Circadian and menstrual rhythms in frequency variations of spontaneous otoacoustic emissions from human ears

Something in Our Ears Is Oscillating, but What? A Modeller's View of Efforts to Model Spontaneous Emissions

When David Kemp discovered "spontaneous ear noise" in 1978, it opened up a whole new perspective on how the cochlea works. The continuous tonal sound emerging from most healthy human ears, now called spontaneous otoacoustic emissions or SOAEs, was an unmistakable sign that our hearing organ must be considered an active detector, not just a passive microphone, just as Thomas Gold had speculated some 30 years earlier. Clearly, something is oscillating as a byproduct of that sensitive inbuilt detector, but what exactly is it? Here, we give a chronological account of efforts to model SOAEs as some form of oscillator, and at intervals, we illustrate key concepts with numerical simulations. We find that after many decades there is still no consensus, and the debate extends to whether the oscillator is local, confined to discrete local sources on the basilar membrane, or global, in which an assembly of micro-mechanical elements and basilar membrane sections, coupled by inner ear fluid, interact over a wide region. It is also undecided whether the cochlear oscillator is best described in terms of the well-known Van der Pol oscillator or the less familiar Duffing or Hopf oscillators. We find that irregularities play a key role in generating the emissions. This paper is not a systematic review of SOAEs and their properties but more a historical survey of the way in which various oscillator configurations have been applied to modelling human ears. The conclusion is that the difference between the local and global approaches is not clear-cut, and they are probably not mutually exclusive concepts. Nevertheless, when one sees how closely human SOAEs can be matched to certain arrangements of oscillators, Gold would no doubt say we are on the right track.

Expression profiling of cochlear genes uncovers sex-based cellular function in mouse cochleae

Sex is a pivotal biological factor that significantly impacts tissue homeostasis and disease susceptibility. In the auditory system, sex differences have been observed in cochlear physiology and responses to pathological conditions. However, the underlying molecular mechanisms responsible for these differences remain elusive. The current research explores the differences in gene expression profiles in the cochlea between male and female mice, aiming to understand the functional implication of sex-biased gene expression in each sex. Using RNA-sequencing analysis on cochlear tissues obtained from male and female mice, we identified a significant number of genes exhibiting sex-biased expression differences. While some of these differentially expressed genes are located on sex chromosomes, most are found on autosomal chromosomes. Further bioinformatic analysis revealed that these genes are involved in several key cellular functions. In males, these genes are notably linked to oxidative phosphorylation and RNA synthesis and processing, suggesting their involvement in mitochondrial energy production and regulatory control of gene expression. In contrast, sex-biased genes are associated with mechano-transduction and synaptic transmission within female cochleae. Collectively, our study provides valuable insights into the molecular differences between the sexes and emphasizes the need for future research to uncover their functional implications and relevance to auditory health and disease development.

Studying of Distortion Product of Otoacoustic Emissions in Menopausal Women

Introduction

The sex hormones; estrogen and progesterone have a direct effect on the mechanisms of the inner cochlea and they control the functions of the ascending auditory pathway from the auditory nerve to the cerebral cortex. Therefore, the aim of this study was to determine the amplitude of distortion product of otoacoustic emissions (DPOAE) in postmenopausal women.

Materials and Methods

This cross-sectional case-control study included 60 women who were naturally menopausal and were in the age range of 55 - 45 years (case group). The other 60 included women of the same age and non-menopause (control group). Both groups were selected from individuals who had normal auditory function based on pure tone audiometry, immitance audiometry (tympanometry + ipsilateral and contralateral reflex), speech tests and auditory brainstem responses. Then both groups were evaluated by DPOAE and its findings were analyzed in two groups based on independent t-test and the significance level of the test was determined to be less than 0.05.

Results

The difference between the mean DPOAE domains in the two groups was not significant (P-value = 0.484).

Conclusion

Menopause is not an etiological factor to be created of abnormalities in the cochlea of ​​the inner ear.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-022-03210-1.

Fluctuations of Otoacoustic Emissions and Medial Olivocochlear Reflexes: Tracking One Subject over a Year

The purpose of the study was to measure the variability of transiently evoked otoacoustic emissions (TEOAEs) and the medial olivocochlear reflex (MOCR) over a long period of time in one person. TEOAEs with and without contralateral acoustic stimulation (CAS) by white noise were measured, from which MOCR strength could be derived as either a dB or % change. In this longitudinal case study, measurements were performed on the right and left ears of a young, normally hearing adult female once a week for 1 year. The results showed that TEOAE level and MOCR strength fluctuated over the year but tended to remain close to a baseline level, with standard deviations of around 0.5 dB and 0.05 dB, respectively. The TEOAE latencies at frequencies from 1 to 4 kHz were relatively stable, with maximum changes ranging from 0.5 ms for the 1 kHz band to 0.08 ms for the 4 kHz band. TEOAE levels and MOCR strengths were strongly and negatively correlated, meaning that the higher the TEOAE level, the lower the MOCR. Additionally, comparison of fluctuations between the ears revealed positive correlation, i.e., the higher the TEOAE level or MOCR in one ear, the higher in the second ear.

The resting frequency of echolocation signals changes with body temperature in the hipposiderid bat Hipposideros armiger

Doppler shift (DS) compensating bats adjust in flight the second harmonic of the constant-frequency component (CF2) of their echolocation signals so that the frequency of the Doppler-shifted echoes returning from ahead is kept constant with high precision (0.1-0.2%) at the so-called reference frequency (fref). This feedback adjustment is mediated by an audio-vocal control system that correlates with a maximal activation of the foveal resonance area in the cochlea. Stationary bats adjust the average CF2 with similar precision at the resting frequency (frest), which is slightly below the fref. Over a range of time periods (from minutes up to years), variations of the coupled fref and frest have been observed, and were attributed to age, social influences and behavioural situations in rhinolophids and hipposiderids, and to body temperature effects and flight activity in Pteronotus parnellii. We assume that, for all DS-compensating bats, a change in body temperature has a strong effect on the activation state of the foveal resonance area in the cochlea, which leads to a concomitant change in emission frequency. We tested our hypothesis in a hipposiderid bat, Hipposideros armiger, and measured how the circadian variation of body temperature at activation phases affected frest. With a miniature temperature logger, we recorded the skin temperature on the back of the bats simultaneously with echolocation signals produced. During warm-up from torpor, strong temperature increases were accompanied by an increase in frest, of up to 1.44 kHz. We discuss the implications of our results for the organization and function of the audio-vocal control systems of all DS-compensating bats.

Association Between Nonoptimal Blood Pressure and Cochlear Function

OBJECTIVES

The association between hearing loss and risk factors for cardiovascular disease, including high blood pressure (BP), has been evaluated in numerous studies. However, data from population- and laboratory-based studies remain inconclusive. Furthermore, most prior work has focused on the effects of BP level on behavioral hearing sensitivity. In this study, we investigated cochlear integrity using distortion product otoacoustic emissions (DPOAEs) in persons with subtle elevation in BP levels (nonoptimal BP) hypothesizing that nonoptimal BP would be associated with poorer cochlear function.

DESIGN

Sixty individuals [55% male, mean age = 31.82 (SD = 11.17) years] took part in the study. The authors measured pure-tone audiometric thresholds from 0.25 to 16 kHz and computed four pure-tone averages (PTAs) for the following frequency combinations (in kHz): PTA0.25, 0.5, 0.75, PTA1, 1.5, 2, 3, PTA4, 6, 8, and PTA10, 12.5, 16. DPOAEs at the frequency 2f1-f2 were recorded for L1/L2 = 65/55 dB SPL using an f2/f1 ratio of 1.22. BP was measured, and subjects were categorized as having either optimal BP (systolic/diastolic <120 and <80 mm Hg) or nonoptimal BP (systolic ≥120 or diastolic ≥80 mm Hg or use of antihypertensives). Between-group differences in behavioral thresholds and DPOAE levels were evaluated using 95% confidence intervals. Pearson product-moment correlations were run to assess the relationships between: (1) thresholds (all four PTAs) and BP level and (2) DPOAE [at low (f2 ≤ 2 kHz), mid (f2 > 2 kHz and ≤10 kHz), and high (f2 > 10 kHz) frequency bins] and BP level. Linear mixed-effects models were constructed to account for the effects of BP status, stimulus frequency, age and sex on thresholds, and DPOAE amplitudes.

RESULTS

Significant positive correlations between diastolic BP and all four PTAs and systolic BP and PTA0.25, 0.5, 0.75 and PTA4, 6, 8 were observed. There was not a significant effect of BP status on hearing thresholds from 0.5 to 16 kHz after adjustment for age, sex, and frequency. Correlations between diastolic and systolic BP and DPOAE levels were statistically significant at the high frequencies and for the relationship between diastolic BP and DPOAE level at the mid frequencies. Averaged across frequency, the nonoptimal BP group had DPOAE levels 1.50 dB lower (poorer) than the optimal BP group and differences were statistically significant (p = 0.03).

CONCLUSIONS

Initial findings suggest significant correlations between diastolic BP and behavioral thresholds and diastolic BP and mid-frequency DPOAE levels. However, adjusted models indicate other factors are more important drivers of impaired auditory function. Contrary to our hypothesis, we found that subtle BP elevation was not associated with poorer hearing sensitivity or cochlear dysfunction. We consider explanations for the null results. Greater elevation in BP (i.e., hypertension itself) may be associated with more pronounced effects on cochlear function, warranting further investigation. This study suggests that OAEs may be a viable tool to characterize the relationship between cardiometabolic risk factors (and in particular, stage 2 hypertension) and hearing health.

Auditory evoked potentials: Differences by sex, race, and menstrual cycle and correlations with common psychoacoustical tasks

Auditory brainstem responses (ABRs) and auditory middle-latency responses (AMLRs) to a click stimulus were measured in about 100 subjects. Of interest were the sex differences in those auditory evoked potentials (AEPs), the correlations between the various AEP measures, and the correlations between the AEP measures and measures of otoacoustic emissions (OAEs) and behavioral performance also measured on the same subjects. Also of interest was how the menstrual cycle affected the various AEP measures. Most ABR measures and several AMLR measures exhibited sex differences, and many of the former were substantial. The sex differences tended to be larger for latency than for amplitude of the waves, and they tended to be larger for a weak click stimulus than for a strong click. The largest sex difference was for Wave-V latency (effect size ~1.2). When subjects were dichotomized into Non-Whites and Whites, the race differences in AEPs were small within sex. However, sex and race interacted so that the sex differences often were larger for the White subjects than for the Non-White subjects, particularly for the latency measures. Contrary to the literature, no AEP measures differed markedly across the menstrual cycle. Correlations between various AEP measures, and between AEP and OAE measures, were small and showed no consistent patterns across sex or race categories. Performance on seven common psychoacoustical tasks was only weakly correlated with individual AEP measures (just as was true for the OAEs also measured on these subjects). AMLR Wave Pa unexpectedly did not show the decrease in latency and increase in amplitude typically observed for AEPs when click level was varied from 40 to 70 dB nHL (normal Hearing Level). For the majority of the measures, the variability of the distribution of scores was greater for the males than for the females.

Age-related hearing loss: Why we need to think about sex as a biological variable

It has long been known that age-related hearing loss (ARHL) is more common, more severe, and with an earlier onset in men compared to women. Even in the absence of confounding factors such as noise exposure, these sexdifferences in susceptibility to ARHL remain. In the last decade, insight into the pleiotrophic nature by which estrogen signaling can impact multiple signaling mechanisms to mediate downstream changes in gene expression and/or elicit rapid changes in cellular function has rapidly gathered pace, and a role for estrogen signaling in the biological pathways that confer neuroprotection is becoming undeniable. Here I review the evidence why we need to consider sex as a biological variable (SABV) when investigating the etiology of ARHL. Loss of auditory function with aging is frequency-specific and modulated by SABV. Evidence also suggests that differences in cochlear physiology between women and men are already present from birth. Understanding the molecular basis of these sex differences in ARHL will accelerate the development of precision medicine therapies for ARHL.

Postnatal Effects of Sex Hormones on Click-Evoked Otoacoustic Emissions: A Study of Adolescents with Gender Dysphoria

Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds, generated by the inner ear in response to click-stimuli. A sex difference in emission strength is observed in neonates and adults, with weaker CEOAE amplitudes in males. These differences are assumed to originate from testosterone influences during prenatal male sexual differentiation and to remain stable throughout life. However, recent studies suggested activational, postnatal effects of sex hormones on CEOAEs. Adolescents diagnosed with gender dysphoria (GD) may receive gonadotropin-releasing hormone analogs (GnRHa) in order to suppress endogenous sex hormones and, therefore, pubertal maturation, followed by cross-sex hormone (CSH) treatment. Using a cross-sectional design, we examined whether hormonal interventions in adolescents diagnosed with GD (62 trans boys, assigned female at birth, self-identifying as male; 43 trans girls, assigned male at birth, self-identifying as female), affected their CEOAEs compared to age- and sex-matched controls (44 boys, 37 girls). Sex-typical differences in CEOAE amplitude were observed among cisgender controls and treatment-naïve trans boys but not in other groups with GD. Treatment-naïve trans girls tended to have more female-typical CEOAEs, suggesting hypomasculinized early sexual differentiation, in support of a prominent hypothesis on the etiology of GD. In line with the predicted suppressive effects of androgens, trans boys receiving CSH treatment, i.e., testosterone plus GnRHa, showed significantly weaker right-ear CEOAEs compared with control girls. A similar trend was seen in trans boys treated with GnRHa only. Unexpectedly, trans girls showed CEOAE masculinization with addition of estradiol. Our findings show that CEOAEs may not be used as an unequivocal measure of prenatal androgen exposure as they can be modulated postnatally by sex hormones, in the form of hormonal treatment.

Differences in common psychoacoustical tasks by sex, menstrual cycle, and race

The psychoacoustical literature contains multiple reports about small differences in performance depending upon the sex and phase of the menstrual cycle of the subjects. In an attempt to verify these past reports, a large-scale study was implemented. After extensive training, the performance of about 75 listeners was measured on seven common psychoacoustical tasks. For most tasks, the signal was a 3.0-kHz tone. The initial data analyses failed to confirm some past outcomes. Additional analyses, incorporating the limited information available about the racial background of the listeners, did confirm some of the past reports, with the direction and magnitude of the differences often diverging for the White and Non-White listeners. Sex differences and race differences interacted for six of the seven tasks studied. These interactions suggest that racial background needs to be considered when making generalizations about human auditory performance, and when considering failures of reproducibility across studies. Menstrual differences were small, but generally larger for Whites than Non-Whites. Hormonal effects may be responsible for the sex and cycle differences that do exist, and differences in intra-cochlear melanocytes may account for the race differences.

The 1.06 frequency ratio in the cochlea: evidence and outlook for a natural musical semitone

A frequency ratio of about 1.06 often appears in cochlear mechanics, and the question naturally arises, why? The ratio is close to that of the semitone (1.059) in music, giving reason to think that this aspect of musical perception might have a cochlear basis. Here, data on synchronised spontaneous otoacoustic emissions is presented, and a clustering of ratios between 1.05 and 1.07 is found with a peak at 1.063 ± 0.005. These findings reinforce what has been found from previous sources, which are reviewed and placed alongside the present work. The review establishes that a peak in the vicinity of 1.06 has often been found in human cochlear data. Several possible cochlear models for explaining the findings are described. Irrespective of which model is selected, the fact remains that the cochlea itself appears to be the origin of a ratio remarkably close to an equal-tempered musical semitone, and this close coincidence leads to the suggestion that the inner ear may play a role in constructing a natural theory of music. The outlook for such an enterprise is surveyed.

Do sex differences in CEOAEs and 2D:4D ratios reflect androgen exposure? A study in women with complete androgen insensitivity syndrome

Background

Studies investigating the influence of perinatal hormone exposure on sexually differentiated traits would greatly benefit from biomarkers of these early hormone actions. Click-evoked otoacoustic emissions show sex differences that are thought to reflect differences in early androgen exposure. Women with complete androgen insensitivity syndrome (CAIS), who lack androgen action in the presence of XY-chromosomes, enabled us to study the effect of complete androgen inaction. The main goal was to investigate a possible link between click-evoked otoacoustic emissions and effective androgen exposure and, thus, whether this can be used as a biomarker. In addition, we aimed to replicate the only previous 2nd vs 4th digit-ratio study in women with CAIS, because despite the widely expressed criticisms of the validity of this measure as a biomarker for prenatal androgen exposure, it still is used for this purpose.

Methods

Click-evoked otoacoustic emissions and digit ratios from women with CAIS were compared to those from control men and women.

Results

The typical sex differences in click-evoked otoacoustic emissions and digit ratios were replicated in the control groups. Women with CAIS showed a tendency towards feminine, i.e., larger, click-evoked otoacoustic emission amplitudes in the right ear, and a significant female-typical, i.e., larger, digit ratio in the right hand. Although these results are consistent with androgen-dependent development of male-typical click-evoked otoacoustic emission amplitude and 2nd to 4th digit ratios, the within-group variability of these two measures was not reduced in women with CAIS compared with control women.

Conclusions

In line with previous studies, our findings in CAIS women suggest that additional, non-androgenic, factors mediate male-typical sexual differentiation of digit ratios and click-evoked otoacoustic emissions. Consequently, use of these measures in adults as retrospective markers of early androgen exposure is not recommended.

Validation of a noninvasive test routinely used in otology for the diagnosis of cerebrospinal fluid shunt malfunction in patients with normal pressure hydrocephalus

OBJECT

Ventriculoperitoneal shunting is the first-line treatment for normal pressure hydrocephalus. Noninvasive auditory tests based on recorded otoacoustic emissions were assessed, as currently used for universal neonatal hearing screenings, for the diagnosis of cerebrospinal fluid shunt malfunction. The test was designed based on previous works, which demonstrated that an intracranial pressure change induces a proportional, characteristic, otoacoustic-emission phase shift.

METHODS

Forty-four patients with normal pressure hydrocephalus (23 idiopathic and 21 secondary cases) were included in this prospective observational study. The male:female sex ratio was 1.44, the age range was 21–87 years (mean age 64.3 years), and the range of the follow-up period was 1–3 years (mean 20 months). Patients were implanted with a Sophy SU8 adjustable-pressure valve as the ventriculoperitoneal shunt. The phase shifts of otoacoustic emissions in response to body tilt were measured preoperatively, immediately postoperatively, and at 3–6 months, 7–15 months, 16–24 months, and more than 24 months postoperatively. Three groups were enrolled: Group 1, 19 patients who required no valve opening-pressure adjustment; Group 2, 18 patients who required valve opening-pressure adjustments; and Group 3, 7 patients who required valve replacement.

RESULTS

In Group 1, phase shift, which was positive before surgery, became steadily negative after surgery and during the follow-up. In Group 2, phase shift, which was positive before surgery, became negative immediately after surgery and increasingly negative after a decrease in the valve-opening pressure. In Group 3, phase shift was positive in 6 cases and slightly negative in 1 case before revision, but after revision phase shift became significantly negative in all cases.

CONCLUSIONS

Otoacoustic emissions noninvasively reflect cerebrospinal fluid shunt function and are impacted by valve-opening pressure adjustments. Otoacoustic emissions consistently diagnosed shunt malfunction and predicted the need for surgical revision. The authors’ diagnostic test, which can be repeated without risk or discomfort by an unskilled operator, may address the crucial need of detecting valve dysfunction in patients with poor clinical outcome after shunt surgery.

Sleep Disturbance and Altered Expression of Circadian Clock Genes in Patients With Sudden Sensorineural Hearing Loss

The cause of sudden sensorineural hearing loss (SSNHL) remains unclear and therefore it is often considered as idiopathic. Sleep disturbance has been linked to SSNHL and circadian rhythm disruption, but the link between circadian rhythm disruption and SSNHL has never been investigated.In this study, we surveyed the sleep quality of 38 patients with SSNHL using a simple insomnia sleep questionnaire. The expression of circadian clock genes in peripheral blood (PB) leukocytes from 38 patients with SSNHL and 71 healthy subjects was accessed using real-time quantitative reverse transcriptase-polymerase chain reaction and validated using immunocytochemical staining.We found that 61.8% of patients with SSNHL suffered from insomnia before the insult of hearing loss. Besides, significantly decreased expression of PER1, CRY1, CRY2, CLOCK, BMAL1, and CKlε was found in PB leukocytes of patients with SSNHL when compared with healthy subjects. SSNHL patients with vertigo had significantly lower expression of CRY1 and CKlε than patients without vertigo symptoms. Our results imply the association of sleep disturbance and disrupted circadian rhythm in SSNHL.

Click-evoked otoacoustic emissions in children and adolescents with gender identity disorder

Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds that are produced by the inner ear in response to click-stimuli. CEOAEs generally have a higher amplitude in women compared to men and neonates already show a similar sex difference in CEOAEs. Weaker responses in males are proposed to originate from elevated levels of testosterone during perinatal sexual differentiation. Therefore, CEOAEs may be used as a retrospective indicator of someone's perinatal androgen environment. Individuals diagnosed with Gender Identity Disorder (GID), according to DSM-IV-TR, are characterized by a strong identification with the other gender and discomfort about their natal sex. Although the etiology of GID is far from established, it is hypothesized that atypical levels of sex steroids during a critical period of sexual differentiation of the brain might play a role. In the present study, we compared CEOAEs in treatment-naïve children and adolescents with early-onset GID (24 natal boys, 23 natal girls) and control subjects (65 boys, 62 girls). We replicated the sex difference in CEOAE response amplitude in the control group. This sex difference, however, was not present in the GID groups. Boys with GID showed stronger, more female-typical CEOAEs whereas girls with GID did not differ in emission strength compared to control girls. Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys.

Low-frequency sound affects active micromechanics in the human inner ear

Noise-induced hearing loss is one of the most common auditory pathologies, resulting from overstimulation of the human cochlea, an exquisitely sensitive micromechanical device. At very low frequencies (less than 250 Hz), however, the sensitivity of human hearing, and therefore the perceived loudness is poor. The perceived loudness is mediated by the inner hair cells of the cochlea which are driven very inadequately at low frequencies. To assess the impact of low-frequency (LF) sound, we exploited a by-product of the active amplification of sound outer hair cells (OHCs) perform, so-called spontaneous otoacoustic emissions. These are faint sounds produced by the inner ear that can be used to detect changes of cochlear physiology. We show that a short exposure to perceptually unobtrusive, LF sounds significantly affects OHCs: a 90 s, 80 dB(A) LF sound induced slow, concordant and positively correlated frequency and level oscillations of spontaneous otoacoustic emissions that lasted for about 2 min after LF sound offset. LF sounds, contrary to their unobtrusive perception, strongly stimulate the human cochlea and affect amplification processes in the most sensitive and important frequency range of human hearing.

Estrogenic modulation of auditory processing: a vertebrate comparison

Sex-steroid hormones are well-known regulators of vocal motor behavior in several organisms. A large body of evidence now indicates that these same hormones modulate processing at multiple levels of the ascending auditory pathway. The goal of this review is to provide a comparative analysis of the role of estrogens in vertebrate auditory function. Four major conclusions can be drawn from the literature: First, estrogens may influence the development of the mammalian auditory system. Second, estrogenic signaling protects the mammalian auditory system from noise- and age-related damage. Third, estrogens optimize auditory processing during periods of reproductive readiness in multiple vertebrate lineages. Finally, brain-derived estrogens can act locally to enhance auditory response properties in at least one avian species. This comparative examination may lead to a better appreciation of the role of estrogens in the processing of natural vocalizations and mayprovide useful insights toward alleviating auditory dysfunctions emanating from hormonal imbalances.

Comparison of Transient and Distortion-Product Otoacoustic Emissions during the Luteal and Follicular Phases of the Menstrual Cycle

We conducted a study to examine cochlear activity in women with a naturally occurring menstrual cycle by measuring transient otoacoustic emissions (TOAEs) and distortion-product otoacoustic emissions (DPOAEs). Our study population was made up of 11 women aged 20 to 40 years (mean: 35.6) who were not taking a contraceptive medication or hormone therapy. Measurements of TOAEs and DPOAEs were made during both the follicular phase and the luteal phase of the menstrual cycle. We found no statistically significant difference in any of the TOAE amplitude values between the two phases. Although a sharp decrease at the 0.75 kHz frequency was seen in DPOAEs during both phases, none of the amplitude values in the tested frequencies were significantly different between the two phases. The absence of TOAE and DPOAE amplitude changes suggests that it is unnecessary to take into account the phase of the menstrual cycle when interpreting the results of otoacoustic emissions testing.

The effect of static ear canal pressure on human spontaneous otoacoustic emissions: spectral width as a measure of the intra-cochlear oscillation amplitude

Spontaneous otoacoustic emissions can be detected as peaks in the Fourier spectrum of a microphone signal recorded from the ear canal. The height, center frequency, and spectral width of SOAE peaks changed when a static pressure was applied to the ear canal. Most commonly, with either increasing or decreasing static pressure, the frequency increased, the amplitude decreased, and the width increased. These changes are believed to result from changes in the middle ear properties. Specifically, reduced middle ear transmission is assumed to attenuate the amplitude of emissions. We reconsidered this explanation by investigating the relation between peak height and width. We showed that the spectral width of SOAE peaks is approximately proportional to \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ 1/\sqrt {{{\hbox{peak}}\;{\hbox{height}}}} $$\end{document}. This is consistent with a (Rayleigh) oscillator model in which broadening of the SOAE peak is caused by broadband intra-cochlear noise, which is assumed to be independent of static ear canal pressure. The relation between emission peak height and width implicates that the intra-cochlear oscillation amplitude attentuates relative to the intra-cochlear noise level when a static ear canal pressure is applied. Apparently, ear canal static pressure directly affects the active mechanics in the inner ear.

Long-term stability of spontaneous otoacoustic emissions

Spontaneous otoacoustic emissions (SOAEs) were measured longitudinally for durations up to 19.5 years. Initial ages of the subjects ranged from 6 to 41 years. The most compelling finding was a decrease in frequency of all emissions in all subjects, which was approximately linear in %/year and averaged 0.25%/year. SOAE levels also tended to decrease with age, a trend that was significant, but not consistent across emissions, either within or across subjects. Levels of individual SOAEs might decrease, increase, or remain relatively constant with age. Several types of frequency/level instabilities were noted in which some SOAEs within an ear interacted such that their levels were negatively correlated. These instabilities often persisted for many years. SOAEs were also measured in two females over the course of their pregnancies. No changes in SOAE levels or frequencies were seen, that were larger than have been reported in females over a menstrual cycle, suggesting that levels of female gonadal hormones do not have a significant direct effect on SOAE frequencies or levels.

Effects of glycerol intake and body tilt on otoacoustic emissions reflect labyrinthine pressure changes in Menière's disease

It is known that by influencing stapes stiffness thus the ear's impedance, changes in intracranial and intralabyrinthine pressure induce a characteristic phase shift in otoacoustic emissions (OAE) around 1 kHz in human ears. Thus, if the regulation of pressure in intralabyrinthine compartments were abnormal in Menière patients, OAEs might help detect it. Body tilt, which acts on intracranial pressure, and administration of an osmotically active substance provide two simple ways of manipulating intralabyrinthine pressure. Here, 14 patients with typical signs of an attack of unilateral endolymphatic hydrops were submitted to postural changes and a glycerol test. Their OAEs initially collected in upright position served as references, then OAEs were measured in supine position, and back to the upright posture one and 3h after glycerol intake. Twenty control subjects were also tested for body tilt. The main effect of body tilt and glycerol was a phase rotation of OAEs peaking around 1 kHz. Its frequency dependence matched the one due to a pressure-related change in stapes or basilar membrane stiffness predicted by the ear model of Zwislocki (1962). The average glycerol-induced phase shifts were similar in size in Menière vs. asymptomatic ear and audiometric thresholds were stable after glycerol intake in line with the model predicting little change in the magnitude of the transfer function. These data support a simple conductive pressure-related mechanism explaining the action of glycerol on inner ear responses. The fact that the mean postural shift was three times larger in Menière than asymptomatic and control ears suggests an additional effect in allegedly hydropic ears.

Effects of low-frequency biasing on spontaneous otoacoustic emissions: frequency modulation

It was previously reported that low-frequency biasing of cochlear structures can suppress and modulate the amplitudes of spontaneous otoacoustic emissions (SOAEs) in humans [Bian, L. and Watts, K. L. (2008). "Effects of low-frequency biasing on spontaneous otoacoustic emissions: Amplitude modulation," J. Acoust. Soc. Am. 123, 887-898]. In addition to amplitude modulation, the bias tone produced an upward shift of the SOAE frequency and a frequency modulation. These frequency effects usually occurred prior to significant modifications of SOAE amplitudes and were dependent on the relative strength of the bias tone and a particular SOAE. The overall SOAE frequency shifts were usually less than 2%. A quasistatic modulation pattern showed that biasing in either positive or negative pressure direction increased SOAE frequency. The instantaneous SOAE frequency revealed a "W-shaped" modulation pattern within one biasing cycle. The SOAE frequency was maximal at the biasing extremes and minimized at the zero crossings of the bias tone. The temporal modulation of SOAE frequency occurred with a short delay. These static and dynamic effects indicate that modifications of the mechanical properties of the cochlear transducer could underlie the frequency shift and modulation. These biasing effects are consistent with the suppression and modulation of SOAE amplitude due to shifting of the cochlear transducer operating point.

Transmission of infrasonic pressure waves from cerebrospinal to intralabyrinthine fluids through the human cochlear aqueduct: Non-invasive measurements with otoacoustic emissions

The cochlear aqueduct connecting intralabyrinthine and cerebrospinal fluids (CSF) acts as a low-pass filter that should be able to transmit infrasonic pressure waves from CSF to cochlea. Recent experiments have shown that otoacoustic emissions generated at 1kHz respond to pressure-related stapes impedance changes with a change in phase relative to the generator tones, and provide a non-invasive means of assessing intracochlear pressure changes. In order to characterize the transmission to the cochlea of CSF pressure waves due to respiration, the distortion-product otoacoustic emissions (DPOAE) of 12 subjects were continuously monitored around 1kHz at a rate of 6.25epochs/s, and their phase relative to the stimulus tones was extracted. The subjects breathed normally, in different postures, while thoracic movements were recorded so as to monitor respiration. A correlate of respiration was found in the time variation of DPOAE phase, with an estimated mean amplitude of 10 degrees , i.e. 60mm water, suggesting little attenuation across the aqueduct. Its phase lag relative to thoracic movements varied between 0 degrees and -270 degrees . When fed into a two-compartment model of CSF and labyrinthine spaces, these results suggest that respiration rate at rest is just above the resonance frequency of the CSF compartment, and just below the corner frequency of the cochlear-aqueduct low-pass filter, in line with previous estimates from temporal bone and intracranial measurements. The fact that infrasonic CSF waves can be monitored through the cochlea opens diagnostic possibilities in neurology.

Sex differences in otoacoustic emissions measured in rhesus monkeys (Macaca mulatta)

Click-evoked otoacoustic emissions (CEOAEs) and distortion-product OAEs (DPOAEs) were measured in about 60 rhesus monkeys. CEOAE strength was substantially greater in females than in males, just as in humans. DPOAE strength was generally slightly stronger in females, just as in humans. In males, CEOAEs were weaker (more masculine) in the fall breeding season and in winter than in the summer. In females, CEOAEs were slightly stronger (more feminine) in the fall, when sex steroids are elevated in females (and males), than in the summer when rhesus monkeys are reproductively quiescent. Thus, the sex differences in CEOAEs were greater in the fall than in the summer. We presume that the seasonal fluctuations in OAEs reflect activational hormonal effects, while the basic sex differences in OAEs likely reflect organizational effects of prenatal androgen exposure. Some monkeys of both sexes had been treated with additional testosterone or the anti-androgen flutamide during prenatal development. In accord with expectations, prenatal androgen treatment weakened CEOAEs in females, and prenatal flutamide treatment strengthened CEOAEs in males. For DPOAEs, the differences between treated and untreated groups were mostly small and often inconsistent. Taken as a whole, the data from both rhesus monkeys and humans suggest that the linear, reflection-based mechanism of OAE production that underlies CEOAEs is more sensitive to prenatal androgenic processes than is the nonlinear distortion mechanism that underlies DPOAEs.

Gender effects on high frequency distortion product otoacoustic emissions in humans

OBJECTIVE

Gender has been reported to affect many tests of the auditory system, including distortion product otoacoustic emission (DPOAE) group delay and level when elicited with lower frequency stimuli (<8 kHz). Using custom equipment, the effect of gender on DPOAEs at higher frequencies was explored. It is expected that differences in group delay reported at very low frequencies (e.g., 0.78 Hz) will not be replicated at higher frequencies. Additionally, it was hypothesized that female subjects would display larger-level DPOAEs at higher frequencies, based on evidence that female subjects tend to have larger emissions when elicited with lower frequency stimuli.

DESIGN

DPOAEs were measured in 37 subjects (20 females and 17 males) with normal behavioral thresholds, middle ear function, and present acoustic reflexes at 1 kHz with contralateral stimulation. Behavioral thresholds were measured through 16 kHz using Békèsy tracking. Ratio and frequency sweeps were used to calculate DPOAE group delay and measure DPOAE levels, respectively. Ratio sweeps were obtained at f2 frequencies of 1, 2, 4, 8, 10, 12, 14, and 16 kHz, with L1 = 60 and L2 = 45 dB SPL, with the ratio (f2/f1) varied from 1.11 to 1.3. Frequency sweeps were measured with L1 = 60 and L2 = 45 dB SPL and an f2/f1 of 1.2 at discrete f2 frequencies between 1 and 16 kHz. Data were subjected to repeated-measures analysis of variance.

RESULTS

Significant frequency-by-gender interactions were found for group delay (for data from 1 to 8 kHz) and level (for data from 9 to 15 kHz). The frequency-by-gender interaction and the main effect of gender were not significant for the behavioral results.

CONCLUSIONS

Gender-based norms for auditory-evoked potentials measures are standard in clinical settings. The results of the present study, in agreement with previous studies, indicate that significant interactions exist between gender and DPOAE group delay values in the lower frequencies, and between gender and DPOAE levels at the higher frequencies. To reach the goal of using high frequency DPOAEs in clinical protocols, such as for auditory neuropathy/dys-synchrony diagnosis and ototoxicity monitoring, DPOAEs elicited with conventional and higher frequency stimuli must be understood, including the role of gender to determine if an effect on clinical protocols would exist.

Prenatal sex hormone effects on child and adult sex-typed behavior: methods and findings

There is now good evidence that human sex-typed behavior is influenced by sex hormones that are present during prenatal development, confirming studies in other mammalian species. Most of the evidence comes from clinical populations, in which prenatal hormone exposure is atypical for a person's sex, but there is increasing evidence from the normal population for the importance of prenatal hormones. In this paper, we briefly review the evidence, focusing attention on the methods used to study behavioral effects of prenatal hormones. We discuss the promises and pitfalls of various types of studies, including those using clinical populations (concentrating on those most commonly studied, congenital adrenal hyperplasia, androgen insensitivity syndrome, ablatio penis, and cloacal exstrophy), direct measures of hormones in the general population (assayed through umbilical cord blood, amniotic fluid, and maternal serum during pregnancy), and indirect measures of hormones in the general population (inferred from intrauterine position and biomarkers such as otoacoustic emissions, finger length ratios, and dermatoglyphic asymmetries). We conclude with suggestions for interpreting and conducting studies of the behavioral effects of prenatal hormones.

Spontaneous basilar membrane oscillation and otoacoustic emission at 15 kHz in a guinea pig

A spontaneous otoacoustic emission (SOAE) measured in the ear canal of a guinea pig was found to have a counterpart in spontaneous mechanical vibration of the basilar membrane (BM). A spontaneous 15-kHz BM velocity signal was measured from the 18-kHz tonotopic location and had a level close to that evoked by a 14-kHz, 15-dB SPL tone given to the ear. Lower-frequency pure-tone acoustic excitation was found to reduce the spontaneous BM oscillation (SBMO) while higher-frequency sound could entrain the SBMO. Octave-band noise centered near the emission frequency showed an increased narrow-band response in that frequency range. Applied pulses of current enhanced or suppressed the oscillation, depending on polarity of the current. The compound action potential (CAP) audiogram demonstrated a frequency-specific loss at 8 and 12 kHz in this animal. We conclude that a relatively high-frequency spontaneous oscillation of 15 kHz originated near the 15-kHz tonotopic place and appeared at the measured BM location as a mechanical oscillation. The oscillation gave rise to a SOAE in the ear canal. Electric current can modulate level and frequency of the otoacoustic emission in a pattern similar to that for the observed mechanical oscillation of the BM.

Gender-dependent differences in biological rhythms of mice

The advantage of a variable's rhythm resides in its optimal time-phasing. This implies that, for a given function, members of a species will strive to exhibit identical time-phasing namely, their inter-individual genetic differences will be masked. To examine the generality of this assumption we explored if inbred mice exhibit gender dependent differences in rhythm parameters of biochemical variables. Male and female mice, entrained by exposure to 12:12 light:dark illumination were sacrificed, every 3 hours over a 27 hours period. Activities of creatine-phosphokinase (CK) and alkaline- phosphatase (AP), white blood cell (WBC) counts and urea nitrogen (UN) concentration were determined at each time point. For each significant rhythm four parameters were computed: period, acrophase, mesor and amplitude. In addition two derived parameters were also calculated: relative-amplitude (RA) and the rate of change in RA (CRA) which provide information about the slope and width of the peak. Patterns of most variables exhibited a compound rhythm containing two significant periodicities. Gender dependent differences were documented in the parameters of most rhythms indicating that the genetic and physiological differences limit to a certain extent the phasing ability of the entraining signals and point to an independent control of each of the rhythm parameters.

Mammalian spontaneous otoacoustic emissions are amplitude-stabilized cochlear standing waves

Mammalian spontaneous otoacoustic emissions (SOAEs) have been suggested to arise by three different mechanisms. The local-oscillator model, dating back to the work of Thomas Gold, supposes that SOAEs arise through the local, autonomous oscillation of some cellular constituent of the organ of Corti (e.g., the "active process" underlying the cochlear amplifier). Two other models, by contrast, both suppose that SOAEs are a global collective phenomenon--cochlear standing waves created by multiple internal reflection--but differ on the nature of the proposed power source: Whereas the "passive" standing-wave model supposes that SOAEs are biological noise, passively amplified by cochlear standing-wave resonances acting as narrow-band nonlinear filters, the "active" standing-wave model supposes that standing-wave amplitudes are actively maintained by coherent wave amplification within the cochlea. Quantitative tests of key predictions that distinguish the local-oscillator and global standing-wave models are presented and shown to support the global standing-wave model. In addition to predicting the existence of multiple emissions with a characteristic minimum frequency spacing, the global standing-wave model accurately predicts the mean value of this spacing, its standard deviation, and its power-law dependence on SOAE frequency. Furthermore, the global standing-wave model accounts for the magnitude, sign, and frequency dependence of changes in SOAE frequency that result from modulations in middle-ear stiffness. Although some of these SOAE characteristics may be replicable through artful ad hoc adjustment of local-oscillator models, they all arise quite naturally in the standing-wave framework. Finally, the statistics of SOAE time waveforms demonstrate that SOAEs are coherent, amplitude-stabilized signals, as predicted by the active standing-wave model. Taken together, the results imply that SOAEs are amplitude-stabilized standing waves produced by the cochlea acting as a biological, hydromechanical analog of a laser oscillator. Contrary to recent claims, spontaneous emission of sound from the ear does not require the autonomous mechanical oscillation of its cellular constituents.

The relationships between otoacoustic emissions and relative lengths of fingers and toes in humans

Both otoacoustic emissions (OAEs) and the relative length of the index and ring fingers (the 2D:4D ratio) exhibit large sex differences, and both exhibit masculinization effects in female homosexuals and bisexuals. Because these sex differences exist in young children, the implication is that both types of measure are affected by prenatal androgen exposure, but it has been unknown to what degree these two types of measure are related. Accordingly, OAEs and the relative lengths of the fingers and the toes were measured in 59 heterosexual females, 55 heterosexual males, 29 homosexual females, and 33 homosexual males. The correlations between the two types of measure were unexpectedly quite low in both the heterosexual and nonheterosexual groups. For example, the correlation between number of spontaneous OAEs per ear and 2D:4D was less than 0.25, for both sexes and both sexual orientations. One interpretation of these results is that the prenatal hormonal mechanisms producing the sex differences in OAEs differ in quality, degree, or timing from those producing the sex differences in relative finger length. That is, OAEs and 2D:4D may be windows onto slightly different prenatal processes or times during prenatal development. Measures of mental-rotation ability also were obtained on these participants, and those correlations with relative finger length also were small.

The influence of hypothermia on outer hair cells of the cochlea and its efferents

Transient evoked otoacoustic emissions (TEOAE) were recorded in 21 guinea-pigs undergoing hypothermia. The minimal average body temperature during cooling was 26 degrees C/24.9 degrees C measured orally or rectally, respectively. The animals were subsequently warmed to normal body temperature. A clear influence of body temperature on TEOAE could be documented. During cooling the amplitude and reproducibilities decreased, disappearing completely at a mean temperature below 28.5 degrees C (oral) and 27.3 degrees C (rectal). The emissions reappeared during rewarming at a mean temperature of 30.1 degrees C (oral) and 30.8 degrees C (rectal). Contralateral auditory stimulation (CAS) led to a decrease of the amplitudes of TEOAE during cooling down to a mean of 33 degrees C/32 degrees C (oral/rectal temperature). During rewarming, influences of the CAS could be recognized, again at an oral temperature above 35 degrees C. The changes to the TEOAE observed in these experiments suggest that hypothermia affects not only the outer hair cells (OHC) of the cochlea but also the efferent supply to the cochlea.

Effect of sleep stages on synchronized spontaneous otoacoustic emissions in pre-term neonates

OBJECTIVES

In infants, auditory tests are mainly performed during sleep, since they spend most of their time asleep, and because quiet is required for the duration of the recording session to obtain a precise and reliable response. The aim of this study was to investigate the effect of sleep stages on synchronized spontaneous otoacoustic emissions (sSOAEs) in pre-term neonates at the age where the sleep states begin to be well established and auditory screening can be performed in a neonatology unit before discharge.

METHODS

Synchronized SOAEs were repeatedly recorded during a polygraphic sleep recording using the Otodynamic ILO88 system in 10 pre-term neonates at 36 weeks post-conception.

RESULTS

Variations of sSOAE peak numbers occurred in each subject during the recording session. There was no clear relation between sSOAE peak number fluctuations and the different sleep stages.

CONCLUSIONS

The sSOAE variations appeared to be closely related to experimental conditions, i.e. the mean background noise level. sSOAEs with the highest amplitude were always recorded; however, those with the smallest amplitude were the first to disappear from the recordings with higher background noise.

The behavior of spontaneous otoacoustic emissions during and after postural changes

Spontaneous otoacoustic emissions (SOAEs) were studied in humans during and after postural changes. The subjects were tilted from upright to a recumbent position (head down 30 degrees) and upright again in a 6-min period. The SOAEs were recorded continuously and analyzed off-line. The tilting caused a change in the SOAE spectrum for all subjects. Frequency shifts of 10 Hz, together with changes of amplitude (5 dB) and width (5 Hz), were typically observed. However, these changes were observed in both directions (including the appearance and disappearance of emission peaks). The most substantial changes occurred in the frequency region below 2 kHz. An increase of the intracranial pressure, and consequently of the intracochlear fluid pressure, is thought to result in an increased stiffness of the cochlear windows, which is probably mainly responsible for the SOAE changes observed after the downward turn. The time for the spectrum to regain stability after a postural change differed between the two maneuvers: 1 min for the downward and less than 10 s for the upward turn.

Masculinizing effects on otoacoustic emissions and auditory evoked potentials in women using oral contraceptives

The otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) measured in two separate large scale studies were examined retrospectively for potential differences between those women using, and those not using, oral contraception (OC). Fourteen dependent variables were examined, all of which exhibited substantial sex differences. For 13 of those 14 dependent variables, the means for the users of OC were shifted away from the means of the non-users in the direction of the males. Specifically, for four different measures of OAE strength, for seven of eight measures of AEP latency or amplitude, and for two cognitive tests (mental rotation and water level), the means for the users of OC were located intermediate to those of the non-users of OC and the males. Few of these differences between users and non-users of OC achieved statistical significance, but the near universality of the direction of the difference suggests that oral contraceptives do produce a weak masculinizing effect on some auditory structures. These weak masculinizing effects appear to run contrary to the facts that the levels of both free testosterone and estradiol are lower in women using OC than in normal-cycling women. Past findings on auditory sex differences may have underestimated those sex differences.

Sex differences in auditory sensitivity of chinchillas before and after exposure to impulse noise

OBJECTIVE

To determine if chinchillas exhibit sex differences in 1) basic auditory sensitivity and 2) susceptibility to cochlear damage and hearing loss from high-level impulse noise.

DESIGN

The auditory sensitivity of 73 chinchillas was assessed by measuring evoked potentials from electrodes implanted in the inferior colliculus (IC-EVPs) and cubic (2f1-f2) distortion product otoacoustic emissions (CDPs). A subgroup of 16 chinchillas were retested after exposure to simulated M16 rifle fire (150 dB pSPL impulse noise). Thresholds and postexposure temporary and permanent threshold shifts were compared as a function of sex and frequency using analysis of variance procedures. Cochleograms, showing the percent of hair cells missing as a function of location on the basilar membrane, were constructed to show inner hair cell (IHC) and outer hair cell (OHC) losses for each group.

RESULTS

Female chinchillas had slightly lower high-frequency thresholds, and slightly higher low-frequency thresholds than male chinchillas, but similar IC-EVP and CDP amplitude functions. Significant sex differences were observed after exposure to high-level impulse noise. Overall, female chinchillas developed approximately 10 dB more high-frequency hearing loss, but approximately 5 dB less low-frequency hearing loss than males. Hair cell losses, particularly IHC losses, were substantially less for females as compared with males.

CONCLUSIONS

The results point to close similarities between chinchillas and humans with regard to sex/gender differences in basic auditory sensitivity before noise exposure, suggesting that the chinchilla may be a good model for exploring the anatomical and physiological bases of these differences. In addition, the results show significant sex differences in the physiological and anatomical response of the chinchilla cochlea to high-level noise. Similar differences in humans could have important implications with regard to military assignments and hearing conservation programs.

Spontaneous otoacoustic emissions in heterosexuals, homosexuals, and bisexuals

Click-evoked otoacoustic emissions (CEOAEs) were previously shown to be significantly less strong in homosexual and bisexual females than in heterosexual females. Here it is reported that the spontaneous otoacoustic emissions (SOAEs) of those same 60 homosexual and bisexual females were less numerous and weaker than those in 57 heterosexual females. That is, the SOAEs of the homosexual and bisexual females were intermediate to those of heterosexual females and heterosexual males. The SOAE and CEOAE data both suggest that the cochleas of homosexual and bisexual females have been partially masculinized, possibly as part of some prenatal processes that also masculinized whatever brain structures are responsible for sexual orientation. For males of all sexual orientation, the SOAEs were less numerous and weaker than for the females, and there were no significant differences among the 56 heterosexual, 51 homosexual, and 11 bisexual males. All subjects passed a hearing screening test. When all SOAEs above 3000 Hz were excluded (as a control against incipient, undetected hearing loss) the same results were obtained as with the full range of data (550-9000 Hz). The differential use of oral contraceptives by the heterosexual and nonheterosexual females also could not explain the differences in their OAEs.

The influence of body temperature on transient evoked otoacoustic emissions

Thirty patients undergoing open heart surgery under induced hypothermia had transient evoked otoacoustic emissions (TEOAE) recorded during cooling to 26.07 degrees C (standard deviation (SD) 4.25 degrees C) vesically measured temperature and 24.86 degrees C (SD 4.7 degrees C) nasopharyngeally measured temperature respectively. Subsequently tè patients were rewarmed until normal body temperature was reached again. There was a clear influence of body temperature on the amplitudes and reproducibilities of the TEOAE. The relationship of temperature and amplitude or reproducibility during the cooling phase was significantly different from that during rewarming. No TEOAE were measurable during cooling at a mean temperature lower than 33.41 degrees C (SD 2.04 degrees C) vesical temperature and 30.16 degrees C (SD 3.0 degrees C) nasopharyngeal temperature respectively. During rewarming the echoes became recognizable again at a mean temperature of 28.75 degrees C (SD 3.38 degrees C) vesical temperature and 27.49 degrees C (SD 2.99 degrees C) nasopharyngeal temperature. These results suggest a hysteresis in the relationship between the amplitude of TEOAE and temperature, similar to the well-established relationship between evoked potentials and temperature.

Changes in otoacoustic emissions in a transsexual male during treatment with estrogen

Otoacoustic emissions (OAEs) were monitored in two human males undergoing estrogen treatment prior to sex-reversal surgery. In one subject, multiple spontaneous emissions (SOAEs) appeared where none had been evident previously. One reasonable interpretation is that (in this male, at least) androgens normally produced a suppressive effect on the cochlear mechanisms responsible for SOAEs, and that the decline in androgen levels produced by the estrogenic drug led to a reduction in that suppression.

Presence of tinnitus indicated by variable spontaneous otoacoustic emissions

Spontaneous otoacoustic emissions (SOAE) have been widely studied in normal subjects, and there is evidence of their high frequency stability in repeated recordings. A study to determine the frequency stability of SOAE in 53 of 100 consecutive patients, who presented with tinnitus and in whom SOAE were recordable, was undertaken. Patients were divided into five aetiologically homogeneous subgroups: (i) those with normal hearing and no identified pathology, (ii) those with sensorineural hearing loss of unknown origin, (iii) those with normal hearing, but complaining of tinnitus related to head injury, (iv) those with endolymphatic hydrops, and (v) those with noise exposure. The control group consisted of 20 subjects, selected on the basis of recordable SOAE from 38 volunteers with normal hearing and no tinnitus. The prevalence of SOAE and their inter-session frequency stability (reproducibility and relative frequency shift) were analysed. In contrast to the controls, the tinnitus group had significantly increased frequency variability of SOAE (lower reproducibility and increased relative frequency shift). The prevalence of subjects with SOAE was not notably different between the controls and subjects with tinnitus, if the tinnitus group was considered in toto, but a striking 100% prevalence of bilaterally present SOAE was observed in the tinnitus subgroup with head injury.

The influence of disappearing and reappearing spontaneous otoacoustic emissions on one subject's threshold microstructure

The effects of a consistently disappearing and reappearing spontaneous otoacoustic emission (SOAE) at around 2280 Hz on microstructure for pure tones of varying durations in a 33 year-old woman with normal hearing was studied. The SOAE began to appear after 10-15 min in a quiet test room and increased in level by up to 22 dB over a 30-40-min period. The SOAE was measured every 12 to 15 min. Between measurements, the subject performed a signal detection task for pure tones with total durations varying from 20 to 320 ms. The signal frequencies were within a +/- 30-Hz range relative to the SOAE frequency. For signal durations of 40-320 ms, there was a local dip at the target SOAE frequency when it was either not detectable or its level was lower than -14 dB SPL. Subjective threshold levels were as much as 12 dB better than those obtained when the SOAE was -6 dB SPL or greater. The results suggest that a region of the cochlea with high sensitivity and instability can be put into self-oscillation producing an SOAE, possibly by a change of efferent activity. Hearing threshold is affected possibly due to adaptation or masking.

Spontaneous otoacoustic emission frequency is modulated by heartbeat

Detailed analysis of spontaneous otoacoustic emissions (SOAEs) in human subjects revealed that all stable SOAEs sufficiently above the noise floor to permit appropriate analysis have sidebands at multiples of approximately 1 Hz. This is consistent with the hypothesis that SOAEs are modulated by heartbeat. Simultaneous measurement of the rate of blood flow to the thumb and the separation of the spectral sidebands demonstrated that they covary (r = 0.982, p < 5 x 10(-10)). An adaptive least-squares fit (LSF) paradigm was developed to facilitate the measurement of the instantaneous frequency and amplitude of the signals. A combination of traditional spectral analyses and new LSF analyses showed that the sideband generation stems from frequency modulation of the emissions. If there is any amplitude modulation correlated with the blood flow, it is below the noise floor of the analysis. The frequency of the emission was at a minimum when the blood flow was maximal. Examination of alternative mechanisms using computer simulations suggests that these changes stem from changes of 10-100 ppm in the mass of the basilar membrane.