Volume 1, Chapter 08: Non-conventional clinical applications of Otoacoustic Emissions: From middle ear transfer to cochlear homeostasis to access to cerebrospinal fluid pressure.
- Details
- Category: Book "Advances in Audiology ... "
- Last Updated on Friday, 11 May 2018 15:11
- Written by Blandine Lourenço, Fabrice Giraudet, Thierry Mom, Paul Avan
- Hits: 2431
Summary
The potential utility of otoacoustic emissions, especially distortion product ones (DPOAEs), has considerably expanded over the last two decades, from their initial goal, neonatal hearing screening, to new noninvasive methods for monitoring a variety of aspects of hearing relevant to clinical exploration. Because they are exquisitely sensitive to the amplifying capabilities of outer hair cells in the cochlea, DPOAE levels have been profitably used for tracking dangerous changes in cochlear blood flow during vestibular schwannoma resection surgery, or the detrimental effects of noise exposure. But DPOAEs are also ideally suited for probing minor changes in middle and inner-ear transfer functions produced by intracranial or intralabyrinthine pressure changes. Their sensitivity to pressure applies to two clinical domains, for patients with neurological conditions relating to disrupted homeostasis of cerebrospinal fluid, and with Menière symptoms in which endolymphatic pressure may vary abnormally. Both categories can benefit from a noninvasive, technically simple follow-up.
This chapter develops these two original applications of DPOAE detection, from the biophysical models that underpin how they physiologically relate to the tracked structures of interest, to the feasibility, performance and shortcomings of the resulting methods in clinical settings.
Multimedia Links
1. Testing of an MD patient using DPOAEs is shown and explained, from the patient installation, how body tilt is applied and what the OAE screen shows online, completed by online explanations given to the patient.
Chapter Contributors
Blandine Lourenço, PhD
Biomedical engineer and PhD in neurosciences, BL was manager of several clinical research projects using the audiological tests developed by PA (DPOAE and CM) to assess hydrostatic pressure of labyrinthine fluids and alteration in cochlear blood flow in patients. BL helped to improve the technology of the audiological tests and collected /analyzed the clinical data. She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.
Thierry Mom, MD
Head of the functional unit of Auditory implants at the University Hospital of Clermont-Ferrand, France, and teaching researcher. TM focuses his research works, both clinical and fundamental, on the cochlear function. His PhD thesis, 'On acoustic distortion during cochlear ischemia', was achieved in part at the Miami Ear Institute, in 1998. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.
Fabrice Giraudet, PhD
PhD in Neuroscience, Associate Professor in the Laboratory of Neurosensory Biophysics. His research topic is objective electrophysiological and acoustical methods of exploration of the peripheral auditory system in small rodents. Trained as an audiologist in Brussels, he has a long-standing expertise in human audiological assessment (clinical exploration and rehabilitation). He can be reached at : This email address is being protected from spambots. You need JavaScript enabled to view it.
Paul Avan, MD
Being both a physicist and a MD in biophysics, PA developed complementary skills to design original objective methods of exploration of the cochlea and auditory pathways. These methods have been validated on models of mutant mice with precise molecular deficits that affect specific parts of their auditory system, thus creating fruitful bonds between audiology and molecular physiology. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.