January - March 2003: A review of OAE related activities in the Eastern hemisphere

1.  Introduction

       The East is always a region with great diversity in terms of politics, economies and the sociocultural life of its countries. It contains the world most populous country, China with its 1.28 billion people, and many small Southeast Asian countries. The diversity is also evident in the availability and provision of hearing care personnel and resources to the people in the region. Information on deafness and hearing loss is still very scanty and not often comparable among many countries in Southeast Asia1. With this backdrop, it is reasonable to see various OAE related activities in some Asian countries such as China, Japan and Korea; and not much or even no OAE information in others, where OAEs is still a little-known topic.


2. The geographical distribution of OAE papers


       The major countries or economies in Asia include: China, Japan, Korea, India, Singapore, Indonesia, Malaysia, the Philippines, Thailand, Hong Kong and Taiwan. A MEDLINE search of OAE articles recorded in PubMed reveals that relevant research work has originated from China, Japan, Korea, Singapore, Hong Kong and Taiwan. It is not surprising to find insufficient OAE tempo in the other countries, where audiological services are in a different evolutionary status.

        Publications written by researchers and clinicians in China and Japan comprise the greatest proportion of works done in the region. However, most if not all, appear in local journals written in their own languages. In China, OAE articles can be easily found in local medical journals like Lin Chuang Er Bi Yan Hou Ke Za Zhi [Journal of Clinical Otorhinolaryngology (Wu-Han Shih)] and Zhonghua Er Bi Yan Hou Ke Za Zhi [Chinese Journal of Otorhinolaryngology (Beijing)]. Whereas in Japan, Nippon Jibiinkoka Gakkai Kaiho [Journal of the Otorhinolaryngological Society of Japan (Tokyo)] publishes most of the OAE related works done in its country.

        On the other hand, OAE related works done in smaller cities or countries like Hong Kong, Korea, Singapore and Taiwan usually can be found in English journals, and therefore more assessable to interested parties worldwide. The published work is scattered in international journals such as Audiology, Acta Otolaryngologica (Stockholm), Hearing Research, Journal of Audiological Medicine and the International Journal of Pediatric Otorhinolaryngology; and regional journals such as Asia Pacific Journal of Speech, Language and Hearing, and the Journal of Singapore Paediatric Society.

3. OAEs and Neonatal Hearing Screening

       The existence of many successful newborn auditory screening programs using OAEs worldwide has undoubtedly caught the attention of many clinicians in the East. It is a reliable, objective and quick procedure that can cover huge populations. It is also a relatively inexpensive clinical tool and can be performed by trained personnel like the nureses and audiological technicians apart from audiologists. All these features seem to be tailor-made for many Asian countries with their large population size and inadequate audiological personnel.

        Earlier published works done in China 2,3 and Japan 4 focused on targeted neonates or infants (like those with high risk factors or those suspected to have hearing loss) and reported favourable results. The first generation of the OAE devices, such as the Otodynamics ILO-88, were employed because they provided the flexibility of a relatively fast screening as well a detailed analysis of the TEOAE data. Recent published works5,6 consider the possibility of establishing universal screening schemes. Researchers have started evaluating the effectiveness of OAE automated screeners, such as the GSI 70 from Grason-Stadler. "Establishing local neonatal screening programmes are becoming common in the more affluent cities, such as Hong Kong and Shanghai, in China", says Bradley McPherson, Associate Professor of the Divison of Speech and Hearing Sciences in the University of Hong Kong. "And OAE has been trialed in preparation for universal screening and rehabilitation programmes". Readers who are interested in this material can refer to articles describing other Asian screening projects using OAEs in Singapore7, Thailand8 and Hong Kong9.

4. OAEs as a Research Tool

         Although OAEs as used in neonatal screening have very much been established, there are many things we have not clarified about its nature. On the other hand, there are still numerous possibilities in how we use OAEs as a diagnostic tool. Audiologists, ENT specialists, biologists and engineers in Asia see these opportunities and diversify their OAE researches. The first two groups of researchers usually focus their investigations on the clinical application of OAEs. Many reseach groups in many different Asian countries find common interest in establishing OAE norm data from their native young population10-18, varying OAE parameters or conditions to increase clinical accuracy19-30, and assessing the applicability of measuring OAEs in different groups of patients31-49. Apart from clinics and hospitals, quite a number of biology and engineering laboratories devote their efforts to OAE research. Their reseach projects include developing different kinds of animal models50-57 and investigating new measurement protocols58-60.

        Taking all these past diversed experiences together, the final question is "What is the direction of OAE related works in the East?" "I foresee the Asian OAE researchers in the near future will be mainly focussed on consolidating our clinical knowledge, asking questions concerning the screening effectiveness of various OAE procedures, and in developing new means to clearly measure the OAE responses," comments McPherson.

5. References

1. Rafei UM. Work of WHO in SEAR from 1 July 1999 to 30 June 2000. Retrieved on 10 January 2003 from here.

2. Xia Z, Li B. (1998) DPOAE in high-risk neonatal screening for hearing. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 12(7):306-8.

3. Guo Y, Yao D. (1996) The application of otoacoustic emissions in paediatric hearing screening. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 18(4):284-7.

4. Matsumura M, Chida E, Kashiwamura M, Fukuda S, Satoh N, Inuyama Y. (1999) Transient evoked otoacoustic emission measurement in infants. Nippon Jibiinkoka Gakkai Kaiho. 102(11):1234-41.

5. Lin HC, Shu MT, Chang KC, Bruna SM. (2002) A universal newborn hearing screening program in Taiwan. Int J Pediatr Otorhinolaryngol. 63(3):209-18.

6. Matsumura M, Chida E, Suto S, Fukuda S, Kashiwamura M, Kuroda T, Ohwatari R, Inuyama Y. (2001) Utility of OAE screener (GSI 70) for the evaluation of distortion product otoacoustic emissions. Nippon Jibiinkoka Gakkai Kaiho. 104(7):721-7.

7. Ng J, Yun HL. (1992) Otoacoustic emissions (OAE) in paediatric hearing screening--the Singapore experience. J Singapore Paediatr Soc. 34(1-2):1-5.

8. Jariengprasert C, Sriwanyong S, Kasemsuwan L, Supapannachart S. (2002) Early identification of hearing loss in high-risk newborns and young children in Thailand by using transient otoacoustic emissions (TEOAEs). Asia Pacific J of Speech, Language and Hearing. 7:1-9

9. Yu KY. (2002) Effects of DPOAE pass/ refer criteria on outcome of neonatal hearing screening. Dissertation of M.Sc. in Audiology. The University of Hong Kong.

10. Wang YF, Wang SS, Tai CC, Lin LC, Shiao AS. (2002) Hearing screening with portable screening pure-tone audiometer and distortion-product otoacoustic emissions. Zhonghua Yi Xue Za Zhi (Taipei). 65(6):285-92.

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19. Chan RH, McPherson B. (2000). Test-retest reliability of tone burst evoked otoacoustic emissions. Acta Otolaryngologica (Stockholm). 120:825-834

20. Kuroda T, Fukuda S, Chida E, Kashiwamura M, Matsumura M, Oowatari R, Inuyama Y, Sato N. (2000) Influence of spontaneous otoacoustic emission (SOAE) on transiently evoked otoacoustic emission (TEOAE). Nippon Jibiinkoka Gakkai Kaiho. 103(10):1135-40.

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24. Shi Y, Jiang S, Gu R. (1997) Effects of short-term tone exposure on DPOAEs. Zhonghua Er Bi Yan Hou Ke Za Zhi. 32(1):41-4.

25. Wang H, Zhong N. (1997) A study on the contralateral suppressive effects of distortion product otoacoustic emissions. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 11(11):489-92.

26. Wang H, Zhong N. (1997) Effects of selective attention on distortion product otoacoustic emissions. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 11(12):543-5.

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28. Sawaki M, Hattori T, Niwa H. (1994) Forward masking of transiently evoked otoacoustic emissions. Nippon Jibiinkoka Gakkai Kaiho. 97(4):688-95.

29. Kashiwamura M, Satoh N, Fukuda S, Kawanami M, Chida E, Inuyama Y. (1993) Changes in human spontaneous otoacoustic emissions with contralateral acoustic stimulation. Nippon Jibiinkoka Gakkai Kaiho. 96(6):922-30.

30. Abe T, Tsuiki T, Ito S, Endo Y, Suzuki K, O-Uchi T. (1990) Suppression of evoked otoacoustic emissions by contralateral noise exposure in humans. Nippon Jibiinkoka Gakkai Kaiho. 93(11):1890-7.

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32. Lee JS, McPherson B, Yuen KC, Wong LL. (2001) Screening for auditory neuropathy in a school for hearing impaired children. Int J Pediatr Otorhinolaryngol. 19;61(1):39-46.

33. Park MS, Park SW, Choi JH. (2001) Distortion product otoacoustic emissions in diabetics with normal hearing. Scand Audiol Suppl. 52:148-51.

34. Sakashita T, Kubo T, Kyunai K, Ueno K, Hikawa C, Shibata T, Yamane H, Kusuki M, Wada T, Uyama T. (2001) Changes in otoacoustic emission during the glycerol test in the ears of patients with Meniere's disease. Nippon Jibiinkoka Gakkai Kaiho. 104(6):682-93.

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37. Li H, Zhong N. (1998) Analysis of spectral history of distort-product otoacoustic emissions in subjects of transient vertebrobasilar ischemic vertigo. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 12(5):217-20.

38. Wang H, Zhong N. (1998) A study on DPOAE in patients with diabetes mellitus. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 12(11):483-6.

39. Hashimoto Y. (1997) Effect of intravenous injection of lidocaine HCl on evoked otoacoustic emissions in tinnitus case. Nippon Jibiinkoka Gakkai Kaiho. 100(7):747-53.

40. Liang F, Liu C, Liu B. (1997) Otoacoustic emission and auditory efferent function testing in patients with sensori-neural hearing loss. Chin Med J (Engl). 110(2):139-41.

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51. Li K, Wang Z, Ni D. (1998) The effection of obstructing OCB with strychnine on the guinea pig's DPOAE. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 12(8):368-9.

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56. Kumagai S. (1995) Distortion-product otoacoustic emissions in kanamycin-treated guinea pig cochlea. Nippon Jibiinkoka Gakkai Kaiho. 98(3):368-79.

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60. Zheng L, Yang F, Ye D. (1998) Location of cochlear defect by AR spectrum analysis of TEOAE. Zhongguo Yi Liao Qi Xie Za Zhi. 22(4):187-91.