Characterization of spontaneous otoacoustic emissions in 2–4 day old neonates with respect to gender and ear

BACKGROUND： Spontaneous otoacoustic emissions （SOAEs） are regarded as a valuable audio- metric parameter that objectively reflects the function of outer hair cells （OHCs）. Many studies have reported that the incidence of SOAEs in adults is less than 50%. Therefore, measurement of SOAEs may be of little value to clinical examinations. However, the incidence of SOAEs in infants and neonates is higher than in adults. OBJECTIVE： To analyze the basic characteristics of SOAEs in 2–4 day old neonates, and to demonstrate the difference in OHC function between sexes and ears. DESIGN, TIME AND SETTING： Neurophysiological contrast study, performed in the Department of Neonates, Beijing Chaoyang Hospital, Capital Medical University, between December 2007 and August 2008. PARTICIPANTS： A total of 112 newborns （224 ears） consisting of 59 females and 53 males were included in this study. METHODS： The probe was adapted and embedded in the neonate external auditory canal with a foam rubber earplug after checking and clearing up the outer ear canal. The presence of SOAEs was determined when the signal amplitude had a clear peak exceeding –30 dB, or was 3 dB above the noise floor. MAIN OUTCOME MEASURES： The incidence of SOAEs, the number of SOAE signal peaks, and the maximal tension of SOAEs. RESULTS： The incidence in females （79.7%） was higher than males （76.4%） （P 〉 0.05）, and the incidence in right ears （86.6%） was higher than in left ears （69.6%） （P 〈 0.05）. There were no significant difference in the number of SOAE peaks between females and males （4.49 vs. 4.28）, or between right ears and left ears （4.62 vs. 4.12） （P 〉 0.05）. The mean maximum SOAE level per ear in females （–3.29 ± 9.28） dB sound pressure level （SPL） was slightly higher than that in males （–3.91 ± 9.14） dB SPL （P 〉 0.05）. Also, the mean maximum SOAE level in right ears （–2.03 ± 9.11） dB SPL was higher than in left ears （–5.50 ± 9.65） dB SPL （P 〈 0.05）. The maximum SOAE level showed a positive correlation with maximum SOAE number in emitting ears （r = 0.55, P 〈 0.01）. CONCLUSION： The incidence of SOAEs in neonates is high （78.1%） within 4 days of birth. The in-cidence of SOAEs and the maximum SOAE level exhibited a significant difference between right and left ears, but the difference between sexes was insignificant. Both the strongest SOAE signal peak and number of SOAEs per ear are representative of the function OHCs.

Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia

Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs)of young guinea pigs.Thus,it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA.The current study explores maternal IDA’s effect on DPOAEs in newborn babies.Method:A total of 110 newborn babies with gestational age≥34 weeks were considered and a‘betweensubjects’design was used.The participants were divided into 3 groups-“Normal”(61 babies without maternal IDA),“Mild”(28 babies with mild maternal IDA)and“Moderate”(21 babies with moderate maternal IDA).The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies(1 k 8 kHz)and a range of intensities(7040 dB SPL in 10 dB steps).Results:The analysis of both DP-gram and DP input-output(I/O)function showed that there was no significant difference(p>0.05)across the normal,mild,and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities(7040 dB SPL).Also,the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.Conclusion:The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Spontaneous Otoacoustic Emissions in Tinnitus Patients

Otoacoustic emissions (OAEs) are believed to be the products of active cochlear mechanics. They are generally associated with relatively intact outer hair cell function. OAEs usually decrease or become undetectable when hearing loss of cochlear origin exceeds 40-50 dB HL. Subjective tinnitus is a perception of sound without detectable corresponding source. It is most often seen in patients with hearing loss. It is also frequently seen in patients with head injuries. Studies have suggested that the prevalence of spontaneous otoacoustic emissions(SOAEs) is lower in patients with hearing loss and tinnitus than in normal population. There have also been reports on association between tinnitus and SOAEs of unusually high amplitudes, which can be controlled by aspirin administration. The current paper is a preliminary review of clinical data collected from a group of tinnitus patients in an attempt to elucidate on the relationship between SOAEs and tinnitus from a clinical point of view. Audiometric, tinnitus and SOAE data from 59 patients seen at the Oregon Health & Science University Tinnitus Clinic were retrospectively studied. Fifty-four of these 59 patients showed sensorineural hearing loss of various degrees at the time of evaluation, mostly affecting high frequencies. SOAEs were detected in 26 ears (22%) of 18 patients(30.5%). There was no difference in SOAE prevalence between male and female patients. SOAEs were recorded in four of the five patients whose pure tone thresholds were within normal limits up to 8000 Hz. SOAEs appeared to be recorded at a higher rate in patients whose tinnitus started following motor vehicle accidents or head injuries(5/10) than in other patients. Time course of tinnitus did not appear to affect SOAE detection rate. There were no correlations between SOAE frequency and matched tinnitus pitch or frequency of maximum hearing loss. Significance of these findings is discussed.

Backward Propagation of Otoacoustic Emissions

Normal mammalian ears not only detect but also generate sounds. The ear-generated sounds, i.e., otoacoustic emissions (OAEs), can be measured in the external ear canal using a tiny sensitive microphone. In spite of wide applications of OAEs in diagnosis of hearing disorders and in studies of cochlear functions, the question of how the cochlea emits sounds remains unclear. The current dominating theory is that the OAE reaches the cochlear base through a backward traveling wave. However, recently published works, including experimental data on the spatial pattern of basilar membrane vibrations at the emission frequency, demonstrated only forward traveling waves and no signs of backward traveling waves. These new findings indicate that the cochlea emits sounds through cochlear fluids as compression waves rather than through the basilar membrane as backward traveling waves. This article reviews different mechanisms of the backward propagation of OAEs and summarizes recent experimental results.

Isoflurane anesthesia suppresses distortion product otoacoustic emissions in rats

A commonly used anesthetic, isoflurane, can impair auditory function in a dose-dependent manner. However, in rats, isoflurane-induced auditory impairments have only been assessed with auditory brainstem responses; a measure which is unable to distinguish if changes originate from the central or peripheral auditory system. Studies performed in other species, such as mice and guinea-pigs, suggests auditory impairment stems from disrupted OHC amplification. Despite the wide use of the rat in auditory research, these observations have yet to be replicated in the rat animal model. This study used distortion product otoacoustic emissions to assess outer hair cell function in rats that were anesthetized with either isoflurane or a ketamine/xylazine cocktail for approximately 45 min. Results indicate that isoflurane can significantly reduce DPOAE amplitudes compared to ketamine/xylazine, and that responses were more variable with isoflurane than ketamine/xylazine over the 45-min test period. Based on these observations, isoflurane should be used with caution when assessing peripheral auditory function to avoid potentially confounding effects.

An Overview of Electrically Evoked Otoacoustic Emissions in the Mammalian Cochlea

Alternating currents injected into the cochlea are able to evoke outer hair cell-mediated basilar membrane motion, thus give rise to production of otoacoustic emissions. This electrically evoked otoacoustic emission(EEOAE) provides a useful tool for the research of out hair cell electromotility in vivo. This article reviews the research work on EEOAEs in mammals. Features of the EEOAEs and theories of their generation are introduced. Methods of EEOAE measurement are also described.

MEASUREMENT OF AMPLITUDE AND DELAY OF STIMULUS FREQUENCY OTOACOUSTIC EMISSIONS

Although stimulus frequency otoacoustic emissions (SFOAEs) have been used as a non-invasive measure of cochlear mechanics, clinical and experimental application of SFOAEs has been limited by difficulties in accurately deriving quantitative information from sound pressure measured in the ear canal. In this study, a novel signal processing method for multicomponent analysis (MCA) was used to measure the amplitude and delay of the SFOAE. This report shows the delay-frequency distribution of the SFOAE measured from the human ear. A low level acoustical suppressor near the probe tone significantly suppressed the SFOAE, strongly indicating that the SFOAE was generated at characteristic frequency locations. Information derived from this method may reveal more details of cochlear mechanics in the human ear.

Evaluation of SON’OR^(█),a Medical Device for Provoked Otoacoustic Emissions and Brainstem Evoked Response Audiometry Made in Cameroon

Background: There is a huge gap in the audiological care in Africa by comparison with Western countries. Its main reason is the prohibitive cost of the medical devices used to screen or diagnose patients. A Cameroonian team tackled this problem by developing a medical device (SON’OR©) which integrates a new instrumentation amplifier structure dedicated to perform otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA). The major technical challenges to perform OAE and BERA are the synchronization and the amplification of signals of very low amplitude. In this work, we emphasize on the general criteria necessary and indispensable to achieve an optimal amplification. The application of a novel instrumentation amplifier structure characterized by its optimized noise factor in the case of BERA and OEA emissions provides simulations and experimental results fully in line with forecasts. The design of SON’OR©is based on general techniques of electronic instrumentation to which we associated the new instrumentation amplifier structure. Objective: To report the clinical evaluation of SON’OR©as a screening and diagnostic tool. Methods: We conducted a cross sectional comparative study in Centre Hospitalier d’Essos in Yaoundé. We tested SON’OR©on two sets of subjects, one for OAE with OTODYNAMICS Echoport ILO 292-II as gold standard and the other for BERA with NEUROSOFT NEURO AUDIO©as gold standard. Each patient was tested with both devices and then we studied the inter device differences and calculated the sensitivity, specificity, positive predictive value and negative predictive value for each test. Results: We got 52 subjects for OEA and 51 for BERA testing. Sex ratio was 1 woman for 2 men in both groups. Mean age was 24.86(SD = 10.53) and 26.33 (10.55) for OAE and BERA groups respectively. SON’OR©had good performances, showing sensitivity of 92.85%/95%, specificity of 96.77%/90.47%, positive predictive value of 95.21%/93.44% and negative predictive value of 95.23%/92.68% for OAE/ BERA respectively. Conclusion: SON’OR©has good characteristics as a medical diagnostic tool. Furthermore its stability and performances in poor electrical conditions make it a robust device really suited for resource limited settings.

Impact of amplified spontaneous emission noise on the SRS threshold of high-power fiber amplifiers

Impact of amplified spontaneous emission(ASE)noise on the stimulated Raman scattering(SRS)threshold of highpower fiber amplifiers is demonstrated numerically through a spectral evolution approach.The simulation results confirm that ASE noise in the Raman wavelength band could reduce the SRS threshold of high-power fiber amplifiers significantly.As for ASE noise originated the main amplifier,it becomes stronger and reduces the SRS threshold at shorter operation wavelength below 1052 nm.As for ASE noise originated from the seed laser,it reduces the SRS threshold at different operation wavelength under the condition that the Raman ratio is over-90 dB in the seed laser.The theoretical method and results in this work could provide a well reference to extend the operation wavelength of high-power fiber lasers.

Otoacoustic emissions value in patients with idiopathic sudden sensorineural hearing loss

Objectives:This study aimed to determine the prognostic value of otoacoustic emissions(OAEs)in idiopathic sudden sensorineural hearing loss patients.Methods:The study included 30 subjects with unilateral idiopathic sudden sensorineural hearing loss(ISSNHL).Each patient was evaluated four times:at baseline and after one week,one month,and three months of treatment.During each visit,each patient was subjected to full audiological history,otoscopic examination,basic audiological evaluations,and transiently evoked and distortion product otoacoustic emission(TEOAEs&DEOAEs).Results:The hearing thresholds(frequency range 250e8000 Hz)and word recognition scores of patients with detectable TEOAEs and DPOAEs improved significantly,whereas no significant improvements were observed in those with no response.Conclusion:Hearing improvement is better in patients with detectable TEOAEs and DPOAEs.As a result,TEOAEs and DPOAEs are recommended as routine tests in all SSNHL patients to predict outcomes and monitor treatment as TEOAEs and DPOAEs reflect the cochlear OHCs activity.

Otoacoustic emissions recorded in people with chronic migraine

Migraine,a moderate to severe chronic headache occurring on one or both sides,is a common disease affects young people.Although hearing loss in subjects with migraine is not rare,the correlation of migraine with hearing loss is not clear.In this study,we examined hearing loss in young migraine subjects to determine if migraine may be a factor in causing cochlear dysfunction.Seven college students with migraine and three age matched subjects without history of migraine were assessed using extended high frequency audiometry and distortion product otoacoustic emissions(DPOAEs).There was no significant difference in regular audiomeiry threshold between the migraine group and the control group.However,high frequency audiometry(9-16 kHz) showed thresholds at 25 dB nHL or higher in six out of twenty ears in the migraine group.The amplitude of DPOAEs were reduced for more than 10 dB in the migraine group in comparison with the control group.These data suggest that migraine may affect cochlear dysfunction evidenced by the reduced amplitude of DPOAE and high frequency pure-tone audiometry.

Effects of glutamate on distortion-product otoacoustic emissions and auditory brainstem responses in guinea pigs

Objectives To investigate changes in evoked potentials and structure of the guinea pig cochleae during whole cochlear perfusion with glutamate. Methods CM, CAP, DPOAE, and ABR were recorded as indicators of cochlear functions during whole cochlear perfusion. The morphology of the cochlea was studied via transmission electron microscopy. Results There were no significant changes in DPOAE amplitude before and after glutamate perfusion. CM I/O function remained nonlinear during perfusion. ABR latencies were delayed following glutamate perfusion. The average CAP threshold was elevated 35 dB SPL following glutamate perfusion.. The OHCs appeared normal, but the IHCs and afferent dendrites showed cytoplasmic blebs after glutamate perfusion. Conclusions While being a primary amino acid neurotransmitter at the synapses between hair cells and spiral ganglion neurons, excessive glutamate is neurotoxic and can destroy IHCs and spiral ganglion neurons. The technique used in this study can also be used to build an animal model of auditory neuropathy.

Otoacoustic Emissions and Evoked Potentials in Infants after Breast-Feeding Jaundice——Hearing Dysfunction in Breast-Feeding Jaundice

We study hearing in a group of infants with Breast-feeding jaundice (BFJ) by means of Transient-evoked otoacoustic emissions (T-EOE) and Brainstem auditory evoked potentials (BAEP) searching for relationship between bilirubin serum levels and auditory dysfunction. Eleven infants born at-term with BFJ were selected for the study. We studied also 11 control age- and gender matched healthy at-term infants without signs of jaundice. T-EOAE studies were performed between 5-7 days after birth, and 3 months later. BAEP studies were performed once. BFJ group infants exhibited lower amplitudes in T-EOE than infants in the control group. These differences disappear at the 3-month evaluation. In BAEP, we observed a significant latency delay of waves I and V in Breast-feeding jaundice group infants. All infants in both groups demonstrated reproducible wave V response at 30 decibels. No significant correlation values were observed between bilirubin serum levels and T-EOE and BAEP variables. Our data suggest that BFJ can result in transient peripheral and central auditory dysfunction. Dysfunction is reversible after treatment of infants with BFJ.

A Temperature-Insensitive Amplified Spontaneous Emission Broadband Source Based on Er-Doped Fiber

To obtain a stable amplified spontaneous emission（ASE） source for complex environment applications, we design an ASE source and study the output power and spectral characteristics under different ambient temperatures.We optimize the structure of the ASE source to flatten the ASE spectrum, and study the output characteristics in terms of output power and optical spectrum under different pump powers. Then the performance of the ASE source is investigated in the temperature range from-18.9°C to 50°C. A stable-power and flat-spectrum ASE source can be obtained by structural optimization and pump control.

Broadband amplified spontaneous emission from Er^3＋ -doped single-mode tellurite fibre

This paper reports on the fabrication and characterization of a newly erbium-doped single-mode tellurite glass-fibre applicable for 1.5-μm optical amplifiers. A very broad erbium amplified spontaneous emission in the range 1450-1650 nm from erbium-doped single-mode tellurite glass-fibre is obtained upon excitation of a 980-nm laser diode. The effects of the length of glass-fibre and the pumping power of laser diode on the amplified spontaneous emission are discussed. The result indicates that the tellurite glass-fibre is a promising candidate for designing fibre-optic amplifiers and lasers.

Theoretical study of amplified spontaneous emission intensity and bandwidth reduction in polymer

Amplified spontaneous emission （ASE）, including intensity and bandwidth, in a typical example of BuEH-PPV is calculated. For this purpose, the intensity rate equation is used to explain the reported experimental measurements of a BuEH-PPV sample pumped at different pump intensities from Ip = 0.61 MW/cm2 to 5.2 MW/cm2. Both homogeneously and inhomogeneously broadened transition lines along with a model based on the geometrically dependent gain coefficient （GDGC） are examined and it is confirmed that for the reported measurements the homogeneously broadened line is responsible for the light-matter interaction. The calculation explains the frequency spectrum of the ASE output intensity extracted from the sample at different pump intensities, unsaturated and saturated gain coefficients, and ASE bandwidth reduction along the propagation direction. Both analytical and numerical calculations for verifying the GDGC model are presented in this paper. Although the introduced model has shown its potential for explaining the ASE behavior in a specific sample it can be universally used for the ASE study in different active media.

Effect of different metal-backed waveguides on amplified spontaneous emission

We investigate the effect of a metallic electrode on the ability for poly[2-methoxy-5-（2＇-ethylhexyloxy）-1,4- phenylene vinylene] （MEH-PPV） film to undergo amplified spontaneous emission （ASE）. The threshold of the device with Ag cladding is about 10 times greater than that of a metal-free device, but metal such as Al completely shuts off ASE. The ASE recurs when a thin spacer layer, such as a few nanometers of SiO2, is introduced between the MEH-PPV film and the Al cladding. Compared with the Cu or Al electrode, the Ag cladding is most suited to serve as an electrode with its low optical loss due to its high work-function and reflectivity.

Size-dependent Amplified Spontaneous Emission from Organic Crystal Slabs

The authors investigated size-dependent amplified spontaneous emission（ASE） from organic crystals. Specifically, N-（4-{4-[4-（diphenylamino）styryl]styryl}phenyl）-N-phenylbenzene amine（Ph-TPA2） organic crystals were used in the experiment. The ASE threshold was decreased with the decrease of the width of the crystal at the same gain length, which reflects that total internal reflection plays an important role on the ASE properties in these slab organic crystals. The ASE properties pumped by one- and two-photon were also comparatively studied. We found that the thresholds of ASE in two-photon pumping condition are less size-dependent than those in singlephoton condition because of the nonlinear light generation processes in two-photon absorption processes.

Amplified spontaneous emission from metal-backed poly[2-methoxy-5-(2'-ethylhexyloxy)-1,4-phenylenevinylene] film

We investigate the amplified spontaneous emission （ASE） from an Ag-backed poly[2-methoxy-5-（2＇-ethylhexyloxy）- 1,4-phenylenevinylene] （MEH-PPV） film with different film thicknesses. The ASE characteristics of Ag-backed MEH- PPV films with different thicknesses show that increasing the film thickness can reduce the influence of the Ag cladding. The threshold, the gain, and the loss of the device with a thickness of 170 nm are comparable to those of a metal-free device. The lasing threshold of this device is about 7.5 times that of a metal-free device. Our findings demonstrate that Ag-backed MEH-PPV film with an appropriate thickness can still be a good polymer gain material for the fabrication of solid-state lasers.

Solvent-vapour treatment induced performance enhancement of amplified spontaneous emission based on poly[2-methoxy-5-(2'-ethyl-hexyloxy)-1,4-phenylene vinylene]

In this work, performance enhancements of amplified spontaneous emission （ASE） from poly[2-methoxy-5-（2＇- ethyl-hexyloxy）-l,4-phenylene vinylene] （MEH-PPV） have been achieved via solvent vapour treatment. Correlations between the morphology of the film and the optical performance of polymer-based ASE are investigated. The active layers are characterised by atomic force microscopy and optical absorption. The results show that the solvent-vapour treatment can induce the MEH-PPV self-organisation into an ordered structure with a smooth surface, leading to enhanced optical gain. Thus the solvent-vapour treatment is a good method for improving the optical properties of the MEH-PPV.