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Schall- und Geschwindigkeits-DPOAE

Technologie, Methodik und Perspektiven

Sound and velocity DPOAEs

Technology, methodology and perspectives

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Zusammenfassung

Neuere Veröffentlichungen zeigen, dass Messungen der Distorsionsprodukte otoakustischer Emissionen (DPOAE) treffsicherere Diagnosen liefern, wenn erstens die DPOAE-Feinstruktur unterdrückt wird und zweitens die akustische Kalibration verbessert wird. Die Reduzierung der Feinstruktur wirkt sich v. a. im Frequenzbereich bis 4 kHz bei Personen mit intaktem cochleären Verstärker aus und kann die Standardabweichung einer auf DPOAE-Wachstumsfunktionen basierenden Schwellenschätzung von üblicherweise 11 auf 6 dB reduzieren. Eine verbesserte Kalibration des Schallfelds wirkt sich v. a. bei Frequenzen oberhalb 4 kHz aus. Auf laserinterferometrischen Messungen von DPOAE-Wachstumsfunktionen basierende Schwellenschätzungen mit Schallkalibration nahe dem Trommelfell lieferten eine Standardabweichung von 8,6 dB bei Menschen und 6,5 dB bei Meerschweinchen. Eine auf DPOAE-Wachstumsfunktionen basierende Schwellenschätzung hat gegenüber konventionellen DPOAE-Maßen wie DPOAE-Amplitude oder -Rauschabstand den Vorteil, dass mit ihrer Steigung ein unabhängiges Maß zur Verfügung steht, das – wenn auch mit begrenzter Spezifität – Informationen über das Mittelohr liefert. Die Kombination mit Verfahren wie der Messung der akustischen Reflektanz oder der Laservibrometrie am Umbo könnte in Zukunft eine zuverlässige Abgrenzung von Mittelohranteilen in DPOAE-Messungen liefern.

Abstract

Recent publications show that DPOAE measurements can generate a more accurate diagnosis, if (1) their fine structure is suppressed, and (2) if the calibration of the sound field is improved. Reduction of the fine structure is particularly important in the frequency range below 4 kHz in subjects with intact cochlear amplifier and can reduce the standard deviation of threshold estimations based on DPOAE-input/output functions from 11 dB to 6 dB. Improving the sound-field calibration has most impact in the frequency range above 4 kHz. Threshold estimations based on laserinterferometrically measured DPOAE input-output functions where the sound field was calibrated close to the tympanic membrane have been shown to reduce the standard deviation down to 8.6 dB in humans and 6.5 dB in guinea pigs. Compared with conventional DPOAE measures, such as amplitude or signal-to-noise ratio, threshold estimation based on DPOAE-I/O functions has the advantage that its slope provides additional information about the middle-ear; however, its specificity is limited. In the future, combined methods such as acoustic reflectance or laser vibrometry on the umbo promise a reliable assessment of the middle-ear contribution to DPOAE.

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Abbreviations

BM:

Basilarmembran

OAE:

otoakustische Emissionen

DPOAE:

Distorsionsprodukte otoakustischer Emissionen

TEOAE:

transient evozierte OAE

EDPT:

extrapolierte Distorsionsproduktschwelle („estimated distorsion product threshold“)

LDV:

Laser-Doppler-Vibrometer

ROC:

„receiver operating characteristic“

SNR:

Rauschabstand („signal-to-noise ratio“)

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  1. HNO-Klinik Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland

    E. Dalhoff, A. Vetešník, D. Turcanu & A.W. Gummer

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  1. E. Dalhoff
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  2. A. Vetešník
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  3. D. Turcanu
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  4. A.W. Gummer
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Correspondence to E. Dalhoff.

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Dalhoff, E., Vetešník, A., Turcanu, D. et al. Schall- und Geschwindigkeits-DPOAE. HNO 58, 543–555 (2010). https://doi.org/10.1007/s00106-010-2104-z

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