Hybrid measurement of auditory steady-state responses and distortion product otoacoustic emissions using an amplitude-modulated primary tone

A maximum auditory steady-state response (ASSR) amplitude is yielded when the ASSR is elicited by an amplitude-modulated tone (f(c)) with a fixed modulation frequency (f(m) = 40 Hz), whereas the maximum distortion product otoacoustic emission (DPOAE) level is yielded when the DPOAE is elicited using a fixed frequency ratio of the primary tones (f2/f1 = 1.2). When eliciting the DPOAE and ASSR by the same tone pair, optimal stimulation is present for either DPOAE or ASSR and thus adequate simultaneous DPOAE/ASSR measurement is not possible across test frequency f2 or f(c), respectively. The purpose of the present study was to determine whether the ASSR and DPOAE can be measured simultaneously without notable restrictions using a DPOAE stimulus setting in which one primary tone is amplitude modulated. A DPOAE of frequency 2f1-f2 and ASSR of modulation frequency 41 Hz were measured in ten normal hearing subjects at a test frequency between 0.5 and 8 kHz (f2 = f(c)). The decrease in the DPOAE level and the loss in ASSR amplitude during hybrid mode stimulation amounted, on average, to only 2.60 dB [standard deviation (SD) = 1.38 dB] and 1.83 dB (SD = 2.38 dB), respectively. These findings suggest simultaneous DPOAE and ASSR measurements to be feasible across all test frequencies when using a DPOAE stimulus setting where the primary tone f2 is amplitude modulated.     

Pure-tone threshold estimation from extrapolated distortion product otoacoustic emission I/O-functions in normal and cochlear hearing loss ears

A new method for direct pure-tone threshold estimation from input/output functions of distortion product otoacoustic emissions (DPOAEs) in humans is presented. Previous methods use statistical models relating DPOAE level to hearing threshold including additional parameters e.g., age or slope of DPOAE I/O-function. Here we derive a DPOAE threshold from extrapolated DPOAE I/O-functions directly. Cubic 2 f1-f2 distortion products and pure-tone threshold at f2 were measured at 51 frequencies between f2=500 Hz and 8 kHz at up to ten primary tone levels between L2=65 and 20 dB SPL in 30 normally hearing and 119 sensorineural hearing loss ears. Using an optimized primary tone level setting (L1 = 0.4L2 + 39 dB) that accounts for the nonlinear interaction of the two primaries at the DPOAE generation site at f2, the pressure of the 2 f1-f2 distortion product pDP is a linear function of the primary tone level L2. Linear regression yields correlation coefficients higher than 0.8 in the majority of the DPOAE I/O-functions. The linear behavior is sufficiently fulfilled for all frequencies in normal and impaired hearing. This suggests that the observed linear functional dependency is quite general. Extrapolating towards pDP=0 yields the DPOAE threshold for L2. There is a significant correlation between DPOAE threshold and pure-tone threshold (r=0.65, p<0.001). Thus, the DPOAEs that reflect the functioning of an essential element of peripheral sound processing enable a reliable estimation of cochlear hearing threshold up to hearing losses of 50 dBHL without any statistical data.     

The influence of systematic primary-tone level variation L2-L1 on the acoustic distortion product emission 2f1-f2 in normal human ears

The purpose of the present study was to determine the effect of primary-tone level variation, L2--L1, on the amplitude of distortion-product otoacoustic emissions (DPOAEs). The DPOAE at the frequency 2f1--f2 (f2 greater than f1) was measured in 20 ears of ten normally hearing subjects. Acoustic distortion products were generated by primaries f1 and f2 with geometric mean frequencies of 1, 2, and 4 kHz. The f2/f1 ratios were 1.25 (1 kHz), 1.23 (2 kHz), and 1.21 (4 kHz). The primary-tone level L1 was kept constant at either 65 or 75 dB SPL while the second primary-tone level L2 was varied between 20 and 90 dB SPL in 5-dB steps. The level differences L2--L1 generating maximal DPOAE amplitudes depended on L1 and on the geometric mean frequency of f1 and f2. There were large interindividual differences. Overall, the L2--L1 evoking maximal mean DPOAE amplitudes was --10 dB for geometric mean frequencies of 1 and 2 kHz with both L1 = 65 dB SPL and L1 = 75 dB SPL. For 4 kHz, L2-L1 was --5 dB with L1 = 65 dB SPL and 0 dB with L1 = 75 dB SPL. The mean slopes of the DPOAE growth functions in the initial linearly increasing portions were steeper at higher stimulus frequencies, increasing from 0.52 at 1 kHz to 0.72 at 4 kHz for L1 = 65 dB SPL and from 0.48 at 1 kHz to 0.72 at 4 kHz for L1 = 75 dB SPL.     

Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. I. Intersubject variability and consequences on the DPOAE-gram

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. The standard procedure consists of recording the 2f1-f2 DPOAE amplitude as a function of the f2 frequency, using a fixed f2/f1 ratio (DPOAE-gram), close to 1.20. DPOAE amplitude, as recorded in the DPOAE-gram, shows a wide range of values in normal-hearing subjects, which can impair the predictive value of the DPOAE-gram for hearing thresholds. This study is aimed at comparing intersubject variability in 2f1-f2 DPOAE amplitude according to three paradigms: a fixed f2/f1 ratio, such as the DPOAE-gram, a variable ratio DPOAE-gram (f2/f1 adapted to frequency) and an "optimum" DPOAE-gram, where the f2/f1 is adapted both to subject and frequency. The 2f1-f2 DPOAE amplitude has been investigated on 18 normally hearing subjects at ten different f2 frequencies (from 0.75 to 6 kHz), using an f2 fixed, f1 sweep paradigm, and allowed to define, for each frequency, the f2/f1 ratio giving the greatest 2f1-f2 DPOAE amplitude (or optimum ratio). Results showed a large intersubject variability of the optimum ratio, especially at frequencies below 1.5 kHz, and a significant decrease of the optimum ratio with frequency. The optimum DPOAE-gram was underestimated by up to 5.8 dB on average (up to 14.9 dB for an individual subject) by the fixed ratio DPOAE-gram, and by up to 3 dB on average (up to 10.6 dB for an individual subject) by the variable ratio DPOAE-gram. Intersubject variability was slightly but significantly reduced in the optimum DPOAE-gram versus the fixed-ratio DPOAE-gram. Lastly, correlations between tone-burst evoked otoacoustic emission (TBOAE) amplitudes and maximum DPOAE amplitudes were significantly greater than correlations between TBOAE amplitudes and fixed-ratio DPOAE amplitudes.     

Sources of DPOAEs revealed by suppression experiments,inverse fast Fourier transforms,and SFOAEs in impaired ears

DPOAE sources are modeled by intermodulation distortion generated near the f2 place and a reflection of this distortion near the DP place. In a previous paper, inverse fast Fourier transforms (IFFTs) of DPOAE filter functions in normal ears were consistent with this model [Konrad-Martin et al., J. Acoust. Soc. Am. 109, 2862-2879 (2001)]. In the present article, similar measurements were made in ears with specific hearing-loss configurations. It was hypothesized that hearing loss at f2 or DP frequencies would influence the relative contributions to the DPOAE from the corresponding basilar membrane places, and would affect the relative magnitudes of SFOAEs at frequencies equal to f2 and fDP. DPOAEs were measured with f2 = 4 kHz, f1 varied, and a suppressor near fDP. L2 was 25-55 dB SPL (L1 = L2 + 10 dB). SFOAEs were measured at f2 and at 2.7 kHz (the average fDP produced by the f1 sweep) for stimulus levels of 20-60 dB SPL. SFOAE results supported predictions of the pattern of amplitude differences between SFOAEs at 4 and 2.7 kHz for sloping losses, but did not support predictions for the rising- and flat-loss categories. Unsuppressed IFFTs for rising losses typically had one peak. IFFTs for flat or sloping losses typically have two or more peaks; later peaks were more prominent in ears with sloping losses compared to normal ears. Specific predictions were unambiguously supported by the results for only four of ten cases, and were generally supported in two additional cases. Therefore, the relative contributions of the two DPOAE sources often were abnormal in impaired ears, but not always in the predicted manner.     

Distortion product otoacoustic emissions and basilar membrane vibration in the 6-9 kHz region of sensitive chinchilla cochleae

Distortion product otoacoustic emissions (DPOAEs) and basilar membrane (BM) vibration were measured simultaneously in the 6-9 kHz region of chinchilla cochleae. BM-Input-Output functions in a two-tone paradigm behaved similarly to DPOAEs for the 2f1-f2 component, nonmonotonic growth with the intensity of the lower frequency primary and a notch in the functions around 60 dB SPL. Ripples in frequency functions occur in both BM and OAE curves as a function of the distortion frequency. Optimum f2/f1 ratios for DPOAE generation are near 1.2. The slope of phase curves indicates that for low f2f1(<1.1) the emission source is the place location while for f2f1>1.1 the relative constancy of the phase function suggests that the place is the nonlinear region of f2, i.e., the wave location. Magnitudes of the DPOAEs increase rapidly above 60 dB SPL suggesting a different source or mechanism at high levels. This is supported by the observation that the high level DPOAE and BM-DP responses remain for a considerable period postmortem.     

Level dependence of distortion-product otoacoustic emissions measured at high frequencies in humans

Given that high-frequency hearing is most vulnerable to cochlear pathology, it is important to characterize distortion-product otoacoustic emissions (DPOAEs) measured with higher-frequency stimuli in order to utilize these measures in clinical applications. The purpose of this study was to explore the dependence of DPOAE amplitude on the levels of the evoking stimuli at frequencies greater than 8 kHz, and make comparisons with those data that have been extensively measured with lower-frequency stimuli. To accomplish this, DPOAE amplitudes were measured at six different f2 frequencies (2, 5, 10, 12, 14, and 16 kHz), with a frequency ratio (f2/f1) of 1.2, at five fixed levels (30 to 70 dB SPL) of one primary (either f1 or f2), while the other primary was varied in level (30 to 70 dB SPL). Generally, the level separation between the two primary tones (L1 > L2) generating the largest DPOAE amplitude (referred to as the "optimal level separation") decreased as the level of the fixed primary increased. Additionally, the optimal level separation was frequency dependent, especially at the lower fixed primary tone levels ( < or = 50 dB SPL). In agreement with previous studies, the DPOAE level exhibited greater dependence on L1 than on L2.     

Place specificity of multiple auditory steady-state responses

Auditory steady-state responses (ASSRs) were elicited by simultaneously presenting multiple AM (amplitude-modulated) tones with carrier frequencies of 500, 1000, 2000, and 4000 Hz and modulation frequencies of 77, 85, 93, and 102 Hz, respectively. Responses were also evoked by separately presenting single 500- or 2000-Hz AM tones. The objectives of this study were (i) to determine the cochlear place specificity of single and multiple ASSRs using high-pass noise masking and derived-band responses, and (ii) to determine if there were any differences between single- and multiple-stimulus conditions. For all carrier frequencies, derived-band ASSRs for 1-octave-wide derived bands ranging in center frequency from 0.25 to 8 kHz had maximum amplitudes within a 1/2 octave of the carrier frequency. For simultaneously presented AM tones of 500, 1000, 2000, and 4000 Hz, bandwidths for the function of derived-band ASSR amplitude by derived-band center frequency were 476, 737, 1177, and 3039 Hz, respectively. There were no significant differences when compared to bandwidths of 486 and 1371 for ASSRs to AM tones of 500 or 2000 Hz presented separately. Results indicate that ASSRs to moderately intense stimuli (60 dB SPL) reflect activation of reasonably narrow cochlear regions, regardless of presenting AM tones simultaneously or separately.     

Growth of suppression in humans based on distortion-product otoacoustic emission measurements

Distortion-product otoacoustic emissions (DPOAEs) were used to describe suppression growth in normal-hearing humans. Data were collected at eight f(2) frequencies ranging from 0.5 to 8 kHz for L(2) levels ranging from 10 to 60 dB sensation level. For each f(2) and L(2) combination, suppression was measured for nine or eleven suppressor frequencies (f(3)) whose levels varied from -20 to 85 dB sound pressure level (SPL). Suppression grew nearly linearly when f(3) ≈ f(2), grew more rapidly for f(3)?< f(2), and grew more slowly for f(3)?> f(2). These results are consistent with physiological and mechanical data from lower animals, as well as previous DPOAE data from humans, although no previous DPOAE study has described suppression growth for as wide a range of frequencies and levels. These trends were evident for all f(2) and L(2) combinations; however, some exceptions were noted. Specifically, suppression growth rate was less steep as a function of f(3) for f(2) frequencies ≤ 1 kHz. Thus, despite the qualitative similarities across frequency, there were quantitative differences related to f(2), suggesting that there may be subtle differences in suppression for frequencies above 1 kHz compared to frequencies below 1 kHz.     

Temporal aspects of suppression in distortion-product otoacoustic emissions

This study examined the time course of cochlear suppression using a tone-burst suppressor to measure decrement of distortion-product otoacoustic emissions (DPOAEs). Seven normal-hearing subjects with ages ranging from 19 to 28 yr participated in the study. Each subject had audiometric thresholds ≤ 15 dB HL [re ANSI (2004) Specifications for Audiometers] for standard octave and inter-octave frequencies from 0.25 to 8 kHz. DPOAEs were elicited by primary tones with f(2)?= 4.0 kHz and f(1)?= 3.333 kHz (f(2)/f(1)?= 1.2). For the f(2), L(2) combination, suppression was measured for three suppressor frequencies: One suppressor below f(2) (3.834 kHz) and two above f(2) (4.166 and 4.282 kHz) at three levels (55, 60, and 65 dB SPL). DPOAE decrement as a function of L(3) for the tone-burst suppressor was similar to decrements obtained with longer duration suppressors. Onset- and setoff- latencies were ≤ 4 ms, in agreement with previous physiological findings in auditory-nerve fiber studies that suggest suppression results from a nearly instantaneous compression of the waveform. Persistence of suppression was absent for the below-frequency suppressor (f(3)?= 3.834 kHz) and was ≤ 3 ms for the two above-frequency suppressors (f(3)?= 4.166 and 4.282 kHz).     

Cochlear generation of intermodulation distortion revealed by DPOAE frequency functions in normal and impaired ears

Distortion product otoacoustic emission (DPOAE) frequency functions were measured in normal-hearing and hearing-impaired ears. A fixed-f2/swept-f1 paradigm was used with f2 fixed at half-octave intervals from 1 to 8 kHz. L1 was always 10 dB greater than L2, and L2 was varied from 65 to 10 dB SPL in 5-dB steps. The responses were quantified by the frequency and amplitude of the peak response. Peak responses were closer to f2 in higher frequency regions and for lower intensity stimulation. Results from hearing-impaired subjects suggest that audiometric thresholds at the distortion product frequency, fdp, in addition to hearing status at f2, can affect DPOAE results. Results are discussed in terms of several manifestations of a second resonance model, as well as a dual source model for the generation of DPOAEs as measured in the ear canal of humans. It appears that a dual source model accounts for the data better than second filter models.     

Distortion product otoacoustic emissions for hearing threshold estimation and differentiation between middle-ear and cochlear disorders in neonates

Our aim in the present study was to apply extrapolated DPOAE I/O-functions [J. Acoust. Soc. Am. 111, 1810-1818 (2002); 113, 3275-3284 (2003)] in neonates in order to investigate their ability to estimate hearing thresholds and to differentiate between middle-ear and cochlear disorders. DPOAEs were measured in neonates after birth (mean age = 3.2 days) and 4 weeks later (follow-up) at 11 test frequencies between f2 = 1.5 and 8 kHz and compared to that found in normal hearing subjects and cochlear hearing loss patients. On average, in a single ear hearing threshold estimation was possible at about 2/3 of the test frequencies. A sufficient test performance of the approach is therefore suggested. Thresholds were higher at the first measurement compared to that found at the follow-up measurement. Since thresholds varied with frequency, transitory middle ear dysfunction due to amniotic fluid instead of cochlear immaturity is suggested to be the cause for the change in thresholds. DPOAE behavior in the neonate ears differed from that found in the cochlear hearing loss ears. From a simple model it was concluded that the difference between the estimated DPOAE threshold and the DPOAE detection threshold is able to differentiate between sound conductive and cochlear hearing loss.     

Cochlear compression estimates from measurements of distortion-product otoacoustic emissions

Evidence of the compressive growth of basilar-membrane displacement can be seen in distortion-product otoacoustic emission (DPOAE) levels measured as a function of stimulus level. When the levels of the two stimulus tones (f1 and f2) are related by the formula L1 = 39 dB + 0.4 x L2 [Kummer et al., J. Acoust. Soc. Am. 103, 3431-3444 (1998)] the shape of the function relating DPOAE level to L2 is similar (up to an L2 of 70 dB SPL) to the classic Fletcher and Munson [J. Acoust. Soc. Am. 9, 1-10 (1933)] loudness function when plotted on a logarithmic scale. Explicit estimates of compression have been derived based on recent DPOAE measurements from the laboratory. If DPOAE growth rate is defined as the slope of the DPOAE I/O function (in dB/dB), then a cogent definition of compression is the reciprocal of the growth rate. In humans with normal hearing, compression varies from about 1 at threshold to about 4 at 70 dB SPL. With hearing loss, compression is still about 1 at threshold, but grows more slowly above threshold. Median DPOAE I/O data from ears with normal hearing, mild loss, and moderate loss are each well fit by log functions. When the I/O function is logarithmic, then the corresponding compression is a linear function of stimulus level. Evidence of cochlear compression also exists in DPOAE suppression tuning curves, which indicate the level of a third stimulus tone (f3) that reduces DPOAE level by 3 dB. All three stimulus tones generate compressive growth within the cochlea; however, only the relative compression (RC) of the primary and suppressor responses is observable in DPOAE suppression data. An RC value of 1 indicates that the cochlear responses to the primary and suppressor components grow at the same rate. In normal ears, RC rises to 4, when f3 is an octave below f2. The similarities between DPOAE and loudness compression estimates suggest the possibility of predicting loudness growth from DPOAEs; however, intersubject variability makes such predictions difficult at this time.     

Quantitative estimation of minor conductive hearing loss with distortion product otoacoustic emissions in the guinea pig

Subclinical conductive hearing losses (CHLs) can affect otoacoustic emissions and therefore limit their potential in the assessment of the cochlear function. Theoretical considerations to estimate a minor CHL from DPOAE measurements [Kummer et al. (2006). HNO 54, 457-467] are evaluated experimentally. They are based on the fact, that the level difference of the stimulus tones L(1) and L(2) for optimal excitation of the inner ear is given by L(1)=aL(2)+b. A CHL is presumed to attenuate both L(1) and L(2) to the same extent such that excitation of the inner ear is no longer optimal. From the change of L(1) that is necessary to restore optimal excitation of the inner ear and thus to produce maximal DPOAE levels, the CHL can be estimated. In 10 guinea pig ears an experimental CHL was produced, quantified by determination of compound action potential (CAP) thresholds at 8 kHz (CHL(CAP)) and estimated from DPOAE measurements at 8 kHz (CHL(DPOAE)). CHLs up to 12 dB could be assessed. CHL(DPOAE) correlated well with CHL(CAP) (R=0.741, p=0.0142). Mean difference between CHL(DPOAE) and CHL(CAP) was 4.2±2.6 dB. Estimation of minor CHL from DPOAE measurements might help to increase the diagnostic value of DPOAEs.     

Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. II. Interrelations between multicomponent DPOAEs, tone-burst-evoked OAEs, and spontaneous OAEs

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. It is well known that 2f1-f2 DPOAE amplitude increases as the f2/f1 ratio increases from 1.0 to about 1.20, and then decreases as the f2/f1 ratio increases above 1.20, showing an amplitude ratio function, which is thought to be related to cochlear filtering properties. Different lower sideband DPOAEs are believed to show the same amplitude ratio functions as the 2f1-f2 DPOAE, with a magnitude peak situated at a constant DPOAE frequency relative to f2. More recently, several studies have suggested the involvement of a DPOAE component coming from its own distortion product place as well as the DPOAE component coming from the f2 place. To investigate DPOAE generation sites and the importance of the DPOAE frequency place, amplitude ratio functions of 2f1-f2, 3f1-2f2, 4f1-3f2 and 2f2-f1, 3f2-2f1, 4f2-3f1 DPOAE components have been systematically studied in 18 normally hearing subjects, using an f2 fixed, f1 sweep method, and an f1 fixed, f2 sweep method, at ten different f2 frequencies. Results show a dependency of the distortion magnitude peak on f2 frequency for each lower sideband DPOAE, and a small frequency shift of the distortion peak for the high order lower sideband DPOAE components. Strong correlation between the different lower sideband DPOAE amplitude were obtained, whether they were recorded with the same f1 (and a different f2) or with the same f2 (and a different f1), suggesting that lower side-band DPOAE amplitude does not depend on small variations in the f2 frequency. Moreover, correlations between DPOAE amplitude and tone-burst evoked otoacoustic emissions (TBOAEs) are highly significant for TBOAEs centered at the f2 frequency and at 1/2 octave below the f2 frequency, suggesting some degree of importance of the cochlear status at frequencies below f2 in DPOAE amplitude. Subjects presenting spontaneous otoacoustic emissions showed a greater lower sideband DPOAE amplitude recorded for low f2/f1 ratios, and a distortion magnitude peak shifted towards higher frequencies. The best correlation between upper sideband DPOAE amplitude and lower sideband DPOAE amplitude occurred for lower sideband DPOAEs generated by an f2 frequency 1/2 octave to 1 octave below the primaries used to generate upper sideband DPOAEs, suggesting a site of generation basal to f2 for the upper sideband DPOAEs. Correlations between TBOAE amplitude and upper sideband DPOAE amplitude agreed with a site of upper sideband DPOAE generation basal to f2, and which would move with the DPOAE frequency itself.     

Impact of three hours of discotheque music on pure-tone thresholds and distortion product otoacoustic emissions

The aim of this study was to investigate whether distortion product otoacoustic emissions (DPOAEs) are a suitable means for detecting changes in outer hair cell (OHC) functionality due to exposure to three hours of discotheque music and whether efferent reflex strength of the medial olivocochlear bundle is able to predict the ear's susceptibility to high-level noise. High-resolution DPOAEs (Δf(2)=47 Hz) were recorded between 3.5 and 4.5 kHz at close-to-threshold primary tone levels. For comparison, high-resolution pure-tone audiometry was conducted in the same frequency range. Efferent reflex strength was measured by means of DPOAEs at a specific frequency with and without contralateral acoustic stimulation. A significant deterioration of more than 10 dB was found for pure-tone thresholds and DPOAE levels indicating that three hours of high-level noise exert a considerable influence on hearing capability and OHC functionality. A significant correlation between shifts in pure-tone threshold and shifts in DPOAE level occurred when removing data with differing calibration across measurements. There was no clear correlation between efferent reflex strength and shifts in pure-tone threshold or shifts in DPOAE level suggesting that the applied measures of efferent reflex strength may not be suitable for quantifying individual vulnerability to noise.     

Influence of in situ, sound-level calibration on distortion-product otoacoustic emission variability

Standing waves can cause errors during in-the-ear calibration of sound pressure level (SPL), affecting both stimulus magnitude and distortion-product otoacoustic emission (DPOAE) level. Sound intensity level (SIL) and forward pressure level (FPL) are two measurements theoretically unaffected by standing waves. SPL, SIL, and FPL in situ calibrations were compared by determining sensitivity of DPOAE level to probe-insertion depth (deep and "shallow") for a range of stimulus frequencies (1-8 kHz) and levels (20-60 dB). Probe-insertion depth was manipulated with the intent to shift the frequencies with standing-wave minima at the emission probe, introducing variability during SPL calibration. The absolute difference in DPOAE level between insertions was evaluated after correcting for an incidental change caused by the effect of ear-canal impedance on the emission traveling from the cochlea. A three-way analysis of variance found significant main effects for stimulus level, stimulus frequency, and calibration method, as well as significant interactions involving calibration method. All calibration methods exhibited changes in DPOAE level due to the insertion depth, especially above 4 kHz. However, SPL demonstrated the greatest changes across all stimulus levels for frequencies above 2 kHz, suggesting that SIL and FPL provide more consistent measurements of DPOAEs for frequencies susceptible to standing-wave calibration errors.     

Reliability of distortion-product otoacoustic emissions and their relation to loudness

The reliability of distortion-product otoacoustic emission (DPOAE) measurements and their relation to loudness measurements was examined in 16 normal-hearing subjects and 58 subjects with hearing loss. The level of the distortion product (L(d)) was compared across two sessions and resulted in correlations that exceeded 0.90. The reliability of DPOAEs was less when parameters from nonlinear fits to the input/output (I/O) functions were compared across visits. Next, the relationship between DPOAE I/O parameters and the slope of the low-level portion of the categorical loudness scaling (CLS) function (soft slope) was assessed. Correlations of 0.65, 0.74, and 0.81 at 1, 2, and 4 kHz were observed between CLS soft slope and combined DPOAE parameters. Behavioral threshold had correlations of 0.82, 0.83, and 0.88 at 1, 2, and 4 kHz with CLS soft slope. Combining DPOAEs and behavioral threshold provided little additional information. Lastly, a multivariate approach utilizing the entire DPOAE I/O function was used to predict the CLS rating for each input level (dB SPL). Standard error of the estimate when using this method ranged from 2.4 to 3.0 categorical units (CU), suggesting that DPOAE I/O functions can predict CLS measures within the CU step size used in this study (5).     

Breaking away: violation of distortion emission phase-frequency invariance at low frequencies

The phase versus frequency function of the distortion product otoacoustic emission (DPOAE) at 2f(1) - f(2) is approximately invariant at frequencies above 1.5 kHz in human subjects when recorded with a constant f(2)/f(1). However, a secular break from this invariance has been observed at lower frequencies where the phase-gradient becomes markedly steeper. Apical DPOAEs, such as 2f(1)?- f(2), are known to contain contributions from multiple sources. This experiment asked whether the phase behavior of the ear canal DPOAE at low frequencies is driven by the phase of the component from the distortion product (DP) region at 2f(1)?- f(2), which exhibits rapid phase accumulation. Placing a suppressor tone close in the frequency to 2f(1)?- f(2) reduced the contribution of this component to the ear canal DPOAE in normal-hearing adult human ears. When the contribution of this component was reduced, the phase behavior of the ear canal DPOAE was not altered, suggesting that the breaking from DPOAE phase invariance at low frequencies is an outcome of apical-basal differences in cochlear mechanics. The deviation from DPOAE phase invariance appears to be a manifestation of the breaking from approximate scaling symmetry in the human cochlear apex.     

Distortion product otoacoustic emission test performance when both 2f1-f2 and 2f2-f1 are used to predict auditory status

The objective of this study was to determine whether distortion product otoacoustic emission (DPOAE) test performance, defined as its ability to distinguish normal-hearing ears from those with hearing loss, can be improved by examining response and noise amplitudes at 2 f1-f2 and 2f2-f1 simultaneously. In addition, there was interest in knowing whether measurements at both DPs and for several primary frequency pairs can be used in a multivariate analysis to further optimize test performance. DPOAE and noise amplitudes were measured at 2f1-f2 and 2 f2-f1 for 12 primary levels (L2 from 10 to 65 dB SPL in 5-dB steps) and 9 pairs of primary frequencies (0.5 to 8 kHz in 1/2-octave steps). All data were collected in a sound-treated room from 70 subjects with normal hearing and 80 subjects with hearing loss. Subjects had normal middle-ear function at the time of the DPOAE test, based on standard tympanometric measurements. Measurement-based stopping rules were used such that the test terminated when the noise floor around the 2 f1-f2 DP was < or = -30 dB SPL or after 32 s of artifact-free averaging, whichever occurred first. Data were analyzed using clinical decision theory in which relative operating characteristics (ROC) curves were constructed and areas under the ROC curves were estimated. In addition, test performance was assessed by selecting the criterion value that resulted in a sensitivity of 90% and determining the specificity at that criterion value. Data were analyzed using traditional univariate comparisons, in which predictions about auditory status were based only on data obtained when f2 = audiometric frequency. In addition, multivariate analysis techniques were used to determine whether test performance can be optimized by using many variables to predict auditory status. As expected, DPOAEs were larger for 2f1-f2 compared to 2 f2-f1 in subjects with normal hearing. However, noise amplitudes were smaller for 2f2-f1, but this effect was restricted to the lowest f2 frequencies. A comparison of signal-to-noise ratios (SNR) within normal-hearing ears showed that the 2f1-f2 DP was more frequently characterized by larger SNRs compared to 2f2-f1. However, there were several subjects in whom 2f2-f1 produced a larger SNR. ROC curve areas and specificities for a fixed sensitivity increased only slightly when data from both DPs were used to predict auditory status. Multivariate analyses, in which the inputs included both DPs for several primary frequency pairs surrounding each audiometric frequency, produced the highest areas and specificities. Thus, DPOAE test performance was improved slightly by examining data at two DP frequencies simultaneously. This improvement was achieved at no additional cost in terms of test time. When measurements at both DPs were combined with data obtained for several primary frequency pairs and then analyzed in a multivariate context, the best test performance was achieved. Excellent test performance (ROC) curve areas >0.95% and specificities >92% at all frequencies, including 500 Hz, were achieved for these conditions. Although the results described should be validated on an independent set of data, they suggest that the accuracy with which DPOAE measurements identify auditory status can be improved with multivariate analyses and measurements at multiple DPs.