Intracranial Pressure Modulates Distortion Product Otoacoustic Emissions: A Proof-of-Principle Study

BACKGROUND:There is an important need to develop a noninvasive method for assessing intracranial pressure (ICP). We report a novel approach for monitoring ICP using cochlear-derived distortion product otoacoustic emissions (DPOAEs), which are affected by ICP. OBJECTIVE:We hypothesized that changes i...

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Vydáno v:Neurosurgery Ročník 75; číslo 4; s. 445 - 455
Hlavní autoři: Bershad, Eric M., Urfy, Mian Z., Pechacek, Alina, McGrath, Mary, Calvillo, Eusebia, Horton, Nicholas J., Voss, Susan E.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Copyright by the Congress of Neurological Surgeons 01.10.2014
Wolters Kluwer Health, Inc
Témata:
Adolescent
Adult
Cross-Sectional Studies
Female
Humans
Intracranial Pressure - physiology
Male
Middle Aged
Neurosurgery
Otoacoustic Emissions, Spontaneous - physiology
Prospective Studies
Reproducibility of Results
Spinal Puncture
Young Adult
ISSN:0148-396X, 1524-4040, 1524-4040
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Shrnutí:BACKGROUND:There is an important need to develop a noninvasive method for assessing intracranial pressure (ICP). We report a novel approach for monitoring ICP using cochlear-derived distortion product otoacoustic emissions (DPOAEs), which are affected by ICP. OBJECTIVE:We hypothesized that changes in ICP may be reflected by altered DPOAE responses via an associated change in perilymphatic pressure. METHODS:We measured the ICP and DPOAEs (magnitude and phase angle) during opening and closing in 20 patients undergoing lumbar puncture. RESULTS:We collected data on 18 patients and grouped them based on small (<4 mm Hg), medium (5-11 mm Hg), or large (≥15 mm Hg) ICP changes. A permutation test was applied in each group to determine whether changes in DPOAEs differed from zero when ICP changed. We report significant changes in the DPOAE magnitudes and angles, respectively, for the group with the largest ICP changes and no changes for the group with the smallest changes; the group with medium changes had variable DPOAE changes. CONCLUSION:We report, for the first time, systematic changes in DPOAE magnitudes and phase in response to acute ICP changes. Future studies are warranted to further develop this new approach. ABBREVIATIONS:DPOAE, distortion product otoacoustic emissionICP, intracranial pressureIIH, idiopathic intracranial hypertensionLP, lumbar punctureTBI, traumatic brain injury
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0148-396X
1524-4040
1524-4040
DOI:10.1227/NEU.0000000000000449