otoakustikuri emisia da misi gamoyeneba praqtikaSi

 

irina burZgla

audiologiisa da smenis reabilitaciis centri

xelmZRvaneli: prof. zurab qevaniSvili

 

 

oae-iis fenomenma erTis mxriv mniSvnelovnad Secvala Sexeduleba SigniTa yeris funqcionirebis Sesaxeb, meores mxriv ki uzrunvelyo audiologiuri praqtika kvlevis axali meTodiT. rogorc cnobilia lokokina emsaxureba bgeris energiis Sekrebas da koncentrirebas, magram amasTan damtkicda rom mas aqvs stimulis sapasuxod bgeris generaciis unaric. es bgera Cveulebrivi bgerisgan gansxvavebiT SigniTa yuridan Sua yuris gavliT gareTa sasmeni milisken vrceldeba. igi otoakustikuri emisiis saxeliTaa cnobili. es bgera SeiZleba iqnas registrirebuli gareTa sasmen milSi moTavsebuli miniaturuli mgrZnobiare mikrofonis saSualebiT. oae-iis warmoqmna ganpirobebulia kortis organos receptoruli aparatis, kerZod gareTa wamwamovani ujredebis vibraciiT. vibracia ukukavSiris meqanizmiT gadaecema bazilarul membranas, Semdeg ki sasmen Zvlebs da dafis apks.

arsebobs ori ZiriTadi tipis oae: spontanuri da gamowveuli. spontanuri oae-iis registracia ar saWiroebs bgeriT gamRizianebels. spontanuri oae-a normaluri smenis mqone pirTa 40-60%-Si registrirdeba. goae-a yurze momqmedi gbgeriTi stimulis koxlearul  gamoZaxils anu eqos warmoadgens. goae-iis registracia praqtikulad yvela normaluri smenis mqone yurSia SesaZlebeli. igi erTi an ramdenime regularuli rxevis, zogjer ki erTi an ramdenime calkeuli talRiT aris warmodgenili. goae-a ZiriTadad bgeriTi stimulis miwodebidan 20 wm-is intervalSi aRmocendeba, yvelaze maRali amplitudis rxevebi ki xSirad 12-16 wm-is farglebSi aRiricxeba.

goae-a TiTis anabeWdis msgavsad mkacrad individualuria. goae-iis sarTo paterni, deteqciis zRurbli, amplituduri da droiTi maxasiaTeblebi sxvadasxva pirSi mniSvnelovnad gansxvavebulia. metic, erTi da igive individis marjvena da marcxena yuridan gamowveuli goae-a aseve mniSvnelovnad gansxvavdeba erTmaneTisgan.(sur.1 da sur.2) meores mxriv, erTi da imave yuridan registrirebuli goae-iis konfiguracia stabiluria, calkeul Canawerebs Soris dris didi intervalis SemTxvevaSic ki igi ucvleli rCeba. goae-iis sixSiruli speqtri miwodebuli bgeriTi stimulis sixSireze aris damokidebuli. Tu stimulad farTospeqtriani gamRizianebeli – tkacuni gamoiyeneba, goae-iis speqtric Sesabamisad farToa. tonaluri stimulis sapasuxod aRmocenebuli goae-iis sixSiruli diapazoni ki Sesabamisad SezRuduli da Sesabamis sixSireze aris aqcentirebuli.

goae-a stimulis inversiisas 180 –iT icvlis fazas, es Tviseba misi xmaurisgan sadiferenciaciod gamoiyeneba. garda amisa emisiis saidentifikaciod gamarTlebulia alternirebuli bgeriTi stimulebis gamoyeneba da stimulebis intensivobis varireba, radgan goae-iis sixSiruli speqtri miwodebuli bgeriTi stimulis sixSireze aris damokidebuli. goae-iis registraciisas gasaTvaliswinebelia, rom nebismieri xmamaRali bgera artefaqtia, radgan emisia infradabali bgeraa.

goae-iis aRmocenebis zRurbli gamoyenebuli stimulis fsiqoakustikuri aRqmis zRurbls emTxveva an rogorc wesi axlos aris masTan. bgeriTi gamRizianeblis intensivobis cvlilebisas farTo diapazonSic ki, goae-iis droiTi maxasiaTeblebi, kerZod, calkeuli rxevebis latenturi periodebi ar icvleba. meores mxriv, goae-iis amplituda kanonzomierad, Tumca ara wrfivad cvalebadobs. bgeris intensivobis cvlilebisas goae-iis sxvadasxva ubanSi aRricxul rxevaTa kompleqsi Cveulebriv diferencirebulad icvleba, amasTan calkeuli kompleqsi SeiZleba ucvlelic ki darCes.

goae-a mxolod gamosakvlevi yuris registraciisas aRiricxeba. kontrlateraluri yuris gaRizianeba goae-ias ar warmoSobs. kontrlateraluri yuris stimulaciisas goae-a mxolod maSin diferencirdeba, roca stimulis intensivoba imdenad maRalia, rom “gadasmenis” meqanizmebiT aRiqmeba arastimulirebadi yuris mieradac. am dros goae-iis aRmoceneba ramdenadme igvianebs, amasTan CamorCena im dros Seesabameba, rac bgeris intraauraluri gataregbisaTvis aris saWiro.

gamokvlevaTa erT seriaSi goae erTi yuridan registrirdeboda, meore ki paralelurad farTospeqtriani uwyveti xmauriT maskirdeboda. miRebuli monacemebiT, kontrlateraluri yuris maskireba aranair gavlenas ar axdens ifsilateraluri yuris goae-ze. aseve ar iyo gamovlenili raime mniSvnelovani gansxvaveba goae-iis Canawerebs Soris, romlebic registrirdebodnen ifsilateralur yurze maRali intensivobis xmauriT moqmedebis gareSe da 5 wuTis xangrZlivobis uwyveti xmauriT moqmedebis Semdeg. stimulis fsiqoakustikuri aRqmis Semcirebis an misi sruli aRumqmelobis SemTxvevaSic ki goae-a stabiluri rCeboda. es monacemebi amtkicebs, rom smenis sistemaze ama Tu im moqmedebam SesaZloa mniSvnelovani fsiqoakustikuri Zvrebi gamoiwvios, am dros ki goae-a ucvleli darCes.

msgavsi Sedegebi iqna miRebuli premaskirebis paradigmebiT Catarebul gamokvlevebSi. gamokvlevaTa am seriaSi gamosakvlev pirs oae-iis gamomwvevi signali an izolirebulad miewodeboda an am signals garkveuli intensivobis markeri farTospeqtriani xmauris gzavnili uswrebda win. gamoirkva, rom, zRurbli, romelic goae-iis cvlilebas ganapirobebs, mniSvnelovnad aRemateba maskeris im intensivobas, romelic signalis fsiqoakustikur maskirebas iwvevs. stimulis fsiqoakustikur maskirebis zRurblebze goae-iis cvlilebebi rogorc wesi, odnav iyo SesamCnevi an saerTod ar vlindeboda. Goae-iis srul gaqrobas ar hqonda adgili im premaskirebis SemTxvevaSic ki, rodesac xmauris intensivoba maskirebis zRurbls 30Ddb-iT da metiTac ki aRemateboda.

aRniSnuli monacemebi cxadyofs, rom maskirebis fenomeni or komponents moicavs: dabalzRurblovan centralur nervuls da maRalZRurblovan periferiul receptoruls.

goae-a rogorc prenervuli signali, pirdapir ukavSirdeba yurze moqmed stimuls da stimulze mopasuxe receptoris efeqturobas. receptoris dazianebisas, rasac smenis zRurblis gazrda sdevs Tan oae-a Sesabamisad Semcirebulia. igi rgorc wesi, aRar registrirdeba, roca smenis daqveiTeba aRemateba 20-30 db-s, es logikuria, radgan smenis aseTi xarisxiT dazianebis mizezi praqtikulad yovelTvis gareTa wamwamovani ujredebis seleqtiuri degeneraciaa. es ukanasknelni ki oae-iis uSualo wyarod arian miCneulebi.

oae-iis registraciis meTodma farTo gamoyeneba hpova samedicino praqtikaSi rogorc smenis paTologiis skrining testma. periferiuli warmoSobis gamo oae-a SesaZlebels xdis dadgindes lokokinis funqciuri mdgomareoba, paTologiis SemTxvevaSi ki misi buneba. Ooae-a SeiZleba gamoyenebul iqnas smenis paTologiis da subklinikuri formebis adreul gamosavlenad. oae-iis registraciis meTodi gansakuTrebiT efeqturia risk faqtoris jgufis bavSvebSi smeniT funqciaze zusti warmodgenis misaRebad.

spontanuri otoakustikuri emisia zogjer Seesabameba yurSi tonalur SegrZnebebs. aRniSnuli SegrZneba warmoadgens yuris fiziologiuri xmauris garkveul tips. Znelia imis Tqma, aqvs Tu ara spontanuri otoakustikuri emisiis arsebobas raime klinikuri mniSvneloba, Tumca Tavis mxriv, misi xSiri Tanamgzavri tinitusi, anu yurSi bgeris SegrZneba misi fizikuri ar arsebobis pirobebSi Cveulebriv Semawuxebelia matareblisTvis. tinitusis mqone subieqtebSi spontanuri otoakustikuri emisiis registracia da identifikacia garkveul wilad yuris mdgomareobaze obieqturi kontrolis saSualebas iZleva.

 

 

 

 

literaturis nusxa:

 

  1. Kemp D.T.  Otoacustic emissions: basic facts and applications. Audiology in practice.
  2. Kemp D.T.,  Bray P., Alexander F. and Brown A.M. Seand Audiol Suppel. 25, 1986
  3. Cianfrone G. and Mattia M. Spontaneus otoacustic emission from human ears. Preliminary report.
  4. Гамгебели З.А., Кеванишвили З.Ш., Гвелесиани Т.Г.  Характеристика вызванной отоакустической эмиссий у человека. В кн.: Материалы VII Республ. научн. конфер. физиологов ВУЗ Грузии. Тбилиси 1989.

 

Summary

Otoacoustic Emission and its Clinical Application

 

Irina Burdzgla

 

The discovery of the phenomenon of otoacoustic emission (OAE) has dramatically changed the opinions on the functioning of the inner ear. The OAE is a sound of very low intencities which can be registered by means of a sensitive microphone in the outer auditory canal. Two main types of OAE have been identified – spontaneous and evoked. It has been established that the transient-evoked OAE ( TEOAE) is highly specific and characteristic for individual subjects. Moreover, it has been shown that TEOAE differs in the right and left ears of the same person. The conducted studies have been proved that TEOAE is a stable event. The TEOAEs of the same patterns were registered in our investigations when the intervals between separate tests were rather long – days, weeks or even months. The TEOAE is widely used in clinical audiology as the screening test of the hearing. Due to the peripheral origin, by TEOAE recordings it is possible to estimate the state of cochlea and to reveal the hearing pathology in newborns of the risk groups.