A comparison of transient-evoked and distortion product otoacoustic emissions in normal-hearing and hearing-impaired subjects

Abstract

The ability of transient-evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) to distinguish normal hearing from hearing impairment was evaluated in 180 subjects. TEOAEs were analyzed into octave or one-third octave bands for frequencies ranging from 500 to 4000 Hz. Decision theory was used to generate receiver operating characteristic (ROC) curves for each of three measurements (OAE amplitude, OAE/noise, reproducibility) for each OAE measure (octave TEOAEs, 1/3 octave TEOAEs, DPOAEs), for octave frequencies from 500 to 4000 Hz, and for seven audiometric criteria ranging from 10 to 40 dB HL. At 500 Hz, TEOAEs and DPOAEs were unable to separate normal from impaired ears. At 1000 Hz, both TEOAE measures were more accurate in identifying hearing status than DPOAEs. At 2000 Hz, all OAE measures performed equally well. At 4000 Hz, DPOAEs were better able to distinguish normal from impaired ears. Almost without exception, measurements of OAE/noise and reproducibility performed comparably and were superior to measurements of OAE amplitude, although the differences were small. TEOAEs analyzed into octave bands showed better performance than TEOAEs analyzed into 1/3 octaves. Under standard test conditions, OAE test performance appears to be limited by background noise, especially for the low frequencies.

Detecting high-frequency hearing loss with click-evoked otoacoustic emissions

“…5. (Color online) The AUC is plotted versus frequency for CEOAE predictions of auditory status from the present study at 76 and 73 dB peSPL stimulus levels, CEOAE predictions from Gorga et al (1993), Prieve et al (1993), Hurley and Musiek (1994), Hussain et al (1998), and Lichtenstein and Stapells (1996), SFOAE predictions from Ellison and Keefe (2005), and DPOAE predictions from Gorga et al (1997). For the present study and other studies where possible, the prediction was for audiometric status with normal ears having a HL of 20 dB or better.…”

Low-frequency and high-frequency cochlear nonlinearity in humans

“…In general, the increase in noise level with decreasing frequency is a more significant problem for DPOAE measurements, compared to either stimulus frequency (SFOAE) or transient evoked otoacoustic emission (TEOAE) measurements, because predictions about cochlear responses at one frequency (f 2 ) are based on measurements at a frequency that is about ½ octave lower in frequency (2f 1 -f 2 ). It is likely that this factor underlies differences in the accuracy with which DPOAEs and TEOAEs identify auditory status at low frequencies (Gorga et al, 1993). In efforts to reduce the influence of noise level, averaging times were allowed to increase to unusually long times (see below) when f 2 = 0.5 kHz to reduce noise levels to sufficiently low levels for reliable DPOAE measurements at low stimulus levels.…”

Response Pattern Based on the Amplitude of Ear Canal Recorded Cochlear Microphonic Waveforms across Acoustic Frequencies in Normal Hearing Subjects

“…Not only is low-frequency noise much greater than high-frequency noise, it is also much greater than the actual low-frequency OAE signals. Therefore, low-frequency OAEs are almost always concealed by acoustic background noise in a typical recording under clinical settings (Andersson, Arlinger, & Jacobsson, 2000;Hussain, Gorga, Neely, Keefe, & Peters, 1998 Due to this acoustic background noise limitation, the performance of OAE measurements suffers greatly when assessing low-frequency cochlear functions such as at 500 Hz in clinics (Gorga et al, 1993;Harrison & Norton, 1999;Suckfull et al, 1996). Consequently, the lowest frequency for measuring specific OAE frequencies, such as in DPOAEs, is typically set by manufacturers at 1000 Hz for f 2 primary tones.…”

“…There are inherent limitations associated with the measurement of otoacoustic emissions (OAEs) for assessing cochlear functions (Gorga et al, 1993;Harrison & Norton, 1999;Suckfull, Schneeweiss, Dreher, & Schorn, 1996;Tognola, Ravazzani, & Grandori, 1995;Whitehead, Lonsbury-Martin, & Martin, 1993). Therefore, an alternative clinical assessment approach would be beneficial.…”

“…For example, distortion product OAEs (DPOAEs) are used in clinics to assess cochlear function with an f 2 frequency at 1000 Hz and above (Gorga et al, 1993;Harrison & Norton, 1999;Suckfull et al, 1996). However, OAEs are an acoustic version of cochlear responses, and inherent limitations are associated with acoustic signals.…”