci. 2002; 27(2):106-12. DOI: 10.1046/j.1365-2273.2002.00541.x. View

Freitas V, Alvarenga K, Bevilacqua M, Martinez M, Costa O . Critical analysis of three newborn hearing screening protocols. Pro Fono. 2009; 21(3):201-6. DOI: 10.1590/s0104-56872009000300004. View

Eiserman W, Hartel D, Shisler L, Buhrmann J, White K, Foust T . Using otoacoustic emissions to screen for hearing loss in early childhood care settings. Int J Pediatr Otorhinolaryngol. 2008; 72(4):475-82. DOI: 10.1016/j.ijporl.2007.12.006. View

10.

Darbyshire J, Young J . An investigation of sound levels on intensive care units with reference to the WHO guidelines. Crit Care. 2013; 17(5):R187. PMC: 4056361. DOI: 10.1186/cc12870. View

11.

Moulin A, Collet L, Duclaux R . Contralateral auditory stimulation alters acoustic distortion products in humans. Hear Res. 1993; 65(1-2):193-210. DOI: 10.1016/0378-5955(93)90213-k. View

12.

Williams D, Brown A . The effect of contralateral broad-band noise on acoustic distortion products from the human ear. Hear Res. 1997; 104(1-2):127-46. DOI: 10.1016/s0378-5955(96)00189-x. View

13.

Shnerson A, Devigne C, Pujol R . Age-related changes in the C57BL/6J mouse cochlea. II. Ultrastructural findings. Brain Res. 1981; 254(1):77-88. DOI: 10.1016/0165-3806(81)90060-2. View

14.

Veuillet E, Collet L, Duclaux R . Effect of contralateral acoustic stimulation on active cochlear micromechanical properties in human subjects: dependence on stimulus variables. J Neurophysiol. 1991; 65(3):724-35. DOI: 10.1152/jn.1991.65.3.724. View

15.

Giraud A, Wable J, Chays A, Collet L . Influence of contralateral noise on distortion product latency in humans: is the medial olivocochlear efferent system involved?. J Acoust Soc Am. 1998; 102(4):2219-27. DOI: 10.1121/1.419635. View

16.

Liberman M . Rapid assessment of sound-evoked olivocochlear feedback: suppression of compound action potentials by contralateral sound. Hear Res. 1989; 38(1-2):47-56. DOI: 10.1016/0378-5955(89)90127-5. View

17.

Warren 3rd E, Liberman M . Effects of contralateral sound on auditory-nerve responses. I. Contributions of cochlear efferents. Hear Res. 1989; 37(2):89-104. DOI: 10.1016/0378-5955(89)90032-4. View

18.

Bulankina A, Moser T . Neural circuit development in the mammalian cochlea. Physiology (Bethesda). 2012; 27(2):100-12. DOI: 10.1152/physiol.00036.2011. View

19.

James A, Harrison R, Pienkowski M, Dajani H, Mount R . Dynamics of real time DPOAE contralateral suppression in chinchillas and humans. Int J Audiol. 2005; 44(2):118-29. DOI: 10.1080/14992020400029996. View

20.

Morlet T, Hamburger A, Kuint J, Ari-Even Roth D, Gartner M, Muchnik C . Assessment of medial olivocochlear system function in pre-term and full-term newborns using a rapid test of transient otoacoustic emissions. Clin Otolaryngol Allied Sci. 2004; 29(2):183-90. DOI: 10.1111/j.0307-7772.2004.00786.x. View