Two-source interference as the major reason for auditory-threshold estimation error based on DPOAE input-output functions in normal-hearing subjects.

Fine structure in the frequency response of distortion product otoacoustic emissions (DPOAEs) can severely limit the usefulness of DPOAEs in estimating auditory thresholds. Here, fine structure is removed by extracting the primary-source DPOAE component using the onset-decomposition technique (Vetesník et al., 2009) and auditory threshold estimates are compared to those obtained from DPOAEs in response to conventional, continuous two-tone stimulation. Auditory thresholds are predicted using the estimated distortion product thresholds (EDPTs), obtained from linear regression of input-output (I/O) functions of DPOAE pressure amplitude versus second-tone stimulus level (Boege and Janssen, 2002). The accuracy of the auditory-threshold predictions is derived by comparison with measured auditory thresholds. The parameters of the two primary stimulus tones of frequency f(1) and f(2) and levels of L(1) and L(2) are chosen as: f(2)/f(1) = 1.2 with 1.5 ≤ f(2) ≤ 2.5 kHz, and L(1) = 0.4L(2) + 39 dB SPL, with 25 ≤ L(2) ≤ 65 dB SPL. Data are from 12 normal-hearing subjects with profound DPOAE fine structure. 255 DPOAE I/O functions were measured for each of the two DPOAE paradigms. An EDPT value was accepted as reliable if: 1) the squared correlation coefficient, r(2) ≥ 0.8, 2) the regression slope, s(I/O) ≥ 0.2 µPa/dB, and 3) the standard deviation of the EDPT, σ(EDPT) ≤ 10 dB. The proportion of rejected I/O functions was 8% for onset-decomposition DPOAEs, and 25% for continuous-tone DPOAEs. Removal of data points from the saturation region of the DPOAE I/O function by an automated algorithm reduced the rejection rate, to zero for onset-decomposition DPOAEs, but to only 13% for continuous-tone DPOAEs. In the absence of saturated DPOAE responses, auditory thresholds were predicted with standard deviation of only 4 dB for onset-decomposition DPOAEs, but 12 dB for continuous-tone DPOAEs. In summary, by extracting the primary-source component of the DPOAE by the method of onset-decomposition it is possible to predict human auditory threshold with hitherto unattainable accuracy.

Forward and reverse transfer functions of the middle ear based on pressure and velocity DPOAEs with implications for differential hearing diagnosis.

Recently it was shown that distortion product otoacoustic emissions (DPOAEs) can be measured as vibration of the human tympanic membrane in vivo, and proposed to use these vibration DPOAEs to support a differential diagnosis of middle-ear and cochlear pathologies. Here, we investigate how the reverse transfer function (r-TF), defined as the ratio of DPOAE-velocity of the umbo to DPOAE-pressure in the ear canal, can be used to diagnose the state of the middle ear. Anaesthetized guinea pigs served as the experimental animal. Sound was delivered free-field and the vibration of the umbo measured with a laser Doppler vibrometer (LDV). Sound pressure was measured 2-3 mm from the tympanic membrane with a probe-tube microphone. The forward transfer function (f-TF) of umbo velocity relative to ear-canal pressure was obtained by stimulating with multi-tone pressure. The r-TF was assembled from DPOAE components generated in response to acoustic stimulation with two stimulus tones of frequencies f(1) and f(2); f(2)/f(1) was constant at 1.2. The r-TF was plotted as function of DPOAE frequencies; they ranged from 1.7 kHz to 23 kHz. The r-TF showed a characteristic shape with an anti-resonance around 8 kHz as its most salient feature. The data were interpreted with the aid of a middle-ear transmission-line model taken from the literature for the cat and adapted to the guinea pig. Parameters were estimated with a three-step fitting algorithm. Importantly, the r-TF is governed by only half of the 15 independent, free parameters of the model. The parameters estimated from the r-TF were used to estimate the other half of the parameters from the f-TF. The use of r-TF data - in addition to f-TF data - allowed robust estimates of the middle-ear parameters to be obtained. The results highlight the potential of using vibration DPOAEs for ascertaining the functionality of the middle ear and, therefore, for supporting a differential diagnosis of middle-ear and cochlear pathologies.

Extraction of sources of distortion product otoacoustic emissions by onset-decomposition.

The cubic component of the distortion product otoacoustic emission (DPOAE) in response to two tones of frequency f(1) and f(2) is generated by so-called primary- and secondary-source mechanisms in the cochlea. Interference between the resulting two source components can limit the usefulness of DPOAEs in assessing cochlear function. Although techniques are available for separating the source components, depending on the application, they can be either time-consuming or ineffective without a priori knowledge of optimal parameters. Here, we investigated, in humans, the possibility of separating the source components in the time-domain by sampling the onset and offset of the DPOAE-time signal at appropriate instants. Therefore, a DPOAE paradigm was developed in which the f(2) tone was periodically switched on during the continuous presence of the f(1) tone. F(2) was increased in 20-Hz steps from 1.5 to 2.5 kHz and the ratio f(2)/f(1) held constant at 1.2; measurements were made at six primary tone levels, ranging from L(2)=25 to 65 dB SPL. To investigate the possibility of separating the two sources by appropriate sampling, we developed an algorithm called onset-decomposition. The algorithm is based on the shape properties of DP-grams constructed from DPOAE responses at different time instants in the onset of the DPOAE signal. Thus, at each such time instant, the source components were extracted by time-windowing of the corresponding DP-gram. The time courses of the amplitude onsets of these separated primary- and secondary-source components provided evidence that the primary-source component attained its steady-state before the secondary-source component started to significantly influence the DPOAE by interference with the primary-source component. Consequently, in the final paradigm, the primary-source component is extracted by sampling the DPOAE signal at a single pre-defined time instant after the onset of the f(2) stimulus tone, before the secondary component begins to interfere. Based on the near-absence of interference maxima and minima in the DP-grams, the appropriate sampling instant was 8-10 ms for all frequencies and intensities in the stimulus set. Extracting the primary-source by onset sampling has the advantage that when individual source components for a given f(2) are to be investigated, there is no need to measure a DP-gram. In conclusion, it is shown that the technique can reliably and quickly separate the source components, making it an attractive paradigm for applications in basic research and clinical diagnosis.

Accuracy of velocity distortion product otoacoustic emissions for estimating mechanically based hearing loss.

Distortion product otoacoustic emissions (DPOAEs) measured as vibration of the human eardrum have been successfully used to estimate hearing threshold. The estimates have proved more accurate than similar methods using sound-pressure DPOAEs. Nevertheless, the estimation accuracy of the new technique might have been influenced by endogenous noise, such as heart beat, breathing and swallowing. Here, we investigate in an animal model to what extent the accuracy of the threshold estimation technique using velocity-DPOAEs might be improved by reducing noise sources. Velocity-DPOAE I/O functions were measured in normal and hearing-impaired anaesthetized guinea pigs. Hearing loss was either conductive or induced by furosemide injection. The estimated distortion product threshold (EDPT) obtained by extrapolation of the I/O function to the abscissa was found to linearly correlate with the compound action potential threshold at the f(2) frequency, provided that furosemide data were excluded. The standard deviation of the linear regression fit was 6 dB as opposed to 8 dB in humans, suggesting that this accuracy should be achievable in humans with appropriate improvement of signal-to-noise ratio. For the furosemide animals, the CAP threshold relative to the regression line provided an estimate of the functional loss of the inner hair cell system. For mechanical losses in the middle ear and/or cochlear amplifier, DPOAEs measured as velocity of the umbo promise an accuracy of hearing threshold estimation comparable to classical audiometry.

[Laser Doppler vibrometry: a new tool for diagnosing hearing loss with an intact eardrum]. / Laser Doppler vibrometria: un nou instrument pentru diagnosticarea Hipoacuziei cu timpan închis.

The diagnosis of hearing loss with an intact eardrum frequently requires an entire battery of hearing tests, without the guarantee of an exact diagnosis. The techniques frequently provide only orientation for it, without establishing the site of the lesion and the etiology of the hearing loss. Laser Doppler vibrometry is a new technique, which has recently proved capable, of partially resolving this problem. The method is based on the study of the sound-induced vibration of the eardrum in humans in vivo, using a laser Doppler vibrometer. The method proved to be useful in the diagnosis of the pathology of the middle ear sound transmission system, avoiding the need for exploratory tympanotomy. Called "laser-audiometry", the method promises to become a new diagnostic tool for hearing impairment.