Cochlear microphonic audiometry: A new hearing test for objective diagnosis of deafness

ENT Service, Madrid, Spain.
Acta oto-laryngologica (Impact Factor: 1.1). 10/2008; 129(7):749-54. DOI: 10.1080/00016480802398962
Source: PubMed


Objective audiometric tests could constitute a valuable tool for detection of deafness. This could be especially useful in children (universal newborn hearing screening) and non-collaborative patients, who are especially difficult candidates for classic audiometry. The cochlear microphonic audiometry (CMA) technique offers the possibility of obtaining objective audiometric profiles, highly correlated with those obtained by pure tone audiometry (PTA). Therefore, CMA could be used as an alternative test to obtain the audiometric profile of these patients.
The main purpose of the present study was to demonstrate that CMA provides objective audiometric profiles by avoiding active participation by the patient. Subjects and methods. CMA specific equipment, improved for non-invasive recording of cochlear microphonic potentials, was used. This tool plots the recordings obtained as the classic audiogram. Verification of the method was carried out in adult patients by comparing the PTA with the CMA audiometric profiles obtained for each patient.
Our findings showed that audiometric profiles obtained from CMA are highly correlated, without statistical differences, to those obtained with PTA. More than 81% of patients explored (91.67% at 250 Hz) exhibited differences below 10 dB(HL) between tests at all exploration frequencies, while a low number of cases showed differences over 20 dB(HL).

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    ABSTRACT: Cochlear microphonic (CM) measurements may potentially become a supplementary approach to otoacoustic emission (OAE) measurements for assessing low-frequency cochlear functions in the clinic. The objective of this study was to investigate the measurement of CMs in subjects with high-frequency hearing loss. Currently, CMs can be measured using electrocochleography (ECochG or ECoG) techniques. Both CMs and OAEs are cochlear responses, while auditory brainstem responses (ABRs) are not. However, there are inherent limitations associated with OAE measurements such as acoustic noise, which can conceal low-frequency OAEs measured in the clinic. However, CM measurements may not have these limitations. CMs were measured in human subjects using an ear canal electrode. The CMs were compared between the high-frequency hearing loss group and the normal-hearing control group. Distortion product OAEs (DPOAEs) and audiogram were also measured. The DPOAE and audiogram measurements indicate that the subjects were correctly selected for the two groups. Low-frequency CM waveforms (CMWs) can be measured using ear canal electrodes in high-frequency hearing loss subjects. The difference in amplitudes of CMWs between the high-frequency hearing loss group and the normal-hearing group is insignificant at low frequencies but significant at high frequencies.
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    ABSTRACT: Compared to auditory brainstem responses (ABRs), cochlear microphonics (CMs) may be more appropriate to serve as a supplement to the test of otoacoustic emissions (OAEs). Researchers have shown that low-frequency CMs from the apical cochlea are measurable at the tympanic membrane using high-pass masking noise. Our objective is to study the effect of such noise at different intensities on low-frequency CMs recorded at the ear canal, which is not completely known. Six components were involved in this CM measurement including an ear canal electrode (1), a relatively long and low-frequency toneburst (2), and high-pass masking noise at different intensities (3). The rest components include statistical analysis based on multiple human subjects (4), curve modeling based on amplitudes of CM waveforms (CMWs) and noise intensity (5), and a technique based on electrocochleography (ECochG or ECoG) (6). Results show that low-frequency CMWs appeared clearly. The CMW amplitude decreased with an increase in noise level. It decreased first slowly, then faster, and finally slowly again. In conclusion, when masked with high-pass noise, the low-frequency CMs are measurable at the human ear canal. Such noise reduces the low-frequency CM amplitude. The reduction is noise-intensity dependent but not completely linear. The reduction may be caused by the excited basal cochlea which the low-frequency has to travel and pass through. Although not completely clear, six mechanisms related to such reduction are discussed.
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