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Auteur Dennis F. Fitzpatrick |
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Automated Adaptive Wideband Acoustic Reflex Threshold Estimation in Normal-hearing Adults / Kim Schairer in Ear and hearing, Vol.43, n°2 (Mars-avril 2022)
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Titre : Automated Adaptive Wideband Acoustic Reflex Threshold Estimation in Normal-hearing Adults Type de document : Article Auteurs : Kim Schairer ; Daniel B. Putterman ; Douglas H. Keefe ; Dennis F. Fitzpatrick ; Angela C. Garinis ; Elizabeth R. Kolberg ; M. Patrick Feeney Année de publication : 2022 Article en page(s) : p. 370-378 Langues : Anglais (eng) Descripteurs : HE Vinci
Acoustique
Autres descripteurs
Immitance acoustique ; Reflexe de l'oreille moyenne ; Reflexion a large bandeRésumé : Objectives: Acoustic stapedius reflex threshold (ART) tests are included in a standard clinical acoustic immittance test battery as an objective cross-check with behavioral results and to help identify site of lesion. In traditional clinical test batteries, middle-ear admittance of a 226 Hz probe is estimated using ear-canal measurements in the presence of a reflex-activating stimulus. In the wideband (WB) acoustic immittance ART test used in this study, the pure-tone probe is replaced by a WB probe stimulus and changes in absorbed power are estimated using ear-canal measurements in the presence of the activator. The ART is defined as the lowest level at which a criterion change in admittance (clinical) or absorbed power (WB) is observed in the presence of the activator. In the present study, ARTs were obtained in adults with normal hearing using the clinical, manual method and with a new WB automated adaptive threshold detection method. It was hypothesized that the WB test would result in lower ARTs than the clinical test because reflex-related changes in power absorbance could be observed across multiple frequency bands in the WB test compared with a single frequency in the traditional test.
Design: Data were collected in a prospective research design. ARTs were obtained in ipsilateral and contralateral conditions using 500, 1000, 2000 Hz, and broadband noise (BBN) activators on a clinical system and on an experimental WB system. The bandwidth of the BBN activator was 125 to 4000 Hz on the clinical system and 200 to 8000 Hz on the wideband system. ARTs were estimated at both tympanometric peak pressure (TPP) and ambient pressure on the WB system. Data were collected in both ears of 39 adults (21 males) of mean age 47.7 years (range 23-72 years). Differences in ARTs among the three threshold estimation methods (clinical, WB at TPP, WB at ambient) were examined using the general linear model repeated measures test in SPSS. Post-hoc pairwise comparisons were completed with Bonferroni correction for multiple comparisons. Statistical significance was defined as p
Results: ARTs obtained on the WB system at TPP and ambient pressure were significantly lower than obtained on the clinical system. ARTs obtained on the WB system at TPP were significantly higher than at ambient pressure in the 500 and 2000 Hz ipsilateral conditions.
Conclusions: WB automated adaptive ARTs in normal-hearing adults were lower than for clinical methods when measured at TPP and ambient pressure. Lower presentation levels required to estimate ART in the WB test may be more tolerable to patients. Patients with ARTs that are not present at the maximum level of a traditional reflex test may have present ARTs with a WB ART test, which may reduce the need to refer for additional testing for possible retrocochlear involvement. Automation of the test may allow clinicians more time to attend to the other requisite tasks of a hearing evaluation and make the system useful for telehealth applications.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=292896
in Ear and hearing > Vol.43, n°2 (Mars-avril 2022) . - p. 370-378[article]Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children / Megan L. A. Thomas in Journal of the American Academy of Audiology (JAAA), Vol.28, n°5 (May 2017)
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Titre : Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children Type de document : Article Auteurs : Megan L. A. Thomas ; Dennis F. Fitzpatrick ; Ryan W. McCreery ; [et al.] Année de publication : 2017 Article en page(s) : p. 395-403 Langues : Anglais (eng) Descripteurs : HE Vinci
Enfant (6-12 ans) ; Potentiels évoqués vestibulaires myogéniques (cVEMP) (mVEMP) (oVEMP)Résumé : Background:
Cervical and ocular vestibular-evoked myogenic potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.thieme-connect.de/products/ [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=220380
in Journal of the American Academy of Audiology (JAAA) > Vol.28, n°5 (May 2017) . - p. 395-403[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité Journal of the American Academy of Audiology (JAAA). Vol.28, n°5 (May 2017) Périodique papier Ixelles Rez Consultation sur place uniquement
Exclu du prêtBone Conduction Vibration Vestibular Evoked Myogenic Potential (VEMP) Testing: Reliability in Children, Adolescents, and Young Adults / Nicole L. Greenwalt in Ear and hearing, Vol. 42, n°2 (Mars-Avril 2021)
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Titre : Bone Conduction Vibration Vestibular Evoked Myogenic Potential (VEMP) Testing: Reliability in Children, Adolescents, and Young Adults Type de document : Article Auteurs : Nicole L. Greenwalt ; Jessie N. Patterson ; Amanda I. Rodriguez ; Dennis F. Fitzpatrick ; Katherine R. Gordon ; Kristen L. Janky Année de publication : 2021 Article en page(s) : p. 355-363 Langues : Anglais (eng) Descripteurs : HE Vinci
Conduction osseuse ; Potentiels évoqués vestibulaires myogéniques (cVEMP) (mVEMP) (oVEMP)Résumé : Bone conduction vibration (BCV) vestibular evoked myogenic potentials (VEMP) are clinically desirable in children for multiple reasons. However, no accepted standard exists for stimulus type and the reliability of BCV devices has not been investigated in children. The objective of the current study was to determine which BCV VEMP method (B-71, impulse hammer, or Mini-shaker) yields the highest response rates and reliability in a group of adults, adolescents, and children. It was hypothesized that the Mini-shaker would yield the highest response rates and reliability because it provides frequency specificity, higher output levels without distortion, and the most consistent force output as compared to the impulse hammer and B-71.
Design: Participants included 10 child (ages 5 to 10), 11 adolescent (ages 11 to 18), and 11 young adult (ages 23 to 39) normal controls. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were measured in response to suprathreshold air-conducted, 500 Hz tone bursts and 3 types of BCV (B-71, impulse hammer, and Mini-shaker) across 2 test sessions to assess reliability.
Results: For cVEMP, response rates were 100% for all methods in all groups with the exception of the adult group in response to the impulse hammer (95%). For oVEMP, response rates varied by group and BCV method. For cVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the impulse hammer, and in children using the B-71. For oVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the Mini-shaker or impulse hammer, and in children using the impulse hammer. Age positively correlated with air-conducted oVEMP amplitude, but not cVEMP amplitude or cVEMP corrected amplitude. Age negatively correlated with all BCV VEMP amplitudes with the exception of cVEMP corrected amplitude in response to the Mini-shaker.
Conclusions: All BCV methods resulted in consistent cVEMP responses (response rates 95 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) for all groups. Similarly, all BCV methods resulted in consistent oVEMP responses (89 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) except for the B-71 in adults.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265743
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 355-363[article]Effect of Cochlear Implantation on Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance / Gabrielle R. Merchant in Ear and hearing, Vol. 41, n°5 (Septembre-octobre 2020)
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Titre : Effect of Cochlear Implantation on Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance Type de document : Article Auteurs : Gabrielle R. Merchant ; Kyli M. Schulz ; Jessie N. Patterson ; Dennis F. Fitzpatrick ; Kristen L. Janky Année de publication : 2020 Article en page(s) : p. 1111-1124 Langues : Anglais (eng) Descripteurs : Autres descripteurs
Immitance acoustique
HE Vinci
Audition periphérique ; Implants cochléaires ; Potentiels évoqués vestibulaires myogéniques (cVEMP) (mVEMP) (oVEMP)Résumé : Objectives: The objective of this study was to determine if absent air conduction stimuli vestibular evoked myogenic potential (VEMP) responses found in ears after cochlear implantation can be the result of alterations in peripheral auditory mechanics rather than vestibular loss. Peripheral mechanical changes were investigated by comparing the response rates of air and bone conduction VEMPs as well as by measuring and evaluating wideband acoustic immittance (WAI) responses in ears with cochlear implants and normal-hearing control ears. The hypothesis was that the presence of a cochlear implant can lead to an air-bone gap, causing absent air conduction stimuli VEMP responses, but present bone conduction vibration VEMP responses (indicating normal vestibular function), with changes in WAI as compared with ears with normal hearing. Further hypotheses were that subsets of ears with cochlear implants would (a) have present VEMP responses to both stimuli, indicating normal vestibular function and either normal or near-normal WAI, or (b) have absent VEMP responses to both stimuli, regardless of WAI, due to true vestibular loss.
Design: Twenty-seven ears with cochlear implants (age range 7 to 31) and 10 ears with normal hearing (age range 7 to 31) were included in the study. All ears completed otoscopy, audiometric testing, 226 Hz tympanometry, WAI measures (absorbance), air conduction stimuli cervical and ocular VEMP testing through insert earphones, and bone conduction vibration cervical and ocular VEMP testing with a mini-shaker. Comparisons of VEMP responses to air and bone conduction stimuli, as well as absorbance responses between ears with normal hearing and ears with cochlear implants, were completed.
Results: All ears with normal hearing demonstrated 100% present VEMP response rates for both stimuli. Ears with cochlear implants had higher response rates to bone conduction vibration compared with air conduction stimuli for both cervical and ocular VEMPs; however, this was only significant for ocular VEMPs. Ears with cochlear implants demonstrated reduced low-frequency absorbance (500 to 1200 Hz) as compared with ears with normal hearing. To further analyze absorbance, ears with cochlear implants were placed into subgroups based on their cervical and ocular VEMP response patterns. These groups were (1) present air conduction stimuli response, present bone conduction vibration response, (2) absent air conduction stimuli response, present bone conduction vibration response, and (3) absent air conduction stimuli response, absent bone conduction vibration response. For both cervical and ocular VEMPs, the group with absent air conduction stimuli responses and present bone conduction vibration responses demonstrated the largest decrease in low-frequency absorbance as compared with the ears with normal hearing.
Conclusions: Bone conduction VEMP response rates were increased compared with air-conduction VEMP response rates in ears with cochlear implants. Ears with cochlear implants also demonstrate changes in low-frequency absorbance consistent with a stiffer system. This effect was largest for ears that had absent air conduction but present bone conduction VEMPs. These findings suggest that this group, in particular, has a mechanical change that could lead to an air-bone gap, thus, abolishing the air conduction VEMP response due to an alteration in mechanics and not a true vestibular loss. Clinical considerations include using bone conduction vibration VEMPs and WAI for preoperative and postoperative testing in patients undergoing cochlear implantation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=267129
in Ear and hearing > Vol. 41, n°5 (Septembre-octobre 2020) . - p. 1111-1124[article]Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power / M. Patrick Feeney in Ear and hearing, Vol. 42, n°3 (Mai- Juin 2021)
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Titre : Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power Type de document : Article Auteurs : M. Patrick Feeney ; Douglas H. Keefe ; Lisa L. Hunter ; Dennis F. Fitzpatrick ; Daniel B. Putterman ; Angela C. Garinis Année de publication : 2021 Article en page(s) : p. 547-557 Langues : Anglais (eng) Descripteurs : Autres descripteurs
Otosclerose ; Reflectance acoustique
HE Vinci
Absorbance acoustique ; Oreille moyenne ; Tympanométrie ; Wideband absorbance (WBA)Résumé : Objective: Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate preoperative and postoperative test results.
Design: Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare preoperative and postoperative results at 3 and 6 months.
Results: There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance at 226 Hz was near chance performance, which is consistent with previous findings. There were significant mean differences between preoperative and postoperative tests for absorbance and absorbed power.
Conclusions: Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than static acoustic admittance at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=273194
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 547-557[article]Identifying otosclerosis with aural acoustical tests of absorbance, group delay, acoustic reflex threshold, and otoacoustic emissions / Douglas H. Keefe in Journal of the American Academy of Audiology (JAAA), Vol.28, n°9 (October 2017)
PermalinkImproving the Differential Diagnosis of Otitis Media With Effusion Using Wideband Acoustic Immittance / Gabrielle R. Merchant in Ear and hearing, Vol. 42, n°5 (Septembre-Octobre 2021)
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