Évaluation de l'efficacité des réflexes de protection de l'oreille par la mesure des produits de distorsion acoustiques chez le rat : développement d'un nouvel outil clinique pour l'homme

Abstract : The pure-tone audiometry is a reference tool to assess auditory function but it is able to measure only threshold elevations showing irreversible damages. Measurement of distortion products oto-acoustic emissions (DPOAEs), reflecting the cochlear function, allows early detection of alterations in the inner ear caused by noise or some ototoxic solvents. From paradigm based on a continuous record of cubic DPOAEs (2f1-f2) and a contralateral stimulation triggering the middle-ear reflex, we could explain, in rats, the pharmacological effects of toluene. This aromatic solvent can act on the centers involved in the middle-ear acoustic protection reflex. With the results obtained in animals, a device adapted to humans has been developed, called EchoScan. The EchoScan was tested on 50 healthy volunteers with normal hearing in a first clinical research protocol to verify in particular the reproducibility of its measurements. A second research protocol was then conducted to test this tool among company employees, according to several exposure conditions: unexposed controls, workers exposed to noise, exposed to solvents, exposed to noise and solvents. The results of the first two conditions are presented in this thesis. They confirm the relevance of the measurement of the middle ear reflex threshold in assessing the effects of noise exposure. The results of subjects exposed to solvents will further evaluate the sensitivity of EchoScan in detection of the pharmacological effects, and even in the characterization of chemical substances exposure (in progress). In the future, EchoScan should be particularly promising in occupational medicine, but other applications are already considered, such as the study of pharmacological effects of anesthetics on the middle ear reflex
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Cécile Rumeau. Évaluation de l'efficacité des réflexes de protection de l'oreille par la mesure des produits de distorsion acoustiques chez le rat : développement d'un nouvel outil clinique pour l'homme. Médecine humaine et pathologie. Université de Lorraine, 2013. Français. ⟨NNT : 2013LORR0091⟩. ⟨tel-01749866⟩

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