Preliminary descriptions of transient-evoked and distortion-product otoacoustic emissions from graduates of an intensive care nursery.

Transient-evoked (TEOAE) and distortion-product otoacoustic emissions (DPOAE) were measured in 51 graduates of an intensive care nursery and compared to data obtained from 80 normal-hearing children and adults. All infants had click-evoked auditory brainstem responses (ABR) at 30 dB nHL or less while the older subjects had pure-tone thresholds of 20 dB HL or less for octave frequencies from 250 to 8000 Hz. OAE data were collected using commercially available devices. All data were analyzed in terms of emission amplitude, emission-to-noise ratio, and response reproducibility as a function of frequency. DPOAEs were measured at three points per octave between f2 frequencies of approximately 500 and 8000 Hz. TEOAEs were elicited by clicks and were analyzed in both octave and 1/3-octave bands centered at frequencies from 500 to 4000 Hz, as well as in the broadband condition. In addition, stimulus amplitudes for the clicks used to elicit TEOAEs were analyzed within octave and 1/3-octave bands to determine whether any age-related differences in responses can be accounted for on the basis of stimulus differences. Both emission amplitude and noise amplitude were greater in neonates than adults, although there was variability across frequency. Emission-to-noise ratio and response reproducibility were more similar between groups. For TEOAEs, high-frequency emission-to-noise ratios were larger in neonates compared to older subjects, while the reverse was true in the lower frequencies. Less obvious frequency effects were observed for DPOAEs. These findings are discussed in relation to the potential use of OAEs as screening measures for neonatal hearing loss.

Towards understanding the limits of distortion product otoacoustic emission measurements.

Distortion product otoacoustic emission (DPOAE) data were obtained with a custom-designed system from 20 subjects with normal hearing. Cavity measurements, using this system and an Etymotic ER-10B low-noise microphone system, resulted in estimates of recording system distortion of -20 dB SPL for f2 frequencies ranging from 500 to 8000 Hz, and primary levels ranging from 20 to 75 dB SPL (L2 = L1-10 dB). Using this system it was possible to automatically adjust averaging time in order to obtain the same residual noise levels across frequencies. In all subjects with normal hearing, DPOAEs were measurable over a wide range of primary levels for octave f2 frequencies from 1000 to 8000 Hz, but not at 500 Hz. At 500 Hz, only half of the normal-hearing subjects produced DPOAEs that were above the noise floor. When they did, DPOAE amplitude was less than that observed at higher f2 frequencies. While the cause for response absence in some normal ears may have been due to residual noise, the reduced amplitude suggests that the other factors influence the measurement of DPOAEs at low frequencies. This result may be due to reduced cochlear production of DPOAEs at lower frequencies or reduced transmission through the middle ear.

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

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.

A comparison of auditory brain stem response thresholds and latencies elicited by air- and bone-conducted stimuli.

Auditory brain stem responses (ABRs) were measured for stimuli presented both by air conduction and by bone conduction. Stimuli included clicks and tone bursts at octave frequencies from 250 to 4000 Hz. ABR thresholds were comparable for air- and bone-conducted stimuli. Wave V latencies were longer for bone-conducted stimuli compared to similar responses for air conduction. This effect was evident for both clicks and tone bursts. The fact that these latency differences were largely independent of stimulus spectrum suggests that they are not due to differences between the frequency responses of air and bone conduction transducers. This finding is expected when one considers the interaction between output, threshold, and frequency for both transducer types. These data also suggest that there are inherent differences in transmission by air and bone conduction that affect response latency but are unrelated to the amplitude spectrum in the signal.