Among the objective non-invasive audiological explorations the distorsion products of otoacoustic emissions (DPOAE) allow to quickly assess the function of the cochlear outer hair cells (without the active participation of the subject). This technique is used in newborn screening. While humans are able to perceive sounds in a frequency range of 20Hz to 20kHz, routine clinical audiological assessment is only concerned with frequencies between 1-4kHz.
This obscures the importance of high frequencies (HF) which can be easily assessed by DPOAEs. In young children, the perception of these high frequencies could also play an important role in language acquisition.
The main objective of this study is to evaluate the relationship between subtle high-frequency hearing impairment, as assessed by the DPOAE (non-invasive, rapid and simple audiological test), and language delay or difficulties in a pre-, peri- and school-age pediatric population.
Normal hearing (after an audiometry test, even if an ENT consultation has been carried out beforehand and if the doctor has not found any hearing problem, as defined in the NF EN ISO 70292017-04 standard, and according to an average hearing loss calculated according to the BIAP <20dB HL)
Free and informed consent of the parental authority and the patient
Affiliated to the social security system
Presenting a developmental language acquisition disorder (score according to the EVALO / EVALEO test)
Hearing disorder identified during the inclusion visit (presence of cerumen or foreign body in the earwax plug or foreign body in the external auditory canal, tympanometry suggesting a middle ear disorder, audiometry with thresholds outside the normal thresholds outside the normal range (0-20dB HL), absence of responses in (0-20dB HL), absence of responses in acoustic otoemissions or acoustic distortion products) on conversational frequencies between 500Hz and 4kHz.
Declaration by the parents of an ENT follow-up for a hearing disorder and/or a speech therapy for a language disorder
Refusal of participation evoked by the subject
Parallel
acoustic otoemisions
Diagnostic testTOAE and DPOAE
Otoscopy
Diagnostic testpresence of earwax checked by video otoscop
Audiometry
Diagnostic testHearing Threshold will be measured with the AD528 interacoustics
Tympanometry
Diagnostic testTympanic mobility will be measyred with the Titan interacoustics
HF DPOAE measurement
at frequencies 4265, 4688, 5154, 5666, 6229, 6847, 7527, 8275, 9096 and 10000 Hz
Presence or absence of HF DPOAE
assessed by tympanometry, categorisation of this categorisation of this into 3 classes A, B and C frequency will be defined by a signal to noise ratio \> 6 dB. The absence of DPOAE for each frequency will be defined by a signal to noise ratio ≤ 6 dB.
Functional status of the middle ear
assessed by tympanometry, categorisation of this categorisation of this into 3 classes A, B and C
Determination of the average hearing loss (baseline pure tone audiometry)
according to the BIAP, average of audiometric thresholds at 500Hz thresholds at 500Hz, 1kHz, 2kHz and 4kHz
Laterality of hearing loss at the DPOAE level with a classification into 3 groups
Not affected bilaterally affected, unilateral affected, bilateral affected; one side is considered to be affected if at least one of the at least one of the HF DPOAEs is ≤ 6 dB.
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