Abstract
BackgroundTone-burst otoacoustic emissions (TBOAEs) have not been routinely studied in pediatric populations, although tone burst stimuli have greater frequency specificity compared with click sound stimuli. The present study aimed (1) to determine an appropriate stimulus level for neonatal TBOAE measurements when the stimulus center frequency was 1 kHz, (2) to explore the characteristics of 1 kHz TBOAEs in a neonatal population.MethodsA total of 395 normal neonates (745 ears) were recruited. The study consisted of two parts, reflecting the two study aims. Part I included 40 normal neonatal ears, and TBOAE measurement was performed at five stimulus levels in the range 60–80 dB peSPL, with 5 dB incremental steps. Part II investigated the characteristics of the 1 kHz TBOAE response in a large group of 705 neonatal ears, and provided clinical reference criteria based on these characteristics.ResultsThe study provided a series of reference parameters for 1 kHz TBOAE measurement in neonates. Based on the results, a suggested stimulus level and reference criteria for 1 kHz TBOAE measures with neonates were established. In addition, time-frequency analysis of the data gave new insight into the energy distribution of the neonatal TBOAE response.ConclusionTBOAE measures may be a useful method for investigating cochlear function at specific frequency ranges in neonates. However, further studies of both TBOAE time-frequency analysis and measurements in newborns are needed.
Highlights
Tone-burst otoacoustic emissions (TBOAEs) have not been routinely studied in pediatric populations, tone burst stimuli have greater frequency specificity compared with click sound stimuli
In total 745 ears from neonates without any risk factor for hearing disorder and who had passed Click evoked otoacoustic emissions (CEOAEs) screening test were included in this analysis
Part I: Relationship between stimulus level and 1 kHz TBOAE performance The mean response levels and noise levels as functions of tone burst stimulus levels in 40 ears are illustrated in figure 2
Summary
Tone-burst otoacoustic emissions (TBOAEs) have not been routinely studied in pediatric populations, tone burst stimuli have greater frequency specificity compared with click sound stimuli. Since the CEOAE click stimulus has a broad spectrum, and can stimulate a broad frequency region of the cochlea in a single measurement, CEOAE measurement has been especially applied as a general tool in universal neonatal hearing screening (UNHS) programs. Another type of TEOAE – tone burst evoked OAEs (TBOAEs) – uses narrow bandwidth tone stimuli. This allows stimulus energy to be concentrated on a particular area of the basilar membrane and elicits a more frequency-specific cochlear response [1,2].
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