Naomi F Bramhall, Nicole K Whittle, M Patrick Feeney, Garnett P McMillan
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引用次数: 0
Abstract
Purpose: Assessment of the middle ear muscle reflex (MEMR) is a standard part of the clinical audiological test battery that is used to assess middle ear function and identify possible retrocochlear lesions. The use of a wideband MEMR probe allows for additional information across frequency and lower reflex thresholds compared to the standard tonal probe used clinically. Recent animal studies suggest that the wideband MEMR is sensitive to noise-induced cochlear synaptopathy, the selective loss of the synaptic connections between the inner hair cells and the afferent auditory nerve fibers. However, the clinical utility of the wideband MEMR as an indicator of cochlear deafferentation is still unclear. Prior to adoption of the wideband MEMR as part of a diagnostic battery for cochlear deafferentation, it is necessary to determine the test-retest reliability of the measurement.
Method: In a sample of 45 adults with normal hearing and normal tympanograms, wideband MEMR magnitude and threshold were measured at two different test sessions in response to a contralateral broadband noise stimulus at elicitor levels ranging from 60 to 100 dB SPL. The time between test sessions ranged from 2 hr to 5 months.
Results: Test-retest differences increased with elicitor level. In some individuals, there were changes in the magnitude and/or the frequency response of the MEMR between test sessions.
Conclusion: When wideband MEMR testing becomes clinically available, test-retest differences in contralateral wideband MEMR magnitude and threshold can be referenced by clinicians to help with interpretation of wideband MEMR test results.
目的：评估中耳肌肉反射（MEMR）是临床听力学测试系统的一个标准部分，用于评估中耳功能和识别可能的耳蜗后病变。与临床使用的标准音调探头相比，使用宽带MEMR探头可以获得跨频率的额外信息和更低的反射阈值。最近的动物研究表明，宽带MEMR对噪声诱导的耳蜗突触病（内耳毛细胞和传入听神经纤维之间的突触连接的选择性丧失）很敏感。然而，宽带MEMR作为耳蜗脱耳指标的临床应用尚不清楚。在采用宽带MEMR作为耳蜗脱音诊断电池的一部分之前，有必要确定测量的重测可靠性。方法：对45名听力正常、耳膜正常的成年人，在60 ~ 100 dB SPL的对侧宽带噪声刺激下，分别在两个不同的测试时段测量宽带记忆记忆的幅度和阈值。两次测试之间的时间间隔从2小时到5个月不等。结果：重测差异随激发剂水平的增加而增加。在一些个体中，记忆记忆的幅度和/或频率响应在测试期间发生了变化。结论：当宽带MEMR检测进入临床应用后，对侧宽带MEMR幅度和阈值的重测差异可作为临床医生参考，有助于对宽带MEMR检测结果的解释。补充资料：https://doi.org/10.23641/asha.28454612。
期刊介绍：
Mission: AJA publishes peer-reviewed research and other scholarly articles pertaining to clinical audiology methods and issues, and serves as an outlet for discussion of related professional and educational issues and ideas. The journal is an international outlet for research on clinical research pertaining to screening, diagnosis, management and outcomes of hearing and balance disorders as well as the etiologies and characteristics of these disorders. The clinical orientation of the journal allows for the publication of reports on audiology as implemented nationally and internationally, including novel clinical procedures, approaches, and cases. AJA seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of clinical audiology, including audiologic/aural rehabilitation; balance and balance disorders; cultural and linguistic diversity; detection, diagnosis, prevention, habilitation, rehabilitation, and monitoring of hearing loss; hearing aids, cochlear implants, and hearing-assistive technology; hearing disorders; lifespan perspectives on auditory function; speech perception; and tinnitus.
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