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Author: admin | 24.02.2015 | Category: Relieve Tinnitus

Contralateral acoustic stimulation (CAS) has the effect of reducing the amplitude of transient evoked otoacoustic emissions (TEOAE) of the opposite cochlea. In this study, the effect of contralateral acoustic stimulation on TEOAE was investigated in 13 full-term neonates (gestational age, 40-42 weeks). Hearing from birth (or perhaps even earlier) is crucial for normal language development in a child. On the basis of two reports in the literature [13,14], the CAS effect was proved to exist from birth in 18 full-term neonates. Thirteen normal, healthy, full-term babies (7 male, 6 female) born at The Chaim Sheba Medical Center, Tel Hashomer, were tested. Eleven babies were tested at 24-48 hours after birth, and two more were tested on their third and fifth days.
All neonates passed the TEOAE screening test in both ears before being tested for the CAS effect. One ear of each neonate was tested for the CAS effect, because the entire procedure lasted approximately 1 hour when it was successful. The tested ear was chosen arbitrarily according to the side on which the babies were lying in their cribs. For CAS effect, six successive TEOAE measurements were recorded for each baby, alternately without (three) and with (three) simultaneous contralateral noise. The CAS was delivered to the ear by a miniature insert earphone using the same Otodynamics disposable tips used on the type E probe for TEOAE recordings.
For each baby, the testing conditions (stimulus intensity and stability, and the number of noisy presentations) and the response measurements (TEOAE amplitudes with and without contralateral noise) were averaged separately for the recordings with and without the CAS.
The means of the recording conditions of the TEOAE without noise and the TEOAE recorded with contralateral noise are presented in Table 1. The results of our study are in agreement with those of Ryan and Piron [13] and Goforth et al. Most authors concur that a large number of intersubject variations exist in the amount of suppression [5,6,9,18,26].
Because TEOAE amplitude is widely known to differ greatly among tested ears, we tried to establish the existence of a correlation between the level of emission and the amount of the CAS effect. Evidence of efferent function in the neonates strengthens the importance of this system in the hearing process. Presented at the Twenty-Fourth Ordinary Congress of the Neurootological and Equilibriometric Society, Haifa, Israel, April 7, 1997. Product ID: ZA140Sound Oasis Noise GeneratorEase your tinnitus with the The Sound Oasis Noise Generator. Product ID: ZA141Sound Oasis Sound CardsSound Oasis noise Generator owners can now expand their collection of available sounds.
Each horizontal line on the audiogram from top to bottom represents loudness or intensity in units of decibels (dB).
Examples of sounds in everyday life that would be considered soft are a clock ticking, a voice whispering, and leaves rustling.
Examples of sounds in everyday life that would be considered loud are a lawnmower, a car horn, and a rock concert. If we were to compare “normal conversational loudness level” (typically 60 dB) with whispering (typically 30 dB), we’d say that whispering is softer than conversation.
The audiologist uses a red O to indicate the right ear and a blue X to record the left ear.
Items displaying this symbol are blind accessible.These items can be used without sighted assistance. This phenomenon is considered to be mediated via the efferent pathway, from the superior olivary complex through the medial olivocochlear system to the contralateral cochlea.
The TEOAE were recorded alternately with and without simultaneous, contralateral white noise.
From birth, the sensitivity of hearing and frequency selectivity are essential for speech sound perception. Our study adds evidence to the function of the CAS effect from birth in 13 additional babies. On evaluation, the neonatal physician confirmed that all neonates were normal, with no family history of general or auditory pathology.


Once this testing was accomplished, the babies usually became restless, and the other ear was impossible to test. This mode employs a nonlinear click stimulus of 80 microseconds at a rate of 80 presentations per second.
The contralateral acoustic stimulation was a 40-dB HL white noise, generated by a lOD Belton portable audiometer. The CAS effect of each neonate was calculated as the difference between the mean TEOAE amplitude with CAS and the mean TEOAE amplitude without CAS.
Results showed no significant differences by paired t test between the recordings with and without the CAS in regard to stimulus intensity, stability, and the number of noisy sample measurements. Transient evoked otoacoustic emission amplitudes (in decibels SPL; SD in parentheses) with and without contralateral acoustic stimulation. First, no significant correlation was found between the TEOAE amplitude recorded without the contralateral noise and the amount of the CAS effect. Its peculiar way of synapsing differently with the outer and inner hair cells contributed to the interest of many investigators over the years regarding the functional significance of the efferent system. No significant correlation was found between the amount of the CAS effect and the TEOAE amplitude recorded without contralateral noise. Additional new significant dimensions have arisen from findings in Mongolian gerbils, wherein the suppression of the comppound action potential by contralateral noise even preceded the maturation of the otoacoustic emissions [29]. The graph starts with the lowest pitches on the left side and moves to the very highest pitches (frequencies) tested on the right side.
For example, your hearing might be normal in the low pitches while you have hearing loss in high pitches.
The assessment of this suppressive effect provides an objective and noninvasive technique for exploring the function of the efferent auditory system in humans. The outer hair cells have been proved to enhance sensitivity and fine tuning of the auditory system [1].
The neonates had no risk factors for hearing impairment as defined by the Joint Committee on Infant Hearing [15].
The procedure was initiated in more than double the number of babies reported here but could not be completed, as the babies awakened.
Nonlinear clicks consist of four clicks, the first three being in the same phase and amplitude and the fourth opposite in phase and having a threefold larger amplitude. Calibration of the insert earphone was carried out with a Bruel-Kjrer 2209 sound level meter.
Second, despite the small number of subjects, an interesting consideration was assessing whether the neonate's gender or the choice of tested ear (right or left) had any effect either on the TEOAE recordings or on the CAS effect.
In the 1960s, an important role in hearing function was ascribed to the efferent olivocochlear bundle [20-24].
With the tremendous progress in understanding the role and function of the outer hair cells in hearing, significance was attributed also to the efferent role demonstrated by the suppression of the TEOAE. Average reduction of 2.21 dB in the amplitude of the TEOAE was induced by introducing contralateral noise simultaneously with the TEOAE recording.
Effect of contralateral auditory stimuli on active cochlear micromechanical properties in human subjects. Effect of contralateral acoustic stimulation on active cochlear micromechanical properties in human subjects: dependence on stimulus variables.
Effect of contralateral acoustic stimulation on the growth of clickevoked otoacoustic emissions in humans. The influence of contralateral acoustic stimulation on click-evoked otoacoustic emissions in humans. The influence of evoking stimulus level on the neural suppression of transient-evoked otoacoustic emissions.
Changes in endolymphatic potential and crossed olivocochlear bundle stimulation alter cochlear mechanics.
Effect of contralateral sound stimulation on the distortion product 2F1-F2: evidence that the medial efferent system is involved. Efferent suppression of transient-evoked otoacoustic emissions in human infants [abstract].
Referral rates and cost efficiency in a universal newborn hearing screening program using transient-evoked otoacoustic emissions.


Preliminary description of transient-evoked and distortion-product otoacoustic emissions from graduates of an intensive care nursery. Auditory evoked potentials from cochlea to cortex as influenced by activation of the efferent olivocochlear bundle.
Efferent olivo-cochlear bundle: some relationships to noise masking and to stimulus attenuation. Auditory activity in centrifugal and centripetal cochlear fibers in cats: a study of a feedback system. Frequency analysis of the contralateral suppression of evoked otoacoustic emissions by narrow-band noise.
Transient evoked otoacoustic emissions with contralateral stimulation in King-Kopetzky syndrome. Development of contralateral suppression of VIIIth nerve compound action potential (CAP) in the Mongolian gerbil.
Long-term physiological consequences of cutting olivocochlear bundle (OCB) in neonatal animals. The responses are recorded on a chart called an audiogram that shows intensity levels for each frequency tested. The range of frequencies tested by the audiologist are 125 Hz, 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 3000Hz, 4000 Hz, and 8000 Hz. Two previous studies investigated the suppression effect of TEOAE in newborns and revealed a significant effect in 18 full-term neonates. Our study demonstrated additional support for the functional maturity of the medial olivocochlear efferent system from birth. Otoacoustic emissions (OAEs) are associated with the mechanical processes of the outer hair cells [2,3]. The tests were carried out after feeding, during light sleep in a quiet room in the Neonatology Unit. The summation of four successive responses leaves only the nonlinear component of the otoacoustic response.
The CAS effect was expressed also as the percentage change between the averaged TEOAE amplitude recorded with CAS and the amplitude recorded without CAS. As described, accomplishing the entire procedure for one ear was difficult; testing both ears of the same neonate was almost impossible. As early as 1962, Fex [23,24] claimed an auditory feedback system and connection between the two ears via the efferent system.
This magnitude is just a little above the range of 1-2 dB reported in most of the adult studies of the suppression effect. The efferent auditory pathways, investigated particularly with the olivocochlear bundle (OCB) system that terminates in the cochlea, are involved in these processes. This stimUlus paradigm reduces stimulus artifact, cancels all the linear components of the response, and affects the true amplitude of the emission, thereby rendering difficult the absolute quantification of suppression [18]. To calculate this relative difference, the average TEOAE amplitudes were converted from the decibel SPL values calculated by the IL088 analysis system into micro-Pascal. Therefore, when we made a comparison between two ears, we actually compared two different groups of subjects. For many years, it was known that the medial component of the OCB synapses extensively on the outer hair cells. We chose this mode for the neonates, taking into account that both emission and noise amplitudes are greater in neonates than in adults [19]. For both the gender factor (female versus male) and the tested ear factor (right versus left), no significant differences were found either for any of the TEOAE parameters or for the amount of the suppression. However, Ryan and Kemp [9] claimed that with large TEOAE, the effect can be detected easily, whereas among the smaller TEOAE, detecting the differences above the background noise was difficult. Recently, for the first time, acquired knowledge established that transient otoacoustic evoked emissions (TEOAE) facilitated extensive testing of the olivocochlear bundle in awake human beings.
A number of studies proved in both humans [4-9] and animals [10-12] the suppression of spontaneous and evoked emissions by contralateral acoustic stimuli, and this effect was termed suppression effect, or contralateral acoustic stimulation (CAS) effect.



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