Improvement in the objective diagnosis of hearing disorders by a new technique of simultaneous recording of acoustic and electrical responses of the auditory system

Abstract

The measurements of transitory evoked otoacoustic emissions (TEOAE) and auditory brainstem responses (ABR) are widely used in objective audiometry for the diagnosis of conductive or sensorineural hearing losses. In some cases only one of these signals is required for a complete diagnosis, while other cases may require both methods to define findings. With conventional equipment the measurement of TEOAE and ABR is performed with different devices at different times. Devices for simultaneous recording of both signals are currently not available or described, although the physiological circumstances and apparatus requirements would favor such an approach. In the present work a prototype for the simultaneous measurement of TEOAE and ABR is presented and its application tested in 33 normal-hearing adults. The equipment used was based on a general purpose laboratory computer connected to an acoustic stimulator and a dual-channel data acquisition system. Stimuli were composed of click sequences for the cancellation of linear signal components and were presented by an ear canal probe (Otodynamics) which also picked up the microphone signal within the outer ear canal. The EEG activity containing the ABR was recorded through surface electrodes fixed at the patient's vertex and mastoid. Acoustic and electric signals were processed simultaneously, resulting in three independent records representing a non-linear TEOAE and the low and high level ABR. The main advantages of the new approach are an improvement in information output and enhancement in the accuracy of determining the site and extent of a hearing impairment.