Biomedical subjects

Ferdinando Grandori

Publications and source records attributed to Ferdinando Grandori.

8 recordsLinked to original sources

PubMed2005

Cochlear maturation and otoacoustic emissions in preterm infants: a time-frequency approach.

Click-evoked otoacoustic emissions (CEOAEs) from preterm infants were analyzed to characterize developmental changes of cochlear active mechanisms. Due to their strong time-varying properties, CEOAEs were studied with a time-frequency approach--the wavelet transform (WT). By means of the WT, CEOAEs were decomposed into 12 frequency bands, spanning the 0.25-6.25 kHz range. For each band, the root-mean-square (RMS) level and latency were studied as functions of both frequency and age. Because CEOAEs were averaged using the non-linear mode of acquisition, the developmental changes in observed in this study are related to the non-linear component (which is actually the most predominant component of the active cochlear response) of CEOAEs, the linear one being mostly canceled out by non-linear averaging. In our study, there was evidence that properties of CEOAE non-linear components are related to the post-conception age (PCA) in that the levels and latency of CEOAE frequency components changed until the age of about 38 weeks post-conception, whereas after 38 weeks, CEOAE features were very similar to those of term newborns. In particular, the CEOAE levels increased and latency decreased with age. The observed changes in CEOAE properties seem to reveal a development of cochlear active mechanisms, although contributions from outer and middle ear development cannot be excluded. Also, in agreement with previous physiological and behavioral findings, our results revealed that the development of CEOAE properties was not the same for all the frequencies, being greater for frequencies 4 kHz, and resembled the development of the cochlear partition, which proceeds from base to apex.

Acoustic Stimulation↗

PubMed2005

The Milan Project: a newborn hearing screening programme.

AIM: Since 1997 a newborn hearing screening programme has been implemented by the U.O. Neurologia-Neurofisiopatologia and Dipartimento di Neonatologia of the Istituti Clinici di Perfezionamento ICP in Milan for both babies with no risk and those at risk of hearing impairment. This programme was named the Milan Project. METHODS: The protocol for no-risk babies consisted of three stages: in the first two stages, newborns were tested with transient click-evoked otoacoustic emissions (TEOAE), in the third one with conventional auditory brainstem responses (ABR). The first TEOAE test was performed by 36 h of age, before discharge, the second one after 15-30 d in case of referral, and the third one, by ABR, for those babies who failed the second TEOAE stage. Newborns at audiological risk were submitted to conventional ABR before the third month of corrected age. Some of this latter population was also submitted to the TEOAE test. The entire tested population (no-risk babies and newborns at audiological risk) consisted of 19 777 babies: 19 290 without risk ("no risk") and 487 at risk ("at risk"). RESULTS: During the course of the Milan Project, hearing impairment (ABR threshold equal to or greater than 40 dB nHL) was identified in 63 newborns (19 from the no-risk and 44 from the at-risk population), with a prevalence of 0.32%. Bilateral hearing impairment (BHI) was found in 33 newborns (10 from the no-risk and 23 from the at-risk population), corresponding to 0.17%. Among infants with bilateral hearing impairment, 30.3% had no risk factors. The prevalence of hearing impairment was determined on days 15-30 after birth. CONCLUSIONS: The results show that the implementation of a hospital-based, universal neonatal hearing screening programme for babies with and without audiological risk is feasible and effective. The effectiveness of the programme has increased as a function of the years since its inception, with a strong decrease in the referral rate. Further improvement is obtained if the TEOAE measurements are repeated in cases of referral scoring before discharge.

Acoustic Stimulation↗

PubMed2005

Otoacoustic emission latency, cochlear tuning, and hearing functionality in neonates.

Transient evoked otoacoustic emissions of a large population of neonates (466 ears) are analyzed, with the aim of establishing if a significant latency difference can be observed between "pass" (333) and "fail" (133) ears, discriminated with a screening protocol based on band and global reproducibility. The ears that did not pass the test in at least one frequency band are named "fail," for simplicity, but they should be more appropriately defined as "partial pass." In a previous study, significantly different average latencies had been observed in adult subjects, comparing normal hearing and hearing impaired ears [J. Acoust. Soc. Am. 111, 297-308 (2002)], but no similar study has been conducted on neonates yet. An improved wavelet technique was applied to transient evoked otoacoustic emission data, to get accurate experimental measurements of the otoacoustic emission latency. The results show statistically significant differences between the latency distributions of the "pass" and "fail" populations, with the "fail" latencies longer. However, non-Gaussianity of the distributions and systematic errors associated with low reproducibility levels suggested using a conservative approach in the data analysis and interpretation. New otoacoustic estimates of cochlear tuning in neonates are also provided.

Cochlea↗

PubMed2003

Principal component analysis as a method to facilitate fast detection of transient-evoked otoacoustic emissions.

Transient-evoked otoacoustic emissions (TEOAE) are acoustic signals coming from the inner ear (outer hair cells of the cochlea) after acoustic stimulation by clicks. They can be used to investigate the status of the peripheral hearing system. Some of their potential applications (e.g., their use as a tool in newborn hearing screening programs) are deeply related to the duration of each recording session. This duration can be strongly reduced by applying a principal component analysis approach to a set of TEOAE recorded from the same ear at different stimulus levels averaging only a few sweeps (a maximum of 100 versus the classical 260). The PCA approach is shown to be able to enhance the signal-to-noise ratio and, in turn, to allow a correct detection of the responses. Results of the application of this approach in comparison with responses recorded from the same subjects with the classical technique will be shown.

Acoustic Stimulation↗

PubMed2002

Click-evoked otoacoustic emissions recorded from untreated congenital hypothyroid newborns.

Thyroid hormone plays an important role in hearing development. Both a genetic or non-genetic hypothyroidism is often associated with congenital hearing loss. The exact incidence of hearing impairment in untreated congenital hypothyroid (CH) patients is unknown. This paper will present the results of measuring of the transient-evoked otoacoustic emissions (TEOAE) in a population of 29 newborns, who tested positive on a screening test for hypothyroidism (CH group) and in 68 well babies (control group) randomly chosen from all the newborns, classified as PASS, included in the Hearing Screening Program of the San Raffaele Hospital in Milan. TEOAE were recorded in all newborns within 1 month after birth and before beginning L-thyroxine treatment with conventional commercial instrumentation. Both temporal and time-frequency analyses of the emitted responses were conducted by means of a wavelet transform. The comparison of the characteristics of the temporal and frequency content of the responses of the two groups (CH and control) showed no statistically significant difference. No correlation was found between outer hair cell dysfunction and hypothyroidism.

Acoustic Stimulation↗

PubMed2002

Frequency-related effects in the optimization of coils for the magnetic stimulation of the nervous system.

Magnetic stimulation of the nervous system is a non-invasive technique with a large number of applications in neurological diagnosis, brain research, and, recently, therapy. New applications require engineering modifications in order to decrease power consumption and coil heating. This can be accomplished by optimized coils with minimized resistance. In this study the influence of some frequency-related effects (skin and proximity effect) on the coil resistance will be discussed, together with the role played by wire shape, wire section, and twisting effect. The results show that the coil resistance increases with frequency. As an example, for a 20-mm2 circular wire section, the skin effect in the typical frequency range of magnetic stimulator devices (2-4 kHz) increases the coil resistance up to about 45% with respect to its dc value. Moreover, the influence of the frequency is lower for flat wire sections and reasonably small helix twist angle of the coil.

Computer Simulation↗

PubMed2002

Comparison of two methods of TEOAE recording in newborn hearing screening.

This paper summarizes the results of trials performed in two hospitals, comparing the scoring of transient evoked otoacoustic emissions (TEOAEs) on the same neonates and within the same test session, recorded by the fully automatic device EchoScreen (Madsen Electronics/Fischer-Zoth GmbH) and ILO Otodynamics Ltd system. These trials form part of a larger project (Project Sentinel), whose primary aim is to stimulate the creation of new neonatal hearing screening programmes. Four thousand two hundred and forty-eight neonates were tested with both devices (8494 ears), in randomized order. The response scores obtained with the two devices are in full agreement in 98.72% of the tested ears. Considering the recording time, the fully automatic Echo Screen was, on average, about 3.6 times faster than the ILO88, bearing in mind, however, that when using ILO88, the end of the recording is decided by the operator on the basis of some mandatory decision rules.

Acoustic Stimulation↗

PubMedDate not supplied

Design of hearing aid shells by three dimensional laser scanning and mesh reconstruction.

Hearing aid shells (or earmolds) must couple the hearing aid with the user's ear. Earmolds have to fit the subject's outer ear canal properly to ensure a good performance of the aid. Because of the great variability in the anatomical pattern of the ear, earmolds are custom made. At present, an impression of the subject's ear canal is taken and used to fabricate the silicon-made mold. The postimpression activities that typically are performed during the fabrication process modify the physical dimensions of the resulting earmold and thus affect the fit of the product. A novel system for 3-D laser scanning and mesh reconstruction of the surface of ear canal impressions is presented. The reconstructed impression can be digitally stored and passed directly to dedicated CAD 3-D printing machines to model the silicon earmold and thus achieve the best possible fit. The proposed system is based on a couple of cameras and a commercial laser for the surface digitization and on a straightforward algorithm, based on the deformation of a geometric model, for the reconstruction of the acquired surface. Measurements on objects of well-known geometric features and dimensions are performed to assess the accuracy and repeatability levels of this 3-D acquisition system. Robustness to noise of the proposed reconstruction algorithm is determined by simulations with a synthetic test surface. Finally, the first measurements (acquisition+reconstruction) of closed surfaces from ear canal impressions are reported.

Algorithms↗