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The Effect of Noise Exposure on Auditory Threshold, Otoacoustic Emissions, and Electrocochleography

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The Effect of Noise Exposure on Auditory Threshold, Otoacoustic Emissions, and Electrocochleography THE EFFECT OF NOISE EXPOSURE ON AUDITORY THRESHOLD, OTOACOUSTIC EMISSIONS, AND ELECTROCOCHLEOGRAPHY by Alyson Butler LAke, B.S., Au.D. July 2016 DIrector of DIssertAtIon: Andrew StuArt, Ph.D. Major DepArtment: CommunIcatIon Sciences And DIsorders NoIse exposure Is the second leAdIng cause of AcquIred sensorineural heAring loss And Is one of the most common occupAtIonAl And enVIronmentAl hAzards. ExaminIng chAnges In behAVIoral thresholds hAs long been the stAndArd for detectIon And monItoring of noIse-Induced heAring loss (NIHL). It hAs been suggested thAt electrocochleography (ECochG) could be An AddItIonAl tool for Assessing NIHL. OtoAcoustIc emissions (OAEs) proVIde objectIve InformatIon on the Integrity of outer hAIr cell (OHC) functIon And hAve Also been suggested for eVAluAtIng dAmage due to noIse overexposure. The broAd experimentAl questIon wAs: WhAt Is the effect of short- term nArrowbAnd noIse exposure, As A functIon of eAr And gender, on cochleAr functIon As meAsured wIth behAVIoral, ECochG, And OAE IndIces? In Experiment 1, It wAs of Interest to fIrst examine the relIAbIlIty of ECochG electrode type (i.e., Lilly-TM WIck vs. TIPtrode™) at two stImulus rates (i.e., 7.7/s vs. 77.7/s). Electrode And rate were stAtIstIcally signIfIcant (p < .001) predIctors of SP And AP responses (i.e., responses were more Apt to be present when recorded wIth the wIck electrode At the slow rate). Test-retest relIAbIlIty wAs examined wIth correlAtIon coeffIcients, lIneAr mixed model AnAlyses of VAriAnce, test-retest dIfferences, And BlAnd-Altman plots. There were stAtIstIcally signIfIcant correlAtIons (p < .05) between InItIAl test And retest for All ECochG IndIces (i.e., summatIng potentIAl [SP] AmplItude, ActIon potentIAl [AP] lAtency, AP AmplItude, SP/AP AmplItude ratIo, And SP/AP AreA ratIo) when using A LIlly TM-WIck electrode And for All ECochG IndIces except SP AmplItude when testIng wIth A TIPtrode™. AmplItude meAsures were signIfIcantly (p < .01) lArger when recordIng wIth the wIck electrode. SP AmplItudes were signIfIcantly (p < .05) lArger for the fAster rate. AP lAtency wAs sIgnIfIcantly (p < .001) longer for the fAst rate. AP AmplItudes were signIfIcantly (p < .05) lArger for the slower rate. Both SP/AP AmplItude ratIo And SP/AP AreA ratIo were sIgnIfIcantly (p < .001) lArger for the fAst rate. There wAs no stAtIstIcally signIfIcant effect of test on Any ECochG IndIces (p > .05). In Experiment 2, AudItory threshold dIfferences were examined As A functIon of eAr, gender, And frequency. SignIfIcantly (p < .0001) lArger AudItory threshold dIfferences were observed for left eArs And for 3000 Hz thAn 2000 Hz, 4000 Hz or 6000 Hz. AddItIonAlly, stAtIstIcally sIgnIfIcant correlAtIons between right eAr AudItory threshold dIfferences At 3000 Hz And right 2000 Hz pure tone AcoustIc reflex thresholds (p = .04) As well As between left eAr AudItory threshold dIfferences At 3000 Hz And left 2000 Hz pure tone AcoustIc reflex thresholds (p = .03) And 2000 Hz nArrowbAnd noIse AcoustIc reflex thresholds (p = .01) were found. StAtIstIcally signIfIcant maIn effects of level (p < .0001) And frequency (p < .0001) were observed for DPOAE I/O functIons In Experiment 3. DPOAE Absolute AmplItude dIfferences were lArgest for the L1, L2 level of 55, 40 dB SPL And smallest for the L1, L2 level of 65, 65 dB SPL. DPOAE Absolute AmplItude dIfferences were Also smallest for the f2 frequency of 2051 Hz. A stAtIstIcally signIfIcant gender by frequency InteractIon (p < .05) wAs Also IdentIfIed. Females generally hAd lArger DPOAE Absolute AmplItude dIfferences thAn males except At the f2 frequency of 4980 Hz. FInAlly, Experiment 4 reveAled A stAtIstIcally signIfIcant InteractIon of eAr And gender (p < .05) for SP AmplItude. SP AmplItudes were signIfIcantly IncreAsed for female left eArs followIng noIse exposure whIle female right eArs showed essentIAlly no chAnge. AddItIonAlly, left eAr SP/AP AmplItude ratIos And SP/AP AreA ratIos were signIfIcantly (p < .05) IncreAsed followIng noIse exposure. In summary, due to the excellent test-retest relIAbIlIty And eAsier IdentIfIcatIon of ECochG wAve components, LIlly-TM WIck electrodes were deemed superior for recordIng ECochG. Experiments 2, 3, and 4 reveAled thAt behAVIoral thresholds, DPOAE I/O functIons, And ECochG showed meAsureAble chAnges followIng A 2000 Hz nArrowbAnd noIse exposure. THE EFFECT OF NOISE EXPOSURE ON AUDITORY THRESHOLD, OTOACOUSTIC EMISSIONS, AND ELECTROCOCHLEOGRAPHY A DIssertAtIon Presented To the FAculty of the DepArtment of CommunIcatIon Sciences And DIsorders East CArolInA UnIversity In PartIAl FulfIllment of the RequIrements for the Degree Doctor of PhIlosophy In AudIology by Alyson Butler LAke July 2016 © Alyson Butler LAke, 2016 THE EFFECT OF NOISE EXPOSURE ON AUDITORY THRESHOLD, OTOACOUSTIC EMISSIONS, AND ELECTROCOCHLEOGRAPHY by Alyson Butler LAke APPROVED BY: DIRECTOR OF DISSERTATION: __________________________________________ Andrew StuArt, Ph.D. COMMITTEE MEMBER: _________________________________________________ Deborah S. Culbertson, Ph.D. COMMITTEE MEMBER: _________________________________________________ Paul Vos, Ph.D. INTERIM CHAIR OF THE DEPARTMENT OF COMMUNICATION SCIENCES AND DISORDERS: _________________________ Jamie Perry, Ph.D. DEAN OF THE GRADUATE SCHOOL: ___________________________________________________ Paul J. GemperlIne, Ph.D. ACKNOWLEDGEMENTS I would InItIAlly lIke to thAnk my mentor, Dr. Andrew StuArt, for making thIs AccomplIshment In my lIfe possible. I truly AppreciAte the endless help And support throughout the entIrety of thIs lengthy project. Your wIllIngness to work long hours And through weekends And holIdAys dId not go unnotIced. I greAtly AppreciAte your commitment to seeIng me succeed – even wIth the long silences through moves, A new job, And A weddIng! You tAught me more thAn I could hAve ImagIned About AudIology, reseArch design, And, most ImportAntly, lIfe. “Piece of cake!” I would Also lIke to thAnk the CSDI fAculty And stAff As well As my dIssertAtIon committee members – Dr. Deb Culbertson And Dr. Paul Vos – for the dedIcatIon And support throughout my educatIon At East CArolInA UnIversity. SpecifIcally, to my committee, thAnk you both for tAking tIme out of your busy schedules to reAd thIs lengthy document And for All of the Insightful suggestIons thAt helped to make thIs document whAt It Is todAy. A speciAl thAnk you Is In order for my fellow clAssmates, CAndI And Rebecca. WIthout the two of you I would not hAve survived the fIrst semester! We eAch ended up on our own pAth but I truly belIeve everythIng hAppens for A reAson. The completIon of thIs project would not hAve been possible wIthout your help so for thAt I Am forever grateful. For my bestIe – I Am blessed to hAve spent the better pArt of A decade of my lIfe leArnIng And growIng wIth my best friend by my side. I Am so proud of you And VAlue our friendshIp more thAn you know! Finally, I would lIke to thAnk the most ImportAnt people In my lIfe – my fAmily. Amy, Mom, DAd, And MichAel – you hAve been Along for thIs seemingly endless journey – both commiseratIng wIth the ups And downs And celebratIng the successes. Amy – I Am so blessed to hAve such A greAt role model In my lIfe. You tAught me to step out of my comfort zone. Mom And DAd – thAnk you for InstIllIng In me the ImportAnce of dIlIgence And hArd work. Your constAnt support gAve me the confIdence I needed to tAckle even unsurmountAble goAls. And for my MichAel – thAnk you for AlwAys belIeVIng In me And beIng my bIggest fAn. I Am so excited to fInAlly begIn the rest of my lIfe wIth you! TABLE OF CONTENTS LIST OF TABLES ........................................................................................................... xII LIST OF FIGURES ....................................................................................................... xviII LIST OF SYMBOLS AND ABBREVIATIONS ............................................................. xxviII CHAPTER I: REVIEW OF THE LITERATURE ................................................................. 1 IntroductIon ................................................................................................................... 1 AnAtomy And Physiology of the Human Peripheral AudItory System ........................... 2 Outer Ear ................................................................................................................... 3 Sound localIzatIon .................................................................................................. 3 Pressure gAIn of the outer eAr ................................................................................ 4 Middle Ear .................................................................................................................. 5 AreA ratIo ................................................................................................................ 6 Lever ActIon of the ossicles .................................................................................... 6 Middle eAr muscles ................................................................................................. 7 Inner Ear .................................................................................................................. 12 OrgAn of CortI ....................................................................................................... 12 TravellIng wAve ..................................................................................................... 13 FluId spAces ........................................................................................................
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