PRUEBA DE OTOEMISIONES ACÚSTICAS — Transcript

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1. 0:00Otoacoustic emissions are the echo
2. 0:02produced by the hair cells located in
3. 0:04the cochlea. Yes? The outer hair cells,
4. 0:07when we stimulate them with a sound,
5. 0:09for example now that we are talking,
6. 0:11your cells move and that produces an
7. 0:13echo. That echo is measured using
8. 0:16equipment, which is this one we have
9. 0:19here, that performs the otoacoustic
10. 0:21emission test. That is to say, on one
11. 0:24hand, we have the otoacoustic emission
12. 0:26that is produced, meaning it is
13. 0:28produced spontaneously by the cochlea,
14. 0:30and thanks to its existence, we can
15. 0:32measure if our cochlea is functioning
16. 0:34well or not. Yes, if there is a
17. 0:36cochlear pathology or not.
18. 0:38The result of this test will tell us
19. 0:39whether we hear or do not hear.
20. 0:41Exactly. No, whether we hear or do not
21. 0:43hear. It tells us the state of cochlear
22. 0:45health; it does not measure levels, but
23. 0:47rather measures the state of cochlear
24. 0:49health. That is, an emission can come
25. 0:51back poor, and it does not necessarily
26. 0:53mean the baby or the patient, whether a
27. 0:55child or adult, hears poorly. It can be
28. 0:58poor due to different pathologies. For
29. 1:01example, since I am evaluating the
30. 1:03cochlea here, in order to emit a sound,
31. 1:05I have to pass through the outer ear
32. 1:07and middle ear to reach the cochlea. So
33. 1:10, if I have something before that in
34. 1:12the outer ear, a wax plug for example,
35. 1:14that emission will come back poor. Or
36. 1:16mucus or fluid in the middle ear will
37. 1:17cause it to be poor. So then we refer
38. 1:20the patient to an ENT specialist, who
39. 1:22will properly address the middle ear
40. 1:24pathology or any other more significant
41. 1:27condition.
42. 1:28This means that based on this test, we
43. 1:30can know whether or not the signal is
44. 1:33being received in the ear.
45. 1:35Exactly. We emit the sound. For example
46. 1:39, I will show how it is performed. This
47. 1:40is the tip, right? We have the baby. We
48. 1:44place...I am using a larger tip here,
49. 1:45logically, which would be for a small
50. 1:47child, not a baby, but for you to see,
51. 1:49we place the tip. The equipment emits a
52. 1:52sound, that sound reaches the cochlea,
53. 1:54the cilium, that is, the cell, moves,
54. 1:57produces an echo, and the equipment, or
55. 1:59rather this probe, receives it, and
56. 2:01based on that we measure if that
57. 2:03emission is present or absent. It can
58. 2:06be done at any age. Obviously, there
59. 2:08are physiological characteristics to
60. 2:09consider at a certain age—what those
61. 2:11characteristics are—but yes, it can
62. 2:13be done at any age. It's not that an
63. 2:15otoacoustic emission is always
64. 2:16requested for an adult; it's requested
65. 2:18in cases where the adult cannot respond
66. 2:20subjectively. Yes, because we must keep
67. 2:22in mind that it is an objective test,
68. 2:24not a subjective one. That is to say,
69. 2:26we don't need a response from the adult
70. 2:28or the baby, which is why it's done on
71. 2:30babies, because a baby cannot tell me
72. 2:31if they hear or feel something. So it
73. 2:33is an objective test that is performed
74. 2:35entirely by the equipment. Yes. In the
75. 2:38event that the adult cannot answer
76. 2:40because they have some intellectual
77. 2:42pathology or some other type of
78. 2:43difficulty, an otoacoustic emission is
79. 2:45requested and we see how the cochlear
80. 2:47function is. Yes, the doctor sees how
81. 2:49that function is.
82. 2:50To look for what, in the case of adults
83. 2:52?
84. 2:53To look for a pathology, for example,
85. 2:55cochlear, or to make a differential
86. 2:56diagnosis of some retrocochlear
87. 2:58pathology. I mean, it can be used for
88. 3:02several things, for simulators as well;
89. 3:05I mean, there are several, uh, like,
90. 3:07certain situations that allow us to
91. 3:10know, or allow the doctor—we are
92. 3:12going to help the doctor—to know
93. 3:14where the patient's pathology or
94. 3:17difficulty is coming from.
95. 3:19And in the case of babies, for a few
96. 3:21years now, based on legislation, it is
97. 3:23mandatory to perform it on newborns.
98. 3:25Why? It must be done within the first
99. 3:28month of life because, well, let's see,
100. 3:30there is generally a national program,
101. 3:33right? Which says that it is mandatory
102. 3:36because the pathology must be detected
103. 3:39at an early level, that is, early on,
104. 3:41right? Why? Because the earlier a
105. 3:45hearing pathology is detected, the more
106. 3:47that patient will have auditory
107. 3:50habilitation to be able to develop
108. 3:52language and function well in school or
109. 3:55kindergarten. And it is super important
110. 3:58; I mean, the longer they are
111. 3:59auditorily deprived, the worse it will
112. 4:01be. The earlier, if there is a
113. 4:03pathology, the auditory channel is
114. 4:05enabled, the better it will be for all
115. 4:08types of development, whether it be in
116. 4:11the social context, in language
117. 4:13development, or motor development; it
118. 4:15will favor all types of development.
119. 4:18Yes, that is why we must try to ensure
120. 4:20it is within the first month of life.
121. 4:23Usually, we always conduct an anamnesis
122. 4:24, which is an initial interview with
123. 4:26the parents asking how the baby was
124. 4:28born, if the pregnancy was monitored,
125. 4:30if they were in the NICU, why they were
126. 4:31in the NICU, how much they weighed; I
127. 4:33mean, we try to look for hearing risk
128. 4:35factors to see if it recurs or not. If
129. 4:38there is any risk factor and the
130. 4:40otoacoustic emission result is poor, we
131. 4:43obviously refer them directly to the
132. 4:45ENT. Right? Now, if there are no risk
133. 4:48factors and the otoacoustic emission
134. 4:50result is poor, we wait 15 days or a
135. 4:52month, because we suspect there might
136. 4:54be something in the middle ear.
137. 4:56Generally, when they are so little,
138. 4:58there is always a suspicion that there
139. 5:00might still be some fluid. So, that
140. 5:03otoacoustic emission test comes back
141. 5:04noisy. Imagine, as I explained before,
142. 5:07to get here I have to go through all of
143. 5:09this. So, it is quite a complex issue.
144. 5:12We must rule out any pathology of the
145. 5:14outer ear and middle ear. So we always
146. 5:16try not to alarm the parents,
147. 5:17especially first-time parents, by
148. 5:19telling them, "No, no, it didn't turn
149. 5:20out well." Well, it didn't turn out
150. 5:22well, but we have to explain why it
151. 5:24didn't. It didn't turn out well because
152. 5:26it is most likely due to a pathology in
153. 5:28the middle ear or the outer ear. If
154. 5:30that pathology persists, we then refer
155. 5:32them; in other words, if that
156. 5:34otoacoustic emission test is still poor
157. 5:37when I repeat it, we then refer them to
158. 5:40the ENT, I mean, refer them to the ENT,
159. 5:42right? In the first consultation, so
160. 5:45the ENT can rule it out or provide
161. 5:47treatment if necessary. We have already
162. 5:50talked about older adults, newborns,
163. 5:52and when or for what purpose this type
164. 5:54of study would be used in children. The
165. 5:57same thing happens with children.
166. 5:58Sometimes, when there are children we
167. 6:00cannot condition for an audiometry, or
168. 6:02we want to see more if the pathology is
169. 6:05retrocochlear or endocochlear and we
170. 6:07want to contribute more to the
171. 6:09diagnosis, that is, to use a battery of
172. 6:11tests—not just audiometry and speech
173. 6:13audiometry or some evoked potential—
174. 6:15we use the otoacoustic emission, but
175. 6:17that depends on medical indication and
176. 6:19also audiological criteria. Yes. It is
177. 6:22used sparingly, but it is also used
178. 6:25for specific cases, let's say. Specific
179. 6:27, as a complement. Yes,
180. 6:29licensed professional. Thank you very
181. 6:31much.
182. 6:31You're very welcome. Thank you.