Physiopathological significance of distortion-product otoacoustic emissions at 2f1-f2 produced by high- versus low-level stimuli

Pathophysiology of Postoperative Hearing Disorders after Vestibular Schwannoma Resection: Insights from Auditory Brainstem Response and Otoacoustic Emissions

Background: In order to better understand the pathophysiology of surgically induced hearing loss after vestibular schwannoma (VS) surgery, we postoperatively analyzed the hearing status in a series of patients where hearing was at least partially preserved. Methods: Hearing was assessed through tonal audiometry, speech discrimination score, maximum word recognition score (dissyllabic word lists-MaxIS), otoacoustic emissions (OAEs), and auditory brainstem response (ABR). The magnetic resonance imaging (MRI) tumor characterization was also noted. Results: In a series of 24 patients operated on for VS over 5 years, depending on the results of this triple hearing exploration, we could identify, after surgery, patients with either a myelin alteration or partial damage to the acoustic fibers, others with a likely partial cochlear ischemia, and some with partial cochlear nerve ischemia. One case with persisting OAEs and no preoperative ABR recovered hearing and ABR after surgery. Long follow-up (73 ± 57 months) revealed a mean hearing loss of 30 ± 20 dB with a drastic drop of MaxIS. MRI revealed only 25% of fundus invasion. Conclusion: a precise analysis of hearing function, not only with classic audiometry but also with ABR and OEAs, allows for a better understanding of hearing damage in VS surgery.

Cochlear zinc signaling dysregulation is associated with noise-induced hearing loss, and zinc chelation enhances cochlear recovery

Exposure to loud noise triggers sensory organ damage and degeneration that, in turn, leads to hearing loss. Despite the troublesome impact of noise-induced hearing loss (NIHL) in individuals and societies, treatment strategies that protect and restore hearing are few and insufficient. As such, identification and mechanistic understanding of the signaling pathways involved in NIHL are required. Biological zinc is mostly bound to proteins, where it plays major structural or catalytic roles; however, there is also a pool of unbound, mobile (labile) zinc. Labile zinc is mostly found in vesicles in secretory tissues, where it is released and plays a critical signaling role. In the brain, labile zinc fine-tunes neurotransmission and sensory processing. However, injury-induced dysregulation of labile zinc signaling contributes to neurodegeneration. Here, we tested whether zinc dysregulation occurs and contributes to NIHL in mice. We found that ZnT3, the vesicular zinc transporter responsible for loading zinc into vesicles, is expressed in cochlear hair cells and the spiral limbus, with labile zinc also present in the same areas. Soon after noise trauma, ZnT3 and zinc levels are significantly increased, and their subcellular localization is vastly altered. Disruption of zinc signaling, either via ZnT3 deletion or pharmacological zinc chelation, mitigated NIHL, as evidenced by enhanced auditory brainstem responses, distortion product otoacoustic emissions, and number of hair cell synapses. These data reveal that noise-induced zinc dysregulation is associated with cochlear dysfunction and recovery after NIHL, and point to zinc chelation as a potential treatment for mitigating NIHL.

The susceptibility of cochlear outer hair cells to cyclodextrin is not related to their electromotile activity

Niemann-Pick Type C1 (NPC1) disease is a fatal neurovisceral disorder caused by dysfunction of NPC1 protein, which plays a role in intracellular cholesterol trafficking. The cholesterol-chelating agent, 2-hydroxypropyl-β-cyclodextrin (HPβCD), is currently undergoing clinical trials for treatment of this disease. Though promising in alleviating neurological symptoms, HPβCD causes irreversible hearing loss in NPC1 patients and outer hair cell (OHC) death in animal models. We recently found that HPβCD-induced OHC death can be significantly alleviated in a mouse model lacking prestin, an OHC-specific motor protein required for the high sensitivity and sharp frequency selectivity of mammalian hearing. Since cholesterol status is known to influence prestin’s electromotility, we examined how prestin contributes to HPβCD-induced OHC death in the disease context using the NPC1 knockout (KO) mouse model (NPC1-KO). We found normal expression and localization of prestin in NPC1-KO OHCs. Whole-cell patch-clamp recordings revealed a significant depolarization of the voltage-operating point of prestin in NPC1-KO mice, suggesting reduced levels of cholesterol in the lateral membrane of OHCs that lack NPC1. OHC loss and elevated thresholds were found for high frequency regions in NPC1-KO mice, whose OHCs retained their sensitivity to HPβCD. To investigate whether prestin’s electromotile function contributes to HPβCD-induced OHC death, the prestin inhibitor salicylate was co-administered with HPβCD to WT and NPC1-KO mice. Neither oral nor intraperitoneal administration of salicylate mitigated HPβCD-induced OHC loss. To further determine the contribution of prestin’s electromotile function, a mouse model expressing a virtually nonelectromotile prestin protein (499-prestin) was subjected to HPβCD treatment. 499-prestin knockin mice showed no resistance to HPβCD-induced OHC loss. As 499-prestin maintains its ability to bind cholesterol, our data imply that HPβCD-induced OHC death is ascribed to the structural role of prestin in maintaining the OHC’s lateral membrane, rather than its motor function.

A Clinical Study of Effect of Hyperpyrexia on Otoacoustic Emissions in Children

Various degrees of sensory neural hearing loss can be seen in the progression of some hereditary periodic fever syndromes. Otoacoustic emission testing can help to establish the inner ear involvement at an early period of a periodic fever with a risk of hearing loss (Abdul Kadir et al. in J Int Adv Otol 9(2.79):08-11, 2014). Sensorineural hearing loss is the common most complication of bacterial meningitis in childhood (Richardson in Pediatrics 102(6):1364-1368, 1998). When present from birth, or acquired in the pre-school years, hearing loss of any degree, even mild hearing loss, interferes with speech and language development. In addition to obvious communication deficits, the consequences of hearing loss in children and adults include psychosocial problems, such as frustration, irritability, anxiety, the tendency to withdraw from social interactions, and even depression (Dhar and Hall in Otoacoustic emissions: principles, procedures, and protocols, Plural Publishing, San Diego, 2011). OAE are acoustic signals emitted from cochlea to the middle ear and into the external ear where they are recorded. Evoked OAE are undetectable when deafness is above 30-35 dB Sound pressure level (Biswas in Clinical audio-vestibulometry for otologists and neurologists, Bhalani Publishing House, Mumbai, 1995). OAEs permit early detection of inner ear abnormalities associated with a wide variety of diseases and disorders, including Alport syndrome etc. With early detection, the serious consequences of hearing loss can sometimes be prevented. With proper identification and diagnosis of hearing impairment, timely and effective management for the same can be taken. Data for this study was collected from children (5-14 years) attending the Department of Otorhinolaryngology and Paediatrics Out-patient departments in P.E.S.I.M.S.R, Kuppam. Among the study population 43 (57.3%) were male and 32 (42.7%) were females showing the slight male preponderance. study was done on children with temperature > 1000 F, children with temperature were screened with OAE, and OAE was recorded in same children once fever has subsided and results were compared. This is a new study where we compared same group of children with fever and once fever has subsided. In most other studies, study group was compared to the healthy control group. In our study, children with fever having abnormal FDP values at f1were 9, they reverted back to base line once fever has subsided. This shows that there is no much damage to inner ear at lower frequencies. Almost 47 abnormal FDP values at f2 reverted back to normal. At higher frequencies (f3 and f4), there is no much change in abnormal FDPs with fever and after fever has subsided, this shows that there is more damage to inner ear at higher frequencies. This study demonstrated that hyperpyrexia causes hearing loss in children with fever probably due to cochlear involvement. We conclude that OAE can be used as a screening tool in detecting hearing loss among children because the technique is simple, reproducible, not expensive, not time consuming also effectively narrows down the children with high chances of hearing loss thereby effectively improves the chances of early diagnosis and hence children can be rehabilitated early, making a marked change in their future.

Simultaneous Intracochlear Pressure Measurements from Two Cochlear Locations: Propagation of Distortion Products in Gerbil

Sound energy propagates in the cochlea through a forward-traveling or slow wave supported by the cochlear partition and fluid inertia. Additionally, cochlear models support traveling wave propagation in the reverse direction as the expected mechanism for conveying otoacoustic emissions out of the cochlea. Recently, however, this hypothesis has been questioned, casting doubt on the process by which otoacoustic emissions travel back out through the cochlea. The proposed alternative reverse travel path for emissions is directly through the fluids of the cochlea as a compression pressure in the form of a fast wave. In the present study, a custom-made micro-pressure sensor was used in vivo in the gerbil cochlea to map two-tone-evoked pressure responses at distinct longitudinal and vertical locations in both the scala tympani and scala vestibuli. Analyses of the magnitude and phase of intracochlear pressure responses at the primary tone and distortion product frequencies were used to distinguish between fast and slow waves in both the forward- and reverse-propagation directions. Results demonstrated that distortion products may travel in both forward and reverse directions post-generation and the existence of both traveling and compression waves. The forward-traveling component appeared to duplicate the process of any external tone, tuned to the local characteristic-frequency place, as it increased compressively and nonlinearly with primary-tone levels. A compression wave was evidenced at frequencies above the cutoff of the recording site. In the opposite direction, a reverse-traveling wave played the major role in driving the stapes reversely and contributed to the distortion product otoacoustic emission. The compression wave may also play a role in reverse propagation when distortion products are generated at a region close to the stapes.

Age-related shifts in distortion product otoacoustic emissions peak-ratios and amplitude modulation spectra

Amplitude modulation (AM) is an important temporal cue for precise speech and complex sound recognition. However, functional decline of the auditory periphery as well as degradation of central auditory processing due to aging can reduce the salience and resolution of temporal cues. Age-related deficits in central temporal processing have previously been observed at more rapid AM frequencies and various AM depths. These centrally observed changes result from cochlear changes compounded with changes along the ascending auditory pathway. In fact, a decrease in ability to detect temporally modulated sounds accurately could originate from changes in cochlear filtering properties and in cochlear mechanics due to aging. Nonetheless, few studies have examined cochlear mechanisms in AM detection. To assess integrity of the mechanical properties of the auditory periphery, distortion product otoacoustic emissions (DPOAEs) are a tool commonly used in clinics and in research. In this study, we measured DPOAEs to reveal age-related changes in peak f2/f1 ratio and degradation in AM detection by basilar membrane vibration. Two tones (f1 and f2, f2 > f1) at various f2/f1 ratios and simultaneous presentation of one AM and one pure tone were used as stimuli to evoke DPOAEs. In addition of observing reduced DPOAE amplitudes and steeper slopes in the input-output DPOAE functions, higher peak f2/f1 ratios and broader f2/f1 tuning were also observed in aged animals. Aged animals generally had lower distortion product (DP) and first sideband (SB 1) responses evoked by an f1 pure tone and an f2 AM tone, regardless of whether the AM frequency was 45 Hz or 128 Hz. SB 1 thresholds, which corresponds to the smallest stimulus AM depth that can induce cochlear vibrations at the DP generator locus, were higher in aged animals as well. The results suggest that age-related changes in peak f2/f1 ratio and AM detection by basilar membrane vibration are consistent with a reduction in endocochlear potential and reduced prestin activity but with preserved hair cell bundle function. SB 1 responses evoked by f2 AM/f1 pure tone with various AM depths could serve as an estimate for cochlear AM detection. The sidebands of DP could also serve as additional physiological cues for detection of AM in the presence of other tone(s), even at typical conversational levels in speech.

Otoacoustic emission responses of the cochlea to acute and total ischemia

In the present experimental study, we sought to monitor distortion product otoacoustic emissions (DPOAEs) as an indicator of cochlear function, after sudden, total, and irreversible interruption of cochlear blood flow, to provide information on the time course of cochlear response to ischemia. Twenty rats with normal hearing function were included. Complete and abrupt ischemia was provided by decapitation. DPOAEs at 3-8 kHz frequencies were recorded at baseline and exactly every consecutive minute after decapitation, until emissions in all frequencies disappeared completely. Mean DPOAE values decreased significantly and progressively after decapitation for all frequencies. The mean duration of emissions was 8.20 ± 1.96 min (minimum 3 min, maximum 11 min). The longest durations of DPOAEs were observed with 4 and 5 kHz frequencies, and 3 and 6 kHz had the shortest durations. The outer hair cells exposed to acute ischemia seem to exhibit a rapid functional loss; thus, cautious handling of the cochlear vasculature and surrounding structures is necessary in surgical interventions. Additionally, our results provide some idea of the normal tolerance range of the cochlea to ischemia, which could be useful for future studies.

Mutation of Foxo3 causes adult onset auditory neuropathy and alters cochlear synapse architecture in mice

Auditory neuropathy is a form of hearing loss in which cochlear inner hair cells fail to correctly encode or transmit acoustic information to the brain. Few genes have been implicated in the adult-onset form of this disease. Here we show that mice lacking the transcription factor Foxo3 have adult onset hearing loss with the hallmark characteristics of auditory neuropathy, namely, elevated auditory thresholds combined with normal outer hair cell function. Using histological techniques, we demonstrate that Foxo3-dependent hearing loss is not due to a loss of cochlear hair cells or spiral ganglion neurons, both of which normally express Foxo3. Moreover, Foxo3-knock-out (KO) inner hair cells do not display reductions in numbers of synapses. Instead, we find that there are subtle structural changes in and surrounding inner hair cells. Confocal microscopy in conjunction with 3D modeling and quantitative analysis show that synaptic localization is altered in Foxo3-KO mice and Myo7a immunoreactivity is reduced. TEM demonstrates apparent afferent degeneration. Strikingly, acoustic stimulation promotes Foxo3 nuclear localization in vivo, implying a connection between cochlear activity and synaptic function maintenance. Together, these findings support a new role for the canonical damage response factor Foxo3 in contributing to the maintenance of auditory synaptic transmission.

Auditory Distortions: Origins and Functions

To enhance weak sounds while compressing the dynamic intensity range, auditory sensory cells amplify sound-induced vibrations in a nonlinear, intensity-dependent manner. In the course of this process, instantaneous waveform distortion is produced, with two conspicuous kinds of interwoven consequences, the introduction of new sound frequencies absent from the original stimuli, which are audible and detectable in the ear canal as otoacoustic emissions, and the possibility for an interfering sound to suppress the response to a probe tone, thereby enhancing contrast among frequency components. We review how the diverse manifestations of auditory nonlinearity originate in the gating principle of their mechanoelectrical transduction channels; how they depend on the coordinated opening of these ion channels ensured by connecting elements; and their links to the dynamic behavior of auditory sensory cells. This paper also reviews how the complex properties of waves traveling through the cochlea shape the manifestations of auditory nonlinearity. Examination methods based on the detection of distortions open noninvasive windows on the modes of activity of mechanosensitive structures in auditory sensory cells and on the distribution of sites of nonlinearity along the cochlear tonotopic axis, helpful for deciphering cochlear molecular physiology in hearing-impaired animal models. Otoacoustic emissions enable fast tests of peripheral sound processing in patients. The study of auditory distortions also contributes to the understanding of the perception of complex sounds.

Time-domain demonstration of distributed distortion-product otoacoustic emission components

Distortion-product otoacoustic emissions (DPOAEs) were measured in rabbits as time waveforms by employing a phase-rotation technique to cancel all components in the final average, except the 2f1-f2 DPOAE. Subsequent filtering allowed the DPOAE waveform to be clearly visualized in the time domain. In most conditions, f2 was turned off for 6 ms, which produced a gap so that the DPOAE was no longer generated. These procedures allowed the DPOAE onset as well as the decay during the gap to be observed in the time domain. DPOAEs were collected with L1 = L2 = 65-dB sound pressure level primary-tone levels for f2/f1 ratios from 1.25 to 1.01 in 0.02 steps. Findings included the appearance of complex onsets and decays for the DPOAE time waveforms as the f2/f1 ratio was decreased and the DPOAE level was reduced. These complexities were unaffected by interference tones (ITs) near the DPOAE frequency place (fdp), but could be removed by ITs presented above f2, which also increased DPOAE levels. Similar outcomes were observed when DPOAEs were measured at a sharp notch in the DPOAE level as a function of the f2 primary tone frequency, i.e., DP-gram. Both findings were consistent with the hypothesis that the DPOAE-ratio function, and some notches in the DP-gram, are caused by interactions of distributed DPOAE components with unique phases.

Unstable distortion-product otoacoustic emission phase in Menière's disease

The presence of endolymphatic hydrops as a marker of Menière's disease (MD) suggests abnormal pressure in the intralabyrinthine compartments of patients and excessive stiffness of sound-sensitive structures. Otoacoustic emissions (OAEs) have been reported to respond to changes in the ear's stiffness, including those produced by intracranial pressure steps, by a characteristic phase shift around 1 kHz, thereby suggesting a noninvasive means of monitoring MD. Here, body tilt was used for modulating intracranial pressure in forty-one patients with definite MD who were tentatively measured at two stages, with and without active symptoms. Their distortion-product OAEs (DPOAEs) were dynamically monitored around 1 kHz every few seconds in response to body tilt. In a control sample of thirty normal ears, the maximum phase rotation of DPOAEs produced by body tilt was between -18° and +37°. In MD ears with the complete set of symptoms, the posture-induced phase shifts in 32 out of 35 tests fell outside the normative interval, and in 10 tests, although DPOAEs were well above noise floor, their phase was always so abnormally erratic that body tilt produced hardly any additional effect. When MD ears were asymptomatic, nine out of 32 posture tests were abnormal. The excessive DPOAE phase shift is consistent with either a too stiff cochlear partition or a displacement of the operating point of outer hair cells by endolymphatic hydrops.

The remarkable cochlear amplifier

This composite article is intended to give the experts in the field of cochlear mechanics an opportunity to voice their personal opinion on the one mechanism they believe dominates cochlear amplification in mammals. A collection of these ideas are presented here for the auditory community and others interested in the cochlear amplifier. Each expert has given their own personal view on the topic and at the end of their commentary they have suggested several experiments that would be required for the decisive mechanism underlying the cochlear amplifier. These experiments are presently lacking but if successfully performed would have an enormous impact on our understanding of the cochlear amplifier.

Cochlear dysfunction in hyperuricemia: otoacoustic emission analysis

PURPOSE

The objective of this study is to provide evidence that primary hyperuricemia is associated with cochlear dysfunction as other metabolic diseases that interfere with cell metabolism.

MATERIALS AND METHODS

Cochlear function was evaluated in 25 subjects with asymptomatic hyperuricemia using routine diagnostic audiometry along with transient evoked and distortion product otoacoustic emissions (TEOAE and DPOAE, respectively). To support the notion that vascular compromise was a significant underlying factor for such cochlear dysfunction, we assessed vascular anatomical and functional states through measuring the common carotid artery intima-media thickness and flow velocity of the basal intracranial vessels.

RESULTS

Compared with control subjects, reduced response levels of TEOAEs (P < .01) and amplitudes of DPOAEs (P < .001) were detected at higher frequencies. The reduced DPOAE levels at 5 kHz and TEOAEs at 4 kHz correlated significantly with uric acid (P < .05; P < .01), patients' age (P < .06; P < .05), duration since diagnosis of hyperuricemia (P < .05; P < .001), common carotid artery intima-media thickness (P < .05), mean flow velocities of middle cerebral arteries (P < .05), and vertebral arteries (P < .01). Multivariate analysis showed that the abnormalities at higher frequencies were significantly correlated with the duration and degree of hyperuricemia.

CONCLUSIONS

These data suggest that subclinical changes in cochlear function are associated with hyperuricemia. They support the usefulness of otoacoustic emissions in early detection of cochlear dysfunction. It is possible that hyperuricemia could be accompanied by increased stiffness and/or compromise of blood supply of the outer hair cells, which will impair their electromotile response.

Local cochlear damage reduces local nonlinearity and decreases generator-type cochlear emissions while increasing reflector-type emissions

Distortion product otoacoustic emissions (DPOAEs) originate in cochlear nonlinearity and emerge into the ear canal as an apparent sum of emission types, one of which (generator) travels directly out and the other (reflector) travels out following linear reflection. The present study explores intracochlear sources of DPOAEs via simultaneous ear canal and intracochlear pressure measurements in gerbils. A locally damaged cochlea was produced with reduced local intracochlear nonlinearity and significant elevation of the compound action potential thresholds at frequencies represented within the damaged region. In the DPOAE the comparison of healthy to locally damaged cochleae showed the following: (1) In the broad frequency region corresponding to the locally damaged best frequency, DPOAEs evoked by wider f(2)/f(1) stimuli decreased, consistent with the reduction in local nonlinearity. (2) DPOAEs evoked by narrow f(2)/f(1) stimuli often had a bimodal change, decreasing in a lower frequency band and increasing in a band just adjacent and higher, and the DPOAE phase-vs-frequency slope steepened. These changes confirm the complex nature of the DPOAE.

Comparing the optimal signal conditions for recording cubic and quadratic distortion product otoacoustic emissions

Odd- and even-order distortion products (DPs), evoked by two primary tones (f(1),f(2),f(1)<f(2)), represent different aspects of cochlear nonlinearity. The cubic and quadratic difference tones (CDT 2f(1)-f(2) and QDT f(2)-f(1)) are prominent representatives of the odd and even DPs. Distortion product otoacoustic emissions (DPOAEs) were measured within a primary level (L(1),L(2)) space over a wide range of f(2)f(1) ratios to compare the optimal signal conditions for these DPs. For CDT, the primary level difference decreased as L(1) increased with a rate proportional to the f(2)f(1) ratio. Moreover, the optimal ratio increased with L(1). A set of two formulas is proposed to describe the optimal signal conditions. However, for a given level of a primary, increasing the other tone level could maximize the QDT amplitude. The frequency ratio at the maximal QDT was about 1.3 and quite constant across different primary levels. A notch was found in the QDT amplitude at the f(2)f(1) ratio of about 1.22-1.25. These opposite behaviors suggest that the optimal recording conditions are different for CDT and QDT due to the different aspects in the cochlear nonlinearity. Optimizing the DPOAE recordings could improve the reliability in clinical or research practices.

Cochlear nonlinearity in normal-hearing subjects as inferred psychophysically and from distortion-product otoacoustic emissions

The aim was to investigate the correlation between compression exponent, compression threshold, and cochlear gain for normal-hearing subjects as inferred from temporal masking curves (TMCs) and distortion-product otoacoustic emission (DPOAEs) input-output (I/O) curves. Care was given to reduce the influence of DPOAE fine structure on the DPOAE I/O curves. A high correlation between compression exponent estimates obtained with the two methods was found at 4 kHz but not at 0.5 and 1 kHz. One reason is that the DPOAE I/O curves show plateaus or notches that result in unexpectedly high compression estimates. Moderately high correlation was found between compression threshold estimates obtained with the two methods, although DPOAE-based values were around 7 dB lower than those based on TMCs. Both methods show that compression exponent and threshold are approximately constant across the frequency range from 0.5 to 4 kHz. Cochlear gain as estimated from TMCs was found to be approximately 16 dB greater at 4 than at 0.5 kHz. In conclusion, DPOAEs and TMCs may be used interchangeably to infer precise individual nonlinear cochlear characteristics at 4 kHz, but it remains unclear that the same applies to lower frequencies.

Assessment of cochlear function in mice: distortion-product otoacoustic emissions

Distortion-product otoacoustic emissions (DPOAEs) can be measured in the ear canal following the presentation of two tones. These emissions are generated by the outer hair cells (OHCs) of the inner ear and they are reduced or absent when the OHCs are damaged by, for example, exposure to excessive noise or ototoxic drugs. Consequently, DPOAEs provide a powerful and noninvasive means to assess the robustness of OHC function. A detailed method is described for measuring DPOAEs to assess cochlear function in mice. Recommendations are given for the required equipment and instructions are presented for setting up a DPOAE system. Also, a protocol is outlined for measuring DPOAEs in mice and troubleshooting tips are provided. Examples of data analysis procedures following noise exposure in mice are included, as well. These methods are not only applicable to mice, but can be performed using essentially all small laboratory animals.

Supporting evidence for reverse cochlear traveling waves

As a result of the cochlea's nonlinear mechanics, stimulation by two tones results in the generation of distortion products (DPs) at frequencies flanking the primary tones. DPs are measurable in the ear canal as oto-acoustic emissions, and are used to noninvasively explore cochlear mechanics and diagnose hearing loss. Theories of DP emissions generally include both forward and reverse cochlear traveling waves. However, a recent experiment failed to detect the reverse-traveling wave and concluded that the dominant emission path was directly through the fluid as a compression pressure [Ren, 2004, Nat. Neurosc.7, 333-334]. To explore this further, we measured intracochlear DPs simultaneously with emissions over a wide frequency range, both close to and remote from the basilar membrane. Our results support the existence of the reverse-traveling wave: (1) They show spatial variation in DPs that is at odds with a compression pressure. (2) Although they confirm a forward-traveling character of intraocochlear DPs in a broad frequency region of the best frequency, this behavior does not refute the existence of reverse-traveling waves. (3) Finally, the results show that, in cases in which it can be expected, the DP emission is delayed relative to the DP in a way that supports reverse-traveling-wave theory.

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

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

Long term effects of BAPTA in scala media on cochlear function

BAPTA was iontophoresed or allowed to diffuse into the scala media of the first turn of the guinea pig cochlea via pipettes inserted through the round window and basilar membrane. Cochlear action potential (CAP) thresholds for basal turn frequencies were elevated, scala media cochlear microphonic in response to a 207Hz tone were drastically reduced and the distortion products 2f1-f2 and f2-f2 in response to primaries set at 18 and 21.6kHz were eliminated or severely reduced. The animals were recovered and the above measurements repeated between 24 and 240h after the application of BAPTA. In all animals thresholds for basal turn frequencies remained elevated, and the distortion components were severely reduced. The endolymphatic potential (EP), measured through the basilar membrane on recovery, was not significantly different from the values measured before BAPTA was applied. If the effect of BAPTA, in lowering endolymphatic Ca(2+) concentration, is restricted to the destruction of tip links, as has been shown in many other preparations, then these results suggest that this effect has permanent consequences, either because the tip links failed to regenerate or because their destruction precipitated the degeneration of OHCs. These results may have a bearing on the mechanisms behind permanent threshold shift.

The cochleogram of the guinea pig

The cochleogram is an important tool to relate properties of the cochlea (e.g. hair cell loss, damaged hair cells) to their position in the cochlear turns, to calculate the average hair cell density, and to measure the length of the whole cochlea. In this work different methods of plotting cochleograms are compared. We suggest that a sector-wise division of the cochlea for counting a cochleogram has advantages over line diagrams that provide a higher spatial resolution but might lead to misinterpretations of the degree of missing hair cells. The scanning electron microscopic analysis of 171 guinea pig cochleas revealed a mean basilar membrane length of 16.4 +/- 1.4 mm (mean +/- standard deviation) with sector lengths of 6.9, 4.2, 3.2, and 1.9 mm, thus adding relevant information to the morphology of the guinea pig cochlea.

Distortion-product otoacoustic emission suppression growth in normal and noise-exposed rabbits

This study investigated noise-induced changes in suppression growth (SG) of distortion product otoacoustic emissions (DPOAEs). Detailed measurements of SG were obtained in rabbits as a function of f2 frequencies at four primary-tone levels. SG measures were produced by using suppressor tones (STs) presented at two fixed distances from f2. The magnitude of suppression was calculated for each ST level and depicted as contour plots showing the amount of suppression as a function of the f2 frequency. At each f2, SG indices included slope, suppression threshold, and an estimate of the tip-to-tail value. All suppression measures were obtained before and after producing a cochlear dysfunction using a monaural exposure to a 2-h, 110-dB SPL octave-band noise centered at 2 kHz. The noise exposure produced varying amounts of cochlear damage as revealed by changes in DP-grams and auditory brainstem responses. However, average measures of SG slopes, suppression thresholds, and tip-to-tail values failed to mirror the mean DP-gram loss patterns. When suppression-based parameters were correlated with the amount of DPOAE loss, small but significant correlations were observed for some measures. Overall, the findings suggest that measures derived from DPOAE SG are limited in their ability to detect noise-induced cochlear damage.

Middle ear forward and reverse transmission in gerbil

The middle ear transmits environmental sound to the inner ear. It also transmits acoustic energy sourced within the inner ear out to the ear canal, where it can be detected with a sensitive microphone as an otoacoustic emission. Otoacoustic emissions are an important noninvasive measure of the condition of sensory hair cells and to use them most effectively one must know how they are shaped by the middle ear. In this contribution, forward and reverse transmissions through the middle ear were studied by simultaneously measuring intracochlear pressure in scala vestibuli near the stapes and ear canal pressure. Measurements were made in gerbil, in vivo, with acoustic two-tone stimuli. The forward transmission pressure gain was about 20-25 dB, with a phase-frequency relationship that could be fit by a straight line, and was thus characteristic of a delay, over a wide frequency range. The forward delay was about 32 micros. The reverse transmission pressure loss was on average about 35 dB, and the phase-frequency relationship was again delaylike with a delay of about 38 mus. Therefore to a first approximation the middle ear operates similarly in the forward and reverse directions. The observation that the amount of pressure reduction in reverse transmission was greater than the amount of pressure gain in forward transmission suggests that complex motions of the tympanic membrane and ossicles affect reverse more than forward transmission.

Correlation of transiently evoked to distortion-product otoacoustic emission measures in healthy children

OBJECTIVE

Transiently evoked (TEOAEs) and distortion-product otoacoustic emissions at the 2f1-f2 frequency (DPOAEs) are being used as a clinical tool for diagnosis of peripheral auditory pathology. Because both tests are fast and non-invasive, they may be an excellent method for hearing screening in infants and children. The purpose of this study was to compare the TEOAE and DPOAE measures obtained in a group of healthy children.

METHODS

Sixty-six school-aged children with normal hearing were included in the study. Subjects with recent otologic disease or abnormal tympanograms were excluded. TEOAEs and DPOAEs were performed using a DP Echoport ILO 292 Otodynamics analyzer connected to a portable personal computer. Correlation between TEOAE amplitudes and DPOAE levels was estimated.

RESULTS

Correlation between TEOAE amplitudes and DPOAE levels was highly significant across all measured frequencies. Correlation was more significant at the middle frequencies than at the low and high frequencies.

CONCLUSIONS

Although frequency specific information may be obtained by both tests, most reliable results were obtained at the middle frequencies. TEOAE values were more prominent at low frequencies, whereas DPOAEs were more effective at high frequencies. Both methods are reliable, objective, fast and useful tests of the cochlear status and should be included in the standard audiological diagnostic work-up of children.

Distortion-product otoacoustic emission spectra and high-resolution audiometry in noise-induced hearing loss

Distortion product otoacoustic emissions (DPOAE) elicited by 60dB SPL pure tones at f1 and f2 were collected at 2f1-f2, in 1/10th octave steps, in a sample of 36 ears from 27 patients with noise-induced hearing loss (NIHL). They were analyzed in the frequency domain against the outcome of high-resolution pure-tone audiometry, performed with the help of a Békésy sweep-frequency automatic audiometer. The characteristics of DPOAE level plots as a function of frequency (the so-called DP-grams), relative to the DPOAE levels of a control age-matched group, were compared to their alleged counterparts on the audiograms, i.e., the lower and upper frequency boundaries of the interval with hearing loss. Ears with NIHL split into two subgroups, one (n = 25) with a notch in the DP-gram such that its lower boundary matched the lower limit of the audiometric notch (linear regression with a slope of 0.91, r(2) = 0.644, p < 0.001). Likewise, when it existed, its upper boundary matched its upper counterpart on the audiogram (linear regression with a slope of 0.96, r(2) = 0.89, p < 0.001). In this respect, DP-grams performed better than transient-evoked OAE spectra, which exhibited poor correlations with audiogram patterns. The second subgroup (n = 11) exhibited normal DPOAEs at all frequencies despite audiometric losses similar to those of the first subgroup. In all cases, DPOAE levels were poor predictors of the degree of hearing losses. It is hypothesized that NIHL in the second subgroup involves inner hair cells or auditory neurons, instead of outer hair cells in the first subgroup. Provided NIHL affected outer hair cells, DP-grams provided a comparatively accurate predictor of the spectral extent of hearing loss.

Dependence of the DPOAE amplitude pattern on acoustical biasing of the cochlear partition

Distortion product otoacoustic emissions (DPOAEs) were recorded from guinea pigs in response to simultaneous increases in the levels of high frequency primary tones in the presence of a low frequency biasing tone of 30 Hz at 120 dB SPL. The DPOAE amplitudes plotted as functions of the biasing tone phase angle show distinctive repeatable minima, which are identical to the amplitude notches observed for the distortion products at the output of a single saturating non-linearity. The number of the amplitude minima grows with increasing order of the DPOAE, a feature that is also reproduced by the model. The model of DPOAE generation due to a single saturating non-linearity does not explain the experimentally observed asymmetry of the response of the DPOAEs to rising and falling half cycles of the biasing tone. This asymmetry is attributed to a hypothetical mechanism, which adjusts the operating point of the outer hair cell's mechanoelectrical transducer. Experimental data were consistent with a hypothesis that, for the parameters of stimulation used in this study, both lower and upper sideband DPOAEs are dominated by emission generated from a single and spatially localized place in the cochlea.

Two-tone distortion in intracochlear pressure

Two-tone distortion was measured in the intracochlear pressure in the base of the gerbil cochlea, close to the sensory tissue, where the local motions and forces of the organ of Corti can be detected. The measurements probe both the underlying nonlinear process that generates two-tone distortion, and the filtering and spreading of the distortion products. Some of our findings are as follows: (1) The observations were consistent with previous observations of two-tone distortion in BM motion [J. Neurophysiol. 77, 2385-2399 (1997); J. Neurophysiol. 78, 261-270 (1997)]. (2) Frequency sweeps show distortion product tuning and phase-versus-frequency behavior that is similar, but not identical, to single tone tuning. (3) The decay of distortion products with distance from the basilar membrane confirms the feasibility that they could drive the stapes by a direct fluid route, as proposed by Ren [Nat. Neurosci. 7, 333-334 (2004)]. (4) The phases of the distortion products within a single family (the group of distortion products generated by a single primary pair) in some cases alternated between 0 degrees and 180 degrees when referenced to the phases of the primaries. This behavior is predicted by a simple compressive nonlinearity.

Is there a close relationship between changes in amplitudes of distortion product otoacoustic emissions and hair cell damage after exposure to realistic industrial noise in guinea pigs?

In long-term experiments in awake guinea pigs (n = 12), distortion product otoacoustic emissions (DPOAEs) at various frequencies were measured repeatedly over 6-8 months. About 9 weeks after the first measurement, the animals were exposed to industrial noise (car industry, maximal intensity about 110 dB SPL) for 2 h. The amplitudes of DPOAE were measured prior to noise exposure and 10 min, 70 min, 1 day and 2 days after the noise exposure and then once every week. Three to four months after noise exposure, the animals were killed, and the cochleae were prepared for scanning electron microscopy. The row of inner hair cells (IHCs) was complete in all animals, while the rows of outer hair cells (OHCs) showed a considerable hair cell loss in some of the animals without a correlation to the change in amplitudes of DPOAE. However, a closer relationship between the decline of amplitudes of DPOAE and the number of missing and changed OHCs (fused stereocilia bundles, missing tip links) could be established. The number of lost OHC does not reflect the decline in DPOAE in all cases. This discrepancy must be considered when the degree of hearing loss needs to be established from changed DPOAE.

Temporary DPOAE level shifts, ABR threshold shifts and histopathological damage following below-critical-level noise exposures

DPOAE temporary level shift (TLS) at 2f(1)-f(2) and f(2)-f(1), ABR temporary threshold shift (TTS), and detailed histopathological findings were compared in three groups of chinchillas that were exposed for 24 h to an octave band of noise (OBN) centered at 4 kHz with a sound pressure level (SPL) of 80, 86 or 92 dB (n=3,4,6). DPOAE levels at 39 frequencies from f(1)=0.3 to 16 kHz (f(2)/f(1)=1.23; L(2) and L(1)=55, 65 and 75 dB, equal and differing by 10 dB) and ABR thresholds at 13 frequencies from 0.5 to 20 kHz were collected pre- and immediately post-exposure. The functional data were converted to pre- minus post-exposure shift and overlaid upon the cytocochleogram of cochlear damage using the frequency-place map for the chinchilla. The magnitude and frequency place of components in the 2f(1)-f(2) TLS patterns were determined and group averages for each OBN SPL and L(1), L(2) combination were calculated. The f(2)-f(1) TLS was also examined in ears with focal lesions equal to or greater than 0.4 mm. The 2f(1)-f(2) TLS (plotted at f(1)) and TTS aligned with the extent and location of damaged supporting cells. The TLS patterns over frequency had two features which were unexpected: (1) a peak at about a half octave above the center of the OBN with a valley just above and below it and (2) a peak (often showing enhancement) at the apical boundary of the supporting-cell damage. The magnitudes of the TLS and TTS generally increased with increasing SPL of the exposure. The peaks of the TLS and TTS, as well as the peaks and valleys of the TLS pattern moved apically as the SPL of the OBN was increased. However, there was little consistency in the pattern relations with differing L(1), L(2) combinations. In addition, neither the 2f(1)-f(2) nor f(2)-f(1) TLS for any L(1), L(2) combination reliably detected focal lesions (100% OHC loss) from 0.4 to 1.2 mm in size. Often, the TLS went in the opposite direction from what would be expected at focal lesions. Recovery from TLS and TTS was also examined in seven animals. Both TLS and TTS recovered partially or completely, the magnitude depending upon exposure SPL.

Frequency specificity of distortion-product otoacoustic emissions produced by high-level tones despite inefficient cochlear electromechanical feedback

Distortion product otoacoustic emissions (DPOAEs) are thought to stem from the outer hair cells (OHCs) around the normally narrow place tuned to the primary tone stimuli. They are thus said to be frequency-specific: their local absence should accurately pinpoint local OHC damage. Yet the influence of impaired tuning on DPOAE frequency specificity is poorly documented. Mice with local damage to OHCs were examined. Their DPOAEs were frequency-specific in that audiometric notches were accurately tracked. The same cochleae were further impaired by ischemia or furosemide injection inducing strial dysfunction with flat loss of sensitivity and tuning, while the preexisting pattern of damaged OHCs remained unaltered. Despite the loss of cochlear activity, DPOAEs produced by high-level (> or =70 dB SPL) primaries remained large in about the same interval where they had been initially normal, i.e., that with nondamaged OHCs, albeit with a slight frequency shift, of -1.1 kHz on average. Thus, the ability of DPOAEs to map structurally intact OHCs cannot be a mere consequence of cochlear tuning as it largely persists in its absence. The key element for this correct mapping is likely part of intact OHC structures (e.g., stereocilia bundles) and must have some tuning of its own.

Otoacoustic emissions without somatic motility: can stereocilia mechanics drive the mammalian cochlea?

Distortion product otoacoustic emissions (DPOAEs) evoked by low-level tones are a sensitive indicator of outer hair cell (OHC) function. High-level DPOAEs are less vulnerable to cochlear insult, and their dependence on the OHC function is more controversial. Here, the mechanism underlying high-level DPOAE generation is addressed using a mutant mouse line lacking prestin, the molecular motor driving OHC somatic motility, required for cochlear amplification. With prestin deletion, attenuated DPOAEs were measurable at high sound levels. DPOAE thresholds were shifted by approximately 50 dB, matching the loss of cochlear amplifier gain measured in compound action potentials. In contrast, at high sound levels, distortion products in the cochlear microphonic (CM) of mutants were not decreased re wildtypes (expressed re CM at the primaries). Distortion products in both CM and otoacoustic emissions disappeared rapidly after death. The results show that OHC somatic motility is not necessary for the production of DPOAEs at high SPLs. They also suggest that the small, physiologically vulnerable DPOAE that remains without prestin-based motility is due directly to the mechanical nonlinearity associated with stereociliary transduction, and that this stereocilia mechanical nonlinearity is robustly coupled to the motion of the cochlear partition to the extent that it can drive the middle ear.

Cochlear hysteresis: observation with low-frequency modulated distortion product otoacoustic emissions

Low-frequency modulation of distortion product otoacoustic emissions (DPOAEs) can be used to estimate a nonlinear transducer function (fTr) of the cochlea. From gerbils, DPOAEs were measured while presenting a high-level bias tone. Within one period of the bias tone, the magnitudes of the cubic difference tone (CDT, 2f1 - f2) demonstrated two similar modulation patterns (MPs) each resembled the absolute value of the third derivative of the fTr. The center peaks of the MPs occurred at positive sound pressures for rising in bias pressure or loading of the cochlear transducer, and more negative pressures while decreasing bias amplitude or unloading. The corresponding fTr revealed a sigmoid-shaped hysteresis loop with counterclockwise traversal. Physiologic indices that characterized the double MP varied with primary level. A Boltzmann-function-based model with negative damping as a feedback component was proposed. The model was able to replicate the experimental results. Model parameters that fit to the CDT data indicated higher transducer gain and more prominent feedback role at lower primary levels. Both physiologic indices and model parameters suggest that the cochlear transducer dynamically changes its gain with input signal level and the nonlinear mechanism is a time-dependent feedback process.