Two sources of acoustic distortion products from the human cochlea.

The amplitude and phase of both stimulus-frequency and distortion-product emissions have been measured in healthy human ears. In some ears it is possible to model acoustic distortion products (DPs) generated by low-to-moderate stimulus levels as the vector sum of two components originating from distinct regions of the cochlea, one from the f2 place and the other, with a longer delay, from the distortion product place. The phase lag of the more delayed DP component is slightly greater than that of stimulus frequency emissions (SFEs) measured in the same ears.

Effect of otoacoustic emissions on just-noticeable differences for intensity in normally hearing subjects.

Measurements of spontaneous and click-evoked otoacoustic emissions (OAEs) were used to classify listeners with normal hearing into one of two categories--those with spontaneous emissions (SOAEs) and high-level transiently evoked emissions (TEOAEs) in both ears (strong emissions) and those with no SOAEs and low-level TEOAEs in either ear (weak emissions). Just-noticeable differences (jnd's) in intensity for 1-kHz pure tones presented at either 60, 40, or 20 dB SL were determined for these two groups using a continuous pedestal technique. Mean jnd's for intensity for the two groups did not differ significantly. Intratest variability was compared and the group with strong emissions had significantly higher variability for presentation levels of 20 dB SL and lower variability at 60 dB SL. Additional testing of intensity jnd's was performed in individuals with strong emissions using pure tones 30 Hz lower than a targeted SOAE frequency. Large interindividual differences were present without a specific pattern. It is concluded that OAE activity level does not affect the mean jnd for intensity discrimination. Individuals with strong emissions have less variance when performing the test at higher levels and more variance for lower level stimuli than do individuals with weak emission characteristics. Because an ear's OAE characteristics can alter performance on psychoacoustic tasks, knowledge of such characteristics is desirable when psychoacoustic results are acquired and reported.

Otoacoustic emissions: an approach for monitoring aminoglycoside-induced ototoxicity.

Ototoxic drugs, such as aminoglycosides, affect outer hair cell integrity in the inner ear. Transiently evoked otoacoustic emission (TEOAE) characteristics are related to outer hair cell function and can be expected to reflect the influence of ototoxic agents. Transiently evoked otoacoustic emissions were measured during amikacin sulfate therapy in nine patients. The duration of treatment for individual patients ranged from 9 to 33 days. A reversible decrease of overall TEOAE level, occurring after a treatment period longer than 16 days, was found in the majority of patients. The monitoring of TEOAEs is proposed as a method for early identification and, as a result, prevention of aminoglycoside-induced ototoxicity.

Peripheral analysis of frequency in human ears revealed by tone burst evoked otoacoustic emissions.

Otoacoustic emissions were evoked in the same ears with single tone bursts at 1, 2 and 3 kHz and with a complex stimulus consisting of a digital addition of the three tone bursts. Stimuli were presented at 75, 59 and 37 dB SPL to 28 ears of human subjects with normal hearing. The purpose was to determine if comparisons of responses to the complex stimulus with a posthoc addition of responses from single tone bursts could delineate features of cochlear frequency analysis of short-duration signals. For processing of the data, the results from the individual tone bursts were combined offline to form a composite response. This was then compared with the response obtained with the complex stimulus. Results revealed close correspondence between the spectra of the complex and composite responses in all ears despite interindividual differences in response morphology. Correlations between the complex and composite waveforms exceeded 80% for all stimulus levels. Subtractions of the two spectra revealed that the majority of the differences occurred at frequencies on the high-frequency slopes of the 1- and 2-kHz spectral peaks. This was due to a reduction in energy for the responses obtained with the complex stimulus. There was little variation between the two response types in the peak frequencies of their spectra, in the energy at frequencies on the lower frequency sides of the spectral peaks at 1 and 2 kHz, or in the spectral components at 3 kHz. Results reveal characteristics of the analysis of frequency in the preneural stages of cochlear processing.

Effects of atmospheric pressure variation on spontaneous, transiently evoked, and distortion product otoacoustic emissions in normal human ears.

The effects of atmospheric pressure changes on the frequency and amplitude of spontaneous (SOAEs), transiently evoked (TEOAEs) and distortion product (DPOAEs) otoacoustic emissions in normally hearing humans were compared. The purpose was to determine if the transmission of each form of OAE was influenced differently by the middle ear. Sixty-one subjects were tested in a pressure chamber. Twenty-seven SOAEs with a frequency range between 535 to 4729 Hz from 21 subjects were examined. Transiently evoked OAEs were studied in 20 subjects using clicks and tone-bursts at 0.5, 1, 2, 3, and 4 kHz. Distortion-product OAEs were generated at seven geometric mean frequencies between 1 and 8 kHz in another 20 subjects. Spontaneous OAEs were examined by applying atmospheric pressure up to 9 kPa and down to -2.5 kPa, for the measurement of TEOAEs and DPOAEs the pressure was varied from 0 kPa up to 8 kPa. In spite of large interindividual differences, results suggest that the influence of pressure on the three OAEs is frequency specific. The frequency and amplitude change of SOAEs, the modification of the amplitude and spectra of TEOAEs, and the amplitude change of DPOAEs are more influenced by changes in middle ear pressure below 4 kHz than are OAEs in the range at 4 kHz and above.

Repeatability of distortion product otoacoustic emissions in normally hearing humans.

Distortion product otoacoustic emissions (DPOAEs) at the frequency of 2f1-f2 were measured in one or both ears of 12 young adults during 4 test sessions over a 6-week period. The purpose was to determine the variability in DPOAE amplitudes and 'detection thresholds' over repeated measurements using a computer-based time-averaging system. DPOAEs were generated with f1 and f2 relative to (f1f2)1/2 in two basic paradigms: (a) fixed levels of L1 = L2 of 70 and 55 dB SPL over a stimulus range from 0.8 to 8 kHz in 0.2-octave intervals; (b) input-output functions in stimulus regions of 0.8, 1, 1.5, 2, 3, 4 and 6 kHz, L1 from 35 to 70 dB SPL changing in 5-dB steps and L2 at 6 dB below the amplitude of L1. The mean variability of DPOAE amplitudes with equilevel stimuli was 1.8 dB (SD = 1.8) for L1 = 70 dB SPL and 2.9 dB (SD = 2.7) for L1 = 55 dB SPL. It was 1.7 dB (SD = 1.7) and 2.4 dB (SD = 2.0) for comparable levels of L1 with L2 at 6 dB below L1. Variability in amplitude of the DPOAEs for the fixed-level condition was greatest overall above 6 kHz and below 1 kHz and in the 2-kHz region for one third of the subjects. Neither individual differences in emission amplitudes nor the presence of spontaneous otoacoustic emissions had a significant influence on the amount of amplitude variability within ears. Variability was not influenced by the length of time between measurements from 1 to 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Transiently evoked and distortion-product otoacoustic emissions. Comparison of results from normally hearing and hearing-impaired human ears.

Evoked otoacoustic emissions can be measured after a transient stimulus or as distortion products of two pure tones. Measurements of both emission types are being used more frequently as the techniques become easier to implement and the clinical benefits are realized. In addition, comparisons between the two types of emissions from the same ear provide information about cochlear mechanisms. We have measured transiently evoked otoacoustic emissions (TEOAEs) stimulated with clicks and distortion-product otoacoustic emissions (DPOAEs) from 166 ears of individuals with and without hearing impairment. The TEOAE and DPOAE amplitudes were compared with each other and with corresponding audiometric thresholds by frequency. Results revealed a high correspondence between the two emission types (r = .78) and between the distribution of the energy for each emission and audiometric threshold levels at corresponding frequencies (DPOAE, Spearman p = -.84; TEOAE, p = -.77). The DPOAEs were present more often than were TEOAEs when hearing levels across frequency were greater than 30-dB hearing level. The results suggest that both TEOAEs and DPOAEs are derived largely from similar mechanisms. The differences between the occurrence of the two emissions by audiometric threshold level would suggest that TEOAEs may be preferable for screening purposes, whereas DPOAEs may be more valuable for monitoring cochlear changes clinically.

[Use of acoustic distortion products in clinical diagnosis. The site of origin of otoacoustic emissions in the inner ear]. / Der Einsatz akustischer Distorsionsprodukte zur klinischen Diagnostik. Der Entstehungsort ihrer otoakustischen Emissionen im Innenohr.

Distorsion product otoacoustic emissions (DPOAE) are generated by a continuous bitonal stimulation of the cochlea. The resulting emissions are measurable in a definite mathematical function of the primaries (mf1 +/- nf2; f1 < f2). In humans sound emission at the frequency 2f1-f are usually detectable. To determine if a disturbance of DPOAE-amplitude is associated with a cochlear lesion in the frequency region of the evoked emissions or the primaries, we performed suppression experiments using normal-hearing, healthy probands (n = 14). DPOAE were measured in the frequency range between 800 Hz and 8 kHz with different sound-pressure levels for the primaries. Evoked emissions for each proband were measured with these different stimulus parameters to determine baseline values. In suppression experiments sound emissions were evoked continuously with different stimuli between 800 Hz and 8 kHz, disturbed simultaneously with a third tone of 1, 2 and 4 kHz and then compared with baselines. Suppressor tones (1, 2, 4 kHz) reduced significantly the DPOAE amplitudes in the frequency region of the geometric mean of the primaries. This indicates that a reduction of the emission amplitude in associated with a cochlear lesion near the generation site of the DPOAE. The suppression curves exhibit a sharp and steep graph, indicating their relation to cochlear frequency selectivity.

Monitoring the effects of noise exposure using transiently evoked otoacoustic emissions.

One possible alternative to conventional pure-tone testing for screening and monitoring cochlear changes is the measurement of otoacoustic emissions. The aims of this study were to determine the feasibility of using transiently evoked otoacoustic emission (TEOAE) measurements as an objective field procedure and to compare the sensitivity of the measurements indirectly to pure-tone thresholds. The test groups were 117 male recruits and 30 male career cadets in compulsory military service in Switzerland. Transiently evoked otoacoustic emissions were measured before and at the end of a 17-week training period that included exposure to noise from firearms. Results revealed significant changes in response amplitudes in the frequency range from 2 to 4 kHz, whereas changes in the frequency range from 0.5 to 2 kHz were not significant for either group. The changes in relative amplitude did not exceed 15% when spectra containing the lower frequencies were considered. However, they were always greater than 83% within the higher-frequency range. All mean changes were in the direction expected from cochlear damage. Comparison of TEOAE results with pure-tone thresholds measured for a similar sample of subjects indicated that TEOAE testing may be more sensitive than pure-tone audiometry in detecting early cochlear damage from noise. The testing of TEOAEs is feasible as a screening procedure. It offers objective and repeatable information and is substantially less time consuming than pure-tone audiometry.

Clinical monitoring using otoacoustic emissions.

Damaging influences to the cochlea are a leading cause of sensorineural hearing loss. Examples include acute or chronic noise exposure and cochleotoxic drugs such as aminoglycosides. Typically, once damage has occurred, the cochlea cannot recover. Therefore, prevention is critical. If damaging influences cannot be avoided, then secondary prevention or early detection of cochlear hearing loss becomes important. Ideally, methods for the detection of cochlear damage should be as specific and as sensitive as possible. Otoacoustic emissions satisfy these criteria and offer a means of testing aspects of cochlear function in a non-invasive and objective way. Evoked otoacoustic emissions measured either after transient stimuli or during two-tone stimulation (distortion-product otoacoustic emissions) are the types most commonly used for clinical purposes. They are stable over time within individual ears and their repeatability has been established under conditions of clinical testing using commercial equipment. Thus, they are well suited as an effective means of monitoring subtle changes in cochlear status. The possibility of making non-invasive repeated measures of cochlear function has led to the widespread use of otoacoustic emissions in animal experiments. Influences of development, anoxia, anaesthesia, noise, and drugs have been monitored. Preliminary studies in humans demonstrate that cochlear damage due to ototoxic drugs such as aminoglycosides or cisplatin and due to noise exposure can be detected using otoacoustic emissions. Comparison of such results to those available using pure-tone audiometry indicates a greater sensitivity of otoacoustic emissions for detecting early cochlear damage.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of transiently evoked and distortion-product otoacoustic emissions in humans.

The measurement of transiently evoked otoacoustic emissions (TEOAEs) can identify a hearing loss exceeding 25-30 dB HL with high sensitivity. However, further quantification of the hearing loss is not possible, and the frequency specificity of TEOAEs has been questioned. Distortion-product otoacoustic emission (DPOAE) measurements are being developed for clinical use in the hope that they will be more frequency-specific than are TEOAEs. We have compared TEOAEs and DPOAEs in both normally hearing and hearing-impaired subjects with the purpose of learning more about the frequency specificity of these two types of emissions. In a first investigation, toneburst-evoked OAEs were compared to DPOAEs stimulated at 1, 2 and 4 kHz in ten ears without spontaneous otoacoustic emissions of ten normally hearing subjects. Input/output (I/O) functions of DPOAEs at frequency regions of 1 and 2 kHz were characterized by roll-overs and irregularities that were not present in either DPOAE I/O functions at 4 kHz or in TEOAE I/O functions at 1, 2 and 4 kHz. Mean slopes of the I/O functions increased with increasing frequency for DPOAEs and decreased for TEOAEs. In a second investigation, click-evoked OAEs and DPOAEs (stimulated by pure tones in the frequency range of 0.75-6 kHz) were measured in 42 ears of 21 normally hearing subjects and 128 ears of 64 subjects with varying degrees of sensorineural hearing loss. Results from both investigations revealed that the amplitude ratio between DPOAEs and TEOAEs changed systematically with frequency. DPOAE amplitudes became larger with increasing frequency and TEOAE amplitudes became smaller.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of general anesthesia on transiently evoked otoacoustic emissions in humans.

The influence of general anesthesia (GA) on transiently evoked otoacoustic emissions (TEOAEs) was studied in 19 normally hearing women undergoing surgery. Emissions were measured on the day before the operation, after premedication but before the beginning of the operation, and during and after the operation. There were no significant differences in TEOAE amplitude or in reproducibility between results obtained the day before the operation and after premedication. Ten patients received nitrous oxide (N2O) during GA (N2O group), and 9 patients did not (non-N2O group). The amplitude of TEOAEs was reduced during GA in 9 of 10 patients in the N2O group and in 7 of 9 patients in the non-N2O group. However, the average decrease of amplitude after the first 10 minutes was greater in the N2O group (4 +/- 3.4 dB) than in the non-N2O group (0.18 +/- 1.4 dB). The corresponding mean reproducibility of the response decreased in 9 of 10 patients of the N2O group (29% +/- 24%) and was nearly unchanged in the non-N2O group (2.3% +/- 7.2%). The time course of the amplitude reduction was similar in both groups. The smallest amplitudes were reached on an average by 19.3 +/- 11.4 minutes in the N2O group and by 17 +/- 13.6 minutes in the non-N2O group. Preoperative and postoperative TEOAEs were comparable in level and reproducibility. Differential frequency effects imply a middle ear effect for the greater reduction of TEOAE amplitudes in the N2O group due to gas diffusion into the middle ear.(ABSTRACT TRUNCATED AT 250 WORDS)

Suppression of the 2f1-f2 otoacoustic emission in humans.

Suppression of the 2f1-f2 distortion-product otoacoustic emission (DPOAE), stimulated with primaries, f1 and f2, in the frequency regions of 1, 2, and 4 kHz was measured in one ear of 14 human subjects with normal hearing. Suppression rate functions were generated with a suppressor at either 1, 2, or 4 kHz increasing in level from 30 to 76 dB SPL for the corresponding f1 and f2 combinations. Stimulus levels for DPOAEs were L1 = 70 dB SPL and L2 adjusted to produce the highest amplitude DPOAE for each ear (range, 0 to 6 dB below L1). Results indicated that DPOAEs were reduced 3 dB in amplitude for a mean suppressor level of 61 dB SPL. Maximum amplitude reduction occurred at a mean suppressor level of 69 dB SPL. These levels varied little for the three stimulus frequency regions. Mean slopes of the rate functions decreased as stimulus frequency region increased. Suppression tuning curves (STCs) were generated in the same three frequency regions and with L1 at either 70 or 55 dB SPL and L2 adjusted individually for each ear. The tips of the STCs were at frequencies associated with f1 and f2. The tip regions of the STCs for the 4-kHz stimulus condition were more complex in that they contained more multiple minima than did those for the 1- and 2-kHz regions. Results confirm that optimal suppression of the 2f1-f2 DPOAE occurs for frequencies in the vicinity of f1 and f2 rather than at 2f1-f2.

Transiently evoked otoacoustic emissions in patients with Menière's disease.

Transiently evoked otoacoustic emissions (TEOAEs) were stimulated using clicks or 1-kHz tone bursts in both ears of 31 patients with unilateral Meniere's disease. Using click stimuli, responses were present in 29/31 of the non-Meniere's ears and in 26/31 of the Meniere's ears. Stimulation using 1-kHz tone bursts produced responses in 30/31 of the non-Meniere's ears and in 28/31 of the Meniere's ears. Audiometric configuration strongly influenced the presence of TEOAEs in the affected ears. In all but 2 ears with average hearing sensitivity (0.5, 1, 2 kHz) poorer than 25 dB HL, responses were present only when accompanied by at least one pure-tone threshold better than 30 dB HL from 0.75 to 2 kHz. In the opposite ears, all of which had essentially normal hearing, responses were approximately 5 dB lower in level and contained fewer spectral peaks in comparison with results obtained from a normative database. Neither age nor pure-tone results could account for these differences. Thus, TEOAEs obtained from patients with Meniere's disease manifest features that may be considered as atypical either in comparison to results from ears with normal hearing or from ears with relatively flat sensorineural hearing losses due to other etiologies.

Reporting click-evoked and distortion-product otoacoustic emission results with respect to the pure-tone audiogram.

Measurement of transiently evoked otoacoustic emissions, elicited primarily using click stimuli, and distortion-product otoacoustic emissions is gaining prominence as a clinical technique. One proposed application is the estimation of hearing levels. In this report, several formats for describing otoacoustic emission test results obtained from adult subjects are discussed. Descriptive analyses involve comparisons of individual results with normative data obtained from a group of normally hearing adults.

[The clinical use of oto-acoustic emissions of cochlear distortion products]. / Die klinische Anwendung otoakustischer Emissionen kochleärer Distorsionsprodukte.

Otoacoustic emissions of cochlear distortion products (DPOAEs) were measured in normally hearing and hearing-impaired human ears. A total of 133 subjects (231 ears) were tested. Two puretone stimuli f1 and f2 were delivered to a sound probe fixed in the outer ear canal. The frequencies of the two primaries were chosen so that their geometric mean represented pure-tone audiometric frequencies. The otoacoustic emission was measured at the distortion product frequency 2f1-f2 by spectral averaging. For 199 ears, the levels of the primaries were 73 dBHL for L1 and 67 dBHL for L2. Statistical analysis was carried out in 77 ears of 46 subjects with normal hearing (average hearing levels at pure-tone audiometric thresholds less than or equal to 10 dBHL) and 36 ears of 25 subjects exhibiting near-normal hearing (average hearing levels at pure-tone audiometric thresholds less than or equal to 20 dBHL). The mean DPOAE amplitudes were similar in these two groups of ears. In 111 of these 113 ears (98.2%), DPOAEs were detected at three or more of the six tested frequencies between 1 and 6 kHz. DPOAEs were measured in more than 75% of ears at each frequency between 1-6 kHz and in more than 86% between 1-4 kHz. Eighty-six hearing-impaired ears of 44 subjects with sensorineural hearing loss formed the patient group. A highly significant correlation between pure-tone audiometric thresholds and DPOAE amplitudes was demonstrated in the frequency range of 1-4 kHz. Percentiles of DPOAE amplitudes were calculated in 22 ears with a mean pure-tone threshold less than or equal to 5 dBHL and in 12 specially selected pathological ears.(ABSTRACT TRUNCATED AT 250 WORDS)

Repeatability of transiently evoked otoacoustic emissions in normally hearing humans.

Transiently evoked otoacoustic emissions (TEOAEs) were stimulated using clicks. Responses were measured in each ear of 10 adult subjects during three test sessions separated by 3-day intervals. The purpose was to determine the amount of short-term variability in the amplitude of the emissions when measured under similar test conditions. For each of two modes of determining the stimulus level, mean overall response levels varied approximately 1 dB with repeated measurements. The spectra of the responses were analyzed in discrete frequency bands from 0.7 to 5.8 kHz. Response energy peaked at 1.2 kHz and was reduced markedly above 4 kHz. Variability within individual spectral bands was approximately 1 dB from 0.9 to 4.1 kHz and was slightly greater for 0.7 kHz. The amplitude of TEOAEs is stable over successive short-term measurements. The technique can be used as a sensitive means of monitoring cochlear function.

Objective measures of sentence level with respect to loudness.

The best method for objectively measuring the level of running speech has not yet been established. In the present study, subjective and objective measures of the level of sentence pairs were compared. Psychoacoustic judgments of the loudness of ten sentence pairs were made by ten listeners. The level of the sentences was measured using four objective methods. The purpose was to determine which of the objective measures best matched the psychoacoustic data. The objective methods included: Sound level meter (SLM), percentile level, average power level (Leq) and the loudness calculation procedure according to ISO 532 B. There were no significant differences between the estimates using the SLM set on either 'Impulse', 'Fast' or 'Slow' settings, the Leq, the percentile level Lmax and the percentile loudness Nmax to N30 using conventional calculation techniques. The measures obtained using A-weighting on the SLM were not found to be superior to the unweighted measures. These findings have implications for the measurement of the level of sentences used in clinical audiology.