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

[Pulsed DPOAEs in serial measurements : Combined analysis paradigm of simultaneously occurring changes in hearing thresholds and DPOAEs. German version]

BACKGROUND

To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (LEDPT) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss.

MATERIALS AND METHODS

Hearing thresholds were estimated objectively using LEDPT and subjectively using modified Békésy tracking audiometry (LTA). Recordings were performed seven times within three months at 14 frequencies (f2 = 1-14 kHz) in 20 ears (PTA4 (0.5-4 kHz) < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L1, L2 was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded LEDPT for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (LTA, LEDPT), DPOAE levels (LDP), and combinations thereof were determined.

RESULTS

LTA and LEDPT each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining LEDPT, LDP, and LTA into a single parameter yielded a significantly smaller median AD of 2.0 dB.

CONCLUSION

It is expected that an analysis paradigm based on a combination of LEDPT, suprathreshold LDP, and fine-structure-reduced LTA would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.

Reliable Long-Term Serial Evaluation of Cochlear Function Using Pulsed Distortion-Product Otoacoustic Emissions: Analyzing Levels and Pressure Time Courses

OBJECTIVES

To date, there is no international standard on how to use distortion-product otoacoustic emissions (DPOAEs) in serial measurements to accurately detect changes in the function of the cochlear amplifier due, for example, to ototoxic therapies, occupational noise, or the development of regenerative therapies. The use of clinically established standard DPOAE protocols for serial monitoring programs appears to be hampered by multiple factors, including probe placement and calibration effects, signal-processing complexities associated with multiple sites of emission generation as well as suboptimal selection of stimulus parameters.

DESIGN

Pulsed DPOAEs were measured seven times within 3 months for f2 = 1 to 14 kHz and L2 = 25 to 80 dB SPL in 20 ears of 10 healthy participants with normal hearing (mean age = 32.1 ± 9.7 years). L1 values were computed from individual optimal-path parameters derived from the corresponding individual DPOAE level map in the first test session. Three different DPOAE metrics for evaluating the functional state of the cochlear amplifier were investigated with respect to their test-retest reliability: (1) the interference-free, nonlinear-distortion component level ( LOD ), (2) the time course of the DPOAE-envelope levels, LDP ( t ), and (3) the squared, zero-lag correlation coefficient ( ) between the time courses of the DPOAE-envelope pressures, pDP ( t ), measured in two sessions. The latter two metrics include the two main DPOAE components and their state of interference.

RESULTS

Collated over all sessions and frequencies, the median absolute difference for LOD was 1.93 dB and for LDP ( t ) was 2.52 dB; the median of was 0.988. For the low ( f2 = 1 to 3 kHz), mid ( f2 = 4 to 9 kHz), and high ( f2 = 10 to 14 kHz) frequency ranges, the test-retest reliability of LOD increased with increasing signal to noise ratio (SNR).

CONCLUSIONS

On the basis of the knowledge gained from this study on the test-retest reliability of pulsed DPOAE signals and the current literature, we propose a DPOAE protocol for future serial monitoring applications that takes into account the following factors: (1) separation of DPOAE components, (2) use of individually optimal stimulus parameters, (3) SNR of at least 15 dB, (4) accurate pressure calibration, (5) consideration of frequency- and level-dependent test-retest reliabilities and corresponding reference ranges, and (6) stimulus levels L2 that are as low as possible with sufficient SNR to capture the nonlinear functional state of the cochlear amplifier operating at its highest gain.

Pulsed DPOAEs in serial measurements : Combined analysis paradigm of simultaneously occurring changes in hearing thresholds and DPOAEs

BACKGROUND

To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (LEDPT) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss.

MATERIALS AND METHODS

Hearing thresholds were estimated objectively using LEDPT and subjectively using modified Békésy tracking audiometry (LTA). Recordings were performed seven times within three months at 14 frequencies (f2 = 1-14 kHz) in 20 ears (PTA4 (0.5-4 kHz) < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L1, L2 was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded LEDPT for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (LTA, LEDPT), DPOAE levels (LDP), and combinations thereof were determined.

RESULTS

LTA and LEDPT each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining LEDPT, LDP, and LTA into a single parameter yielded a significantly smaller median AD of 2.0 dB.

CONCLUSION

It is expected that an analysis paradigm based on a combination of LEDPT, suprathreshold LDP, and fine-structure-reduced LTA would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.

Deep Learning Models for Predicting Hearing Thresholds Based on Swept-Tone Stimulus-Frequency Otoacoustic Emissions

OBJECTIVES

This study aims to develop deep learning (DL) models for the quantitative prediction of hearing thresholds based on stimulus-frequency otoacoustic emissions (SFOAEs) evoked by swept tones.

DESIGN

A total of 174 ears with normal hearing and 388 ears with sensorineural hearing loss were studied. SFOAEs in the 0.3 to 4.3 kHz frequency range were recorded using linearly swept tones at a rate of 2 Hz/msec, with stimulus level changing from 40 to 60 dB SPL in 10 dB steps. Four DL models were used to predict hearing thresholds at octave frequencies from 0.5 to 4 kHz. The models-a conventional convolutional neural network (CNN), a hybrid CNN-k-nearest neighbor (KNN), a hybrid CNN-support vector machine (SVM), and a hybrid CNN-random forest (RF)-were individually built for each frequency. The input to the DL models was the measured raw SFOAE amplitude spectra and their corresponding signal to noise ratio spectra. All DL models shared a CNN-based feature self-extractor. They differed in that the conventional CNN utilized a fully connected layer to make the final regression decision, whereas the hybrid CNN-KNN, CNN-SVM, and CNN-RF models were designed by replacing the last fully connected layer of CNN model with a traditional machine learning (ML) regressor, that is, KNN, SVM, and RF, respectively. The model performance was evaluated using mean absolute error and SE averaged over 20 repetitions of 5 × 5 fold nested cross-validation. The performance of the proposed DL models was compared with two types of traditional ML models.

RESULTS

The proposed SFOAE-based DL models resulted in an optimal mean absolute error of 5.98, 5.22, 5.51, and 6.06 dB at 0.5, 1, 2, and 4 kHz, respectively, superior to that obtained by the traditional ML models. The produced SEs were 8.55, 7.27, 7.58, and 7.95 dB at 0.5, 1, 2, and 4 kHz, respectively. All the DL models outperformed any of the traditional ML models.

CONCLUSIONS

The proposed swept-tone SFOAE-based DL models were capable of quantitatively predicting hearing thresholds with satisfactory performance. With DL techniques, the underlying relationship between SFOAEs and hearing thresholds at disparate frequencies was explored and captured, potentially improving the diagnostic value of SFOAEs.

Distortion-product otoacoustic emissions measured using synchronized swept-sines

Swept-sines provide a tool for fast and high-resolution measurement of evoked otoacoustic emissions. During the measurement, a response to swept-sine(s) is recorded by a probe placed in the ear canal. Otoacoustic emissions can then be extracted by various techniques, e.g., Fourier analysis, the heterodyne method, and the least-square-fitting (LSF) technique. This paper employs a technique originally proposed with exponential swept-sines, which allows for direct emission extraction from the measured intermodulation impulse response. It is shown here that the technique can be used to extract distortion-product otoacoustic emissions (DPOAEs) evoked with two simultaneous swept-sines. For proper extraction of the DPOAE phase, the technique employs previously proposed adjusted formulas for exponential swept-sines generating so-called synchronized swept-sines (SSSs). Here, the SSS technique is verified using responses derived from a numerical solution of a cochlear model and responses measured in human subjects. Although computationally much less demanding, the technique yields comparable results to those obtained by the LSF technique, which has been shown in the literature to be the most noise-robust among the emission extraction methods.

Weakened Cochlear Nonlinearity During Human Aging and Perceptual Correlates

OBJECTIVE

As humans age, compressive nonlinearity-a hallmark of healthy cochlear function-changes. The nonlinear distortion-component of the distortion product otoacoustic emission (DPOAE) provides a noninvasive gauge of cochlear nonlinearity. Earlier published work has suggested that weakened nonlinearity begins in middle age; the current work extends this investigation into the eight decade of life using advanced DPOAE data collection and analysis methods as well as multiple metrics of nonlinearity, including a test of loudness scaling.

DESIGN

The 2f1-f2 DPOAE was recorded in 20 young adults, 25 middle-aged adults and 32 older adults from f2 = 0.78 to 9.4 kHz with primary tones (f2/f1 = 1.22) swept upward at a rate of 0.5 octave/sec. Only frequencies with audiometric thresholds ≤20 dB HL were included in the analysis and to the extent possible, ears were audiometrically matched to eliminate hearing threshold as a contributing factor to the observed age effects. Input/output functions were generated for the separated distortion-component of the DPOAE to probe compressive nonlinearity of the cochlea, and ipsilateral suppression of the DPOAE was conducted to probe two-tone suppression. To investigate the perceptual effects of weakening nonlinearity on loudness perception, the same subjects performed categorical loudness scaling. Age effects on both DPOAE and loudness scaling variables were assessed, and correlations were conducted between key OAE and perceptual metrics.

RESULTS

Age × Frequency ANOVAs revealed that the compression knee of the DPOAE I/O function occurred at higher stimulus levels in both groups of older adults compared to young adults, suggesting an expanded linear range with aging; also, the compressive slope (growth beyond the knee point) was steeper in older-adults compared to young adults. These results were most notable at high frequencies. ANOVAs including age and auditory threshold as factors confirmed that the age effect observed was independent of threshold. Additionally, in smaller subsets of subjects with audiometrically matched data, these same trends persisted, further ruling out hearing threshold as an influential factor. The growth of DPOAE ipsilateral suppression was shallower near 4 kHz in middle-aged and older adults compared to young adults and elevated suppression thresholds were observed. Results of categorical loudness scaling showed steeper growth of loudness for older adults and, at fixed sensation levels (dB SL), the older-adult group rated tones as louder than did their young-adult counterparts, suggesting abnormal loudness growth and perception. Several correlations between the compression knee of the DPOAE I/O function and key metrics of loudness scaling were significant and accounted for up to one-third of the variance.

CONCLUSIONS

Results indicate that the aging cochlea begins to show weakened nonlinearity in middle age and it progressively weakens further into senescence. The perceptual impact of weakened nonlinearity during aging is manifested as abnormal loudness judgments; that is, in older-adult ears, a tone considered comfortable or medium in young-adult ears can be considered loud. The biophysical origin of this weakened nonlinearity is not known. It is hypothesized to reflect aging-related damage to, or loss of, outer hair cells and their stereocilia. More work is warranted to better define the perceptual impact of a linearized cochlear response in older adults and to consider how this deficit might impact the fitting of hearing aids and other intervention strategies.

Test-retest reliability of distortion-product thresholds compared to behavioral auditory thresholds

When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the progression of cochlear damage. Semi-logarithmic DPOAE input-output (I/O) functions enable the computation of estimated distortion-product thresholds (EDPTs) by means of linear regression, a metric that provides a quantitative estimate of hearing loss due to cochlear-amplifier degradation. DPOAE wave interference and a suboptimal choice of stimulus levels limit the accuracy of EDPTs. This work identifies the test-retest reliability of EDPTs derived from short-pulse DPOAE level maps (EDPT_LM), a method that circumvents limitations associated with both wave interference and suboptimal choice of stimulus levels. The test-retest reliability was compared to that of EDPTs derived from semi-logarithmic I/O functions (EDPT_I/O) and that of behavioral thresholds acquired with pure-tone audiometry (PTA) and modified Békésy tracking audiometry (TA) to provide a foundation for identifying and interpreting significant threshold shifts. The DPOAE-based auditory thresholds (EDPT_LM and EDPT_I/O) and behavioral thresholds (PTA and TA) were recorded seven times within three months at 14 frequencies with f₂ = 1-14 kHz in 20 ears from ten subjects with normal hearing (4PTA_0.5-4kHz < 20 dB HL). To obtain EDPT_LM, short-pulse DPOAEs were recorded using 21 L₁,L₂ pairs. Reconstruction of DPOAE growth behavior as a function of L₁ and L₂ using nonlinear curve fitting enabled the derivation of EDPT_LM for each frequency. Test-retest reliability was determined using three different approaches: 1) centered thresholds, 2) average threshold differences, and 3) average absolute threshold differences, between each possible test session (N = 21). Test-retest reliability based on centered thresholds and average threshold differences showed no statistically significant difference between EDPT_LM, EDPT_I/O, PTA, and TA for the pooled analysis incorporating all stimulus frequencies. Average absolute threshold differences presented small but significant differences in test-retest reliability with median values of 3.00 dB for PTA, 3.20 dB for TA, 3.34 dB for EDPT_LM, and 3.51 dB for EDPT_I/O. A considerable frequency dependence of test-retest reliability was found; namely, the highest test-retest reliability was for EDPT_LM at f₂ = 11 - 14 kHz. Otherwise, at lower frequencies, the highest test-retest reliability was for TA at f₂ =1 - 2 kHz. Overall, the test-retest reliability of EDPT_LM was better than that of EDPT_I/O and was similar to that for behavioral thresholds. Hence, deriving EDPT_LM from individual level maps is a promising and sensitive method for objectively monitoring the state of the cochlea. Furthermore, the detection of an equidirectional threshold change at a single frequency in both EDPT_LM and TA might allow reducing the threshold shift as indication of a follow-up examination from the clinical standard of 10 dB down to 5 dB. This stricter indicator might be beneficial when monitoring cochlear damage, for example ototoxicity, in the presence of (remnant) cochlear amplification at baseline.

Derivation of input-output functions from distortion-product otoacoustic emission level maps

Distortion-product otoacoustic emissions (DPOAEs) emerge from the cochlea when elicited with two tones of frequencies f₁ and f₂. DPOAEs mainly consist of two components, a nonlinear-distortion and a coherent-reflection component. Input-output (I/O) functions of DPOAE pressure at the cubic difference frequency, f_DP=2f₁-f₂, enable the computation of estimated distortion-product thresholds (EDPTs), offering a noninvasive approach to estimate auditory thresholds. However, wave interference between the DPOAE components and suboptimal stimulus-level pairs reduces the accuracy of EDPTs. Here, the amplitude P of the nonlinear-distortion component is extracted from short-pulse DPOAE time signals. DPOAE level maps representing the growth behavior of P in L₁,L₂ space are recorded for 21 stimulus-level pairs and 14 frequencies with f₂=1 to 14 kHz (f₂/f₁=1.2) from 20 ears. Reproducing DPOAE growth behavior using a least-squares fit approach enables the derivation of ridge-based I/O functions from model level maps. Objective evaluation criteria assess the fit results and provide EDPTs, which correlate significantly with auditory thresholds (p < 0.001). In conclusion, I/O functions derived from model level maps provide EDPTs with high precision but without the need of predefined optimal stimulus-level pairs.

Cochlear Mechanisms and Otoacoustic Emission Test Performance

OBJECTIVES

This study aims to determine the impact of controlling cochlear-source mechanism on the accuracy with which auditory status is identified using otoacoustic emissions (OAEs) in two groups of subjects with normal hearing (NH) and subjects with mild to moderate hearing loss.

DESIGN

Data were collected from 212 subjects with NH and with mild to moderate hearing loss who fell into two categories based on a distortion product OAE (DPOAE) screening protocol: the uncertain-identification group (where errors were likely) and the certain-identification group (where errors were unlikely). DPOAE fine-structure patterns were recorded at intervals surrounding f2 = 1, 2 and 4 kHz (f2/f1 ratio = 1.22), with L2 = 35, 45, and 55 dB SPL (L1/L2 ratio = 10 dB). The discrete cosine transform was used to smooth fine structure, limiting the source contribution to the distortion source only. Reflection-source OAEs were also recorded using amplitude-modulated stimulus frequency OAEs (AM-SFOAE). Area under the relative operating characteristic (AROC) curve was used to quantify test accuracy when the source contribution was controlled versus the condition where both sources contribute. Additionally, failure rate, fixed at 5% for NH ears, as a function of behavioral-threshold category was evaluated.

RESULTS

When data for the entire subject group were examined, reducing the reflection-source contribution to the DPOAE did not result in better test performance than the best control condition at any frequency tested. When the subjects with NH were restricted to those with confirmed fine structure, AROC analyses indicated that reducing the reflection-source contribution resulted in several small increases in the accuracy (2%-5%) with which auditory status was identified relative to the best control condition. This improvement was observed for the lowest stimulus levels (i.e., L2 = 35 or 45 dB SPL). In this subset of subjects, distortion-source DPOAEs resulted in more accurate identification of mild hearing loss for a fixed false-positive rate of 5% in NH ears at lower L2's, conditions with poor accuracy in the larger group of subjects. The impact of controlling the source contribution on the identification of moderate losses was less clear in the reduced subject group, with some conditions where the distortion-source DPOAE was more accurate than the control condition and other conditions where there was no change. There was no evidence that reflection-source AM-SFOAEs more accurately identified ears with hearing loss when compared to any of the DPOAE conditions in either the large or reduced group of subjects.

CONCLUSION

While improvements in test accuracy were observed for some subjects and some conditions (e.g., mild hearing losses and low stimulus levels in the reduced subset of subjects), these results suggest that restricting cochlear source contribution by "smoothing" DPOAE fine structure is not expected to improve DPOAE test accuracy in a general population of subjects. Likewise, recording reflection-source OAEs using the AM-SFOAE technique would not be expected to more accurately identify hearing status compared to mixed- or single-source DPOAEs.

Objective audiometry with DPOAEs : New findings for generation mechanisms and clinical applications

Background

Distortion product otoacoustic emissions (DPOAEs) and transient-evoked otoacoustic emissions (TEOAEs) are sound waves generated as byproducts of the cochlear amplifier. These are measurable in the auditory canal and represent an objective method for diagnosing functional disorders of the inner ear. Conventional DPOAE and TEOAE methods permit detection of hearing impairment, but with less than desirable accuracy.

Objective

By accounting for DPOAE generation mechanisms, the aim is to improve the accuracy of inner-ear diagnosis.

Methods

DPOAEs consist of two components, which emerge at different positions along the cochlea and which may cause artifacts due to mutual interference. Here, the two components are separated in the time domain using short stimulus pulses. Optimized stimulus levels facilitate the acquisition of DPOAEs with maximum amplitudes. DPOAE and Békésy audiograms were recorded from 41 subjects in a clinically relevant frequency range of 1.5–6 kHz.

Results

The short stimulus pulses allowed artifact-free measurement of DPOAEs. Semilogarithmic input–output functions yielded estimated distortion product thresholds, which were significantly correlated with the subjectively acquired Békésy thresholds. In addition, they allowed detection of hearing impairment from 20 dB HL, with 95% sensitivity and only a 5% false-positive rate. This accuracy was achieved with a measurement time of about 1–2 min per frequency.

Conclusion

Compared to conventional DPOAE and TEOAE methods, separation of DPOAE components using short-pulse DPOAEs in combination with optimized stimulus parameters considerably enhances the accuracy of DPOAEs for diagnosing impairment of the cochlear amplifier.

Changes in the Compressive Nonlinearity of the Cochlea During Early Aging: Estimates From Distortion OAE Input/Output Functions

OBJECTIVES

The level-dependent growth of distortion product otoacoustic emissions (DPOAEs) provides an indirect metric of cochlear compressive nonlinearity. Recent evidence suggests that aging reduces nonlinear distortion emissions more than those associated with linear reflection. Therefore, in this study, we generate input/output (I/O) functions from the isolated distortion component of the DPOAE to probe the effects of early aging on the compressive nonlinearity of the cochlea.

DESIGN

Thirty adults whose ages ranged from 18 to 64 years participated in this study, forming a continuum of young to middle-age subjects. When necessary for analyses, subjects were divided into a young-adult group with a mean age of 21 years, and a middle-aged group with a mean age of 52 years. All young-adult subjects and 11 of the middle-aged subjects had normal hearing; 4 middle-aged ears had slight audiometric threshold elevation at mid-to-high frequencies. DPOAEs (2f1 - f2) were recorded using primary tones swept upward in frequency from 0.5 to 8 kHz, and varied from 25 to 80 dB sound pressure level. The nonlinear distortion component of the total DPOAE was separated and used to create I/O functions at one-half octave intervals from 1.3 to 7.4 kHz. Four features of OAE compression were extracted from a fit to these functions: compression threshold, range of compression, compression slope, and low-level growth. These values were compared between age groups and correlational analyses were conducted between OAE compression threshold and age with audiometric threshold controlled.

RESULTS

Older ears had reduced DPOAE amplitude compared with young-adult ears. The OAE compression threshold was elevated at test frequencies above 2 kHz in the middle-aged subjects by 19 dB (35 versus 54 dB SPL), thereby reducing the compression range. In addition, middle-aged ears showed steeper amplitude growth beyond the compression threshold. Audiometric threshold was initially found to be a confound in establishing the relationship between compression and age; however, statistical analyses allowed us to control its variance. Correlations performed while controlling for age differences in high-frequency audiometric thresholds showed significant relationships between the DPOAE I/O compression threshold and age: Older subjects tended to have elevated compression thresholds compared with younger subjects and an extended range of monotonic growth.

CONCLUSIONS

Cochlear manifestations of nonlinearity, such as the DPOAE, weaken during early aging, and DPOAE I/O functions become linearized. Commensurate changes in high-frequency audiometric thresholds are not sufficient to fully explain these changes. The results suggest that age-related changes in compressive nonlinearity could produce a reduced dynamic range of hearing, and contribute to perceptual difficulties in older listeners.

Input-output functions of the nonlinear-distortion component of distortion-product otoacoustic emissions in normal and hearing-impaired human ears

Distortion-product otoacoustic emissions (DPOAEs) arise in the cochlea in response to two tones with frequencies f₁ and f₂ and mainly consist of two components, a nonlinear-distortion and a coherent-reflection component. Wave interference between these components limits the accuracy of DPOAEs when evaluating the function of the cochlea with conventional continuous stimulus tones. Here, DPOAE components are separated in the time domain from DPOAE signals elicited with short stimulus pulses. The extracted nonlinear-distortion components are used to derive estimated distortion-product thresholds (EDPTs) from semi-logarithmic input-output (I/O) functions for 20 normal-hearing and 21 hearing-impaired subjects. I/O functions were measured with frequency-specific stimulus levels at eight frequencies f₂ = 1,…, 8 kHz (f₂/f₁ = 1.2). For comparison, DPOAEs were also elicited with continuous primary tones. Both acquisition paradigms yielded EDPTs, which significantly correlated with behavioral thresholds (p < 0.001) and enabled derivation of estimated hearing thresholds (EHTs) from EDPTs using a linear regression relationship. DPOAE-component separation in the time domain significantly reduced the standard deviation of EHTs compared to that derived from continuous DPOAEs (p < 0.01). In conclusion, using frequency-specific stimulus levels and DPOAE-component separation increases the reliability of DPOAE I/O functions for assessing cochlear function and estimating behavioral thresholds.

Level dependence of the nonlinear-distortion component of distortion-product otoacoustic emissions in humans

Distortion-product otoacoustic emissions (DPOAEs) emerge when presenting two primary tones with different frequencies f1 and f2 to the cochlea and are commonly used in diagnosis and research to evaluate the functional state of the cochlea. Optimal primary-tone stimulus levels accounting for the different level dependencies of the traveling-wave amplitudes of the two primary tones near the f2-tonotopic place on the basilar membrane are often used to maximize DPOAE amplitudes. However, parameters defining the optimal levels can be affected by wave interference between the nonlinear-distortion and coherent-reflection components of the DPOAE. Here, the components were separated in the time domain using a pulsed stimulus paradigm and optimal levels determined. Based on the amplitude dependence of the nonlinear-distortion components on primary-tone stimulus levels, level parameters yielding maximum DPOAE amplitudes were derived for six normal-hearing adults and compared to data recorded with continuous two-tone stimulation. The level parameters resulting from analysis of the nonlinear-distortion components show dependence on stimulus frequency and small standard deviations. DPOAE input/output functions derived for optimal levels exhibit larger slopes, wider dynamic range and less variability across subjects than those derived for conventional stimulus and analysis conditions, potentially increasing their reliability and sensitivity for assessing cochlea function.

[High-resolution distortion-product otoacoustic emissions: method and clinical applications]

Unlike pure tone thresholds that assess both peripheral and central sound processing, distortion-product otoacoustic emissions (DPOAEs) selectively mirror the functioning of the cochlear amplifier. High resolution DPOAEs are missing in the toolbox of routine audiometry due to the fact that high resolution DPOAE measurements are more time-consuming when compared to normal clinical DP grams with rough frequency resolution. Measurements of high resolution DPOAEs allow an early assessment of beginning sensory cell damage due to sound overexposure or administration of ototoxic drugs. When using a rough grid, sensory cell damage would be overlooked as in the early state damage only appears at some distinct cochlear sites. A review is given on the method and application of high resolution DPOAEs.

Extraction of otoacoustic distortion product sources using pulse basis functions

Distortion product otoacoustic emissions (DPOAEs) acquired in normal-hearing subjects show considerable variation in amplitude with varying frequency. This is known as DPOAE fine structure. It is widely accepted that fine structure results from wave interference from two DPOAE sources, a non-linear generation component and a coherent reflection component. Here a method is presented that decomposes short-pulse DPOAE recordings into pulse basis functions and enables the quantification of both source components in the time domain, independent of their relative phase and at low cost of measurement time. Input-output functions utilizing the extracted primary-source component are analyzed.