Maturation of cochlear nonlinearity as measured by distortion product otoacoustic emission suppression growth in humans

The growth of distortion product otoacoustic emission (DPOAE) suppression follows a systematic, frequency-dependent pattern. The pattern is consistent with direct measures of basilar-membrane response growth, psychoacoustic measures of masking growth, and measures of neural rate growth. This pattern has its basis in the recognized nonlinear properties of basilar-membrane motion and, as such, the DPOAE suppression growth paradigm can be applied to human neonates to study the maturation of cochlear nonlinearity. The objective of this experiment was to investigate the maturation of human cochlear nonlinearity and define the time course for this maturational process. Normal-hearing adults, children, term-born neonates, and premature neonates, plus a small number of children with sensorineural hearing loss, were included in this experiment. DPOAE suppression growth was measured at two f2 frequencies (1500 and 6000 Hz) and three primary tone levels (55-45, 65-55, and 75-65 dB SPL). Slope of DPOAE suppression growth, as well as an asymmetry ratio (to compare slope for suppressor tones below and above f2 frequency), were generated. Suppression threshold was also measured in all subjects. Findings indicate that both term-born neonates and premature neonates who have attained term-like age, show non-adult-like DPOAE suppression growth for low-frequency suppressor tones. These age effects are most evident at f2 = 6000 Hz. In neonates, suppression growth is shallower and suppression thresholds are elevated for suppressor tones lower in frequency than f2. Additionally, the asymmetry ratio is smaller in neonates, indicating that the typical frequency-dependent pattern of suppression growth is not present. These findings suggest that an immaturity of cochlear nonlinearity persists into the first months of postnatal life. DPOAE suppression growth examined for a small group of hearing-impaired children also showed abnormalities.