Long-term stability of spontaneous otoacoustic emissions

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.

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.

Modeling the characteristics of spontaneous otoacoustic emissions in lizards

Lizard auditory papillae have proven to be an attractive object for modelling the production of spontaneous otoacoustic emissions (SOAE). Here we use an established model (Vilfan and Duke, 2008) and extend it by exploring the effect of varying the number of oscillating elements, the strength of the parameters that describe the coupling between oscillators, the strength of the oscillators, and additive noise. The most remarkable result is that the actual number of oscillating elements hardly influences the spectral pattern, explaining why spectra from very different papillar dimensions are similar. Furthermore, the spacing between spectral peaks primarily depends on the reactive coupling between the oscillator elements. This is consistent with observed differences between lizard species with respect to tectorial covering of hair cells and SOAE peak spacings. Thus, the model provides a basic understanding of the variation in SOAE properties across lizard species.

No otoacoustic evidence for a peripheral basis of absolute pitch

Absolute pitch (AP) is the ability to identify the perceived pitch of a sound without an external reference. Relatively rare, with an incidence of approximately 1/10,000, the mechanisms underlying AP are not well understood. This study examined otoacoustic emissions (OAEs) to determine if there is evidence of a peripheral (i.e., cochlear) basis for AP. Two OAE types were examined: spontaneous emissions (SOAEs) and stimulus-frequency emissions (SFOAEs). Our motivations to explore a peripheral foundation for AP were several-fold. First is the observation that pitch judgment accuracy has been reported to decrease with age due to age-dependent physiological changes cochlear biomechanics. Second is the notion that SOAEs, which are indirectly related to perception, could act as a fixed frequency reference. Third, SFOAE delays, which have been demonstrated to serve as a proxy measure for cochlear frequency selectivity, could indicate tuning differences between groups. These led us to the hypotheses that AP subjects would (relative to controls) exhibit a. greater SOAE activity and b. sharper cochlear tuning. To test these notions, measurements were made in normal-hearing control (N = 33) and AP-possessor (N = 20) populations. In short, no substantial difference in SOAE activity was found between groups, indicating no evidence for one or more strong SOAEs that could act as a fixed cue. SFOAE phase-gradient delays, measured at several different probe levels (20-50 dB SPL), also showed no significant differences between groups. This observation argues against sharper cochlear frequency selectivity in AP subjects. Taken together, these data support the prevailing view that AP mechanisms predominantly arise at a processing level in the central nervous system (CNS) at the brainstem or higher, not within the cochlea.

Reflection- and Distortion-Source Otoacoustic Emissions: Evidence for Increased Irregularity in the Human Cochlea During Aging

Previous research on distortion product otoacoustic emission (DPOAE) components has hinted at possible differences in the effect of aging on the two basic types of OAEs: those generated by a reflection mechanism in the cochlea and those created by nonlinear distortion (Abdala and Dhar in J Assoc Res Otolaryngol 13:403-421, 2012). This initial work led to the hypothesis that micromechanical irregularity ("roughness") increases in the aging cochlea, perhaps as the result of natural tissue degradation. Increased roughness would boost the backscattering of traveling waves (i.e., reflection emissions) while minimally impacting DPOAEs. To study the relational effect of aging on both types of emissions and address our hypothesis of its origin, we measured reflection- and distortion-type OAEs in 77 human subjects aged 18-76 years. The stimulus-frequency OAE (SFOAE), a reflection emission, and the distortion component of the DPOAE, a nonlinear distortion emission, were recorded at multiple stimulus levels across a four-octave range in all ears. Although the levels of both OAE types decreased with age, the rate of decline in OAE level was consistently greater for DPOAEs than for SFOAEs; that is, SFOAEs are relatively preserved with advancing age. Multiple regression analyses and other controls indicate that aging per se, and not hearing loss, drives this effect. Furthermore, SFOAE generation was simulated using computational modeling to explore the origin of this result. Increasing the amount of mechanical irregularity with age produced an enhancement of SFOAE levels, providing support for the hypothesis that increased intra-cochlear roughness during aging may preserve SFOAE levels. The characteristic aging effect-relatively preserved reflection-emission levels combined with more markedly reduced distortion-emission levels-indicates that SFOAE magnitudes in elderly individuals depend on more than simply the gain of the cochlear amplifier. This relative pattern of OAE decline with age may provide a diagnostic marker for aging-related changes in the cochlea.

Even-longer-term stability of spontaneous otoacoustic emissions

This report is an addendum to a previous report by Burns [(2009). J. Acoust. Soc. Am. 125, 3166-3176] that measured spontaneous otoacoustic emissions (SOAEs) in 18 subjects, whose ages at the time of initial measurement ranged from 6 to 42 yr, for follow-up periods of up to 19.5 yr. The major finding of that report was that the frequencies of all SOAEs, in all subjects, declined over time, with an average decline of 0.25% per year. In this report seven SOAEs in the oldest subject were measured for an additional 13.7 yr, for a total follow-up of 33 yr, to age 75.

Tinnitus in Normal-Hearing Participants after Exposure to Intense Low-Frequency Sound and in Ménière's Disease Patients

Tinnitus is one of the three classical symptoms of Ménière’s disease (MD), an inner ear disease that is often accompanied by endolymphatic hydrops. Previous studies indicate that tinnitus in MD patients is dominated by low frequencies, whereas tinnitus in non-hydropic pathologies is typically higher in frequency. Tinnitus of rather low-frequency (LF) quality was also reported to occur for about 90 s in normal-hearing participants after presentation of intense, LF sound (120 dB SPL, 30 Hz, 90 s). LF sound has been demonstrated to also cause temporary endolymphatic hydrops in animal models. Here, we quantify tinnitus in two study groups with chronic (MD patients) and presumably transient endolymphatic hydrops (normal-hearing participants after LF exposure) with a psychophysical procedure. Participants matched their tinnitus either with a pure tone of adjustable frequency and level or with a noise of adjustable spectral shape and level. Sensation levels of matching stimuli were lower for MD patients (mean: 8 dB SL) than for normal-hearing participants (mean: 15 dB SL). Transient tinnitus after LF-exposure occurred in all normal-hearing participants (N = 28). About half of the normal-hearing participants matched noise to their tinnitus, the other half chose a pure tone with frequencies below 2 kHz. MD patients matched their tinnitus with either high-frequency pure tones, mainly above 3 kHz, or with a noise. Despite a significant proportion of MD patients matching low-pass (roaring) noises to their tinnitus, the range of matched stimuli was more heterogeneous than previous data suggested. We propose that in those participants with noise-like tinnitus, the percept is probably generated by increased spontaneous activity of auditory nerve fibers with a broad range of characteristic frequencies, due to an impaired ion balance in the cochlea. For tonal tinnitus, additional mechanisms are conceivable: focal hair cell loss can result in decreased auditory nerve firing and a central auditory overcompensation. Also, normal-hearing participants after LF-exposure experience alterations in spontaneous otoacoustic emissions, which may contribute to a transient tonal tinnitus.

Responses of the Human Inner Ear to Low-Frequency Sound

The perceptual insensitivity to low frequency (LF) sound in humans has led to an underestimation of the physiological impact of LF exposure on the inner ear. It is known, however, that intense, LF sound causes cyclic changes of indicators of inner ear function after LF stimulus offset, for which the term "Bounce" phenomenon has been coined.Here, we show that the mechanical amplification of hair cells (OHCs) is significantly affected after the presentation of LF sound. First, we show the Bounce phenomenon in slow level changes of quadratic, but not cubic, distortion product otoacoustic emissions (DPOAEs). Second, Bouncing in response to LF sound is seen in slow, oscillating frequency and correlated level changes of spontaneous otoacoustic emissions (SOAEs). Surprisingly, LF sound can induce new SOAEs which can persist for tens of seconds. Further, we show that the Bounce persists under free-field conditions, i.e. without an in-ear probe occluding the auditory meatus. Finally, we show that the Bounce is affected by contralateral acoustic stimulation synchronised to the ipsilateral LF sound. These findings clearly demonstrate that the origin of the Bounce lies in the modulation of cochlear amplifier gain. We conclude that activity changes of OHCs are the source of the Bounce, most likely caused by a temporary disturbance of OHC calcium homeostasis. In the light of these findings, the effects of long-duration, anthropogenic LF sound on the human inner ear require further research.

Concurrent Acoustic Activation of the Medial Olivocochlear System Modifies the After-Effects of Intense Low-Frequency Sound on the Human Inner Ear

>Human hearing is rather insensitive for very low frequencies (i.e. below 100 Hz). Despite this insensitivity, low-frequency sound can cause oscillating changes of cochlear gain in inner ear regions processing even much higher frequencies. These alterations outlast the duration of the low-frequency stimulation by several minutes, for which the term 'bounce phenomenon' has been coined. Previously, we have shown that the bounce can be traced by monitoring frequency and level changes of spontaneous otoacoustic emissions (SOAEs) over time. It has been suggested elsewhere that large receptor potentials elicited by low-frequency stimulation produce a net Ca(2+) influx and associated gain decrease in outer hair cells. The bounce presumably reflects an underdamped, homeostatic readjustment of increased Ca(2+) concentrations and related gain changes after low-frequency sound offset. Here, we test this hypothesis by activating the medial olivocochlear efferent system during presentation of the bounce-evoking low-frequency (LF) sound. The efferent system is known to modulate outer hair cell Ca(2+) concentrations and receptor potentials, and therefore, it should modulate the characteristics of the bounce phenomenon. We show that simultaneous presentation of contralateral broadband noise (100 Hz-8 kHz, 65 and 70 dB SPL, 90 s, activating the efferent system) and ipsilateral low-frequency sound (30 Hz, 120 dB SPL, 90 s, inducing the bounce) affects the characteristics of bouncing SOAEs recorded after low-frequency sound offset. Specifically, the decay time constant of the SOAE level changes is shorter, and the transient SOAE suppression is less pronounced. Moreover, the number of new, transient SOAEs as they are seen during the bounce, are reduced. Taken together, activation of the medial olivocochlear system during induction of the bounce phenomenon with low-frequency sound results in changed characteristics of the bounce phenomenon. Thus, our data provide experimental support for the hypothesis that outer hair cell calcium homeostasis is the source of the bounce phenomenon.

An active oscillator model describes the statistics of spontaneous otoacoustic emissions

Even in the absence of external stimulation, the cochleas of most humans emit very faint sounds below the threshold of hearing, sounds that are known as spontaneous otoacoustic emissions. They are a signature of the active amplification mechanism in the cochlea. Emissions occur at frequencies that are unique for an individual and change little over time. The statistics of a population of ears exhibit characteristic features such as a preferred relative frequency distance between emissions (interemission intervals). We propose a simplified cochlea model comprising an array of active nonlinear oscillators coupled both hydrodynamically and viscoelastically. The oscillators are subject to a weak spatial disorder that lends individuality to the simulated cochlea. Our model captures basic statistical features of the emissions: distributions of 1), emission frequencies; 2), number of emissions per ear; and 3), interemission intervals. In addition, the model reproduces systematic changes of the interemission intervals with frequency. We show that the mechanism for the preferred interemission interval in our model is the occurrence of synchronized clusters of oscillators.

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.

Effects of contralateral acoustic stimulation on spontaneous otoacoustic emissions and hearing threshold fine structure

Medial olivocochlear (MOC) influence on cochlear mechanics can be noninvasively, albeit indirectly, explored via the effects of contralateral acoustic stimulation (CAS) on otoacoustic emissions. CAS-mediated effects are particularly pronounced for spontaneous otoacoustic emissions (SOAEs), which are typically reduced in amplitude and shifted upward in frequency by CAS. We investigated whether similar frequency shifts and magnitude reductions were observed behaviorally in the fine structure of pure-tone hearing thresholds, a phenomenon thought to share a common underlying mechanism with SOAEs. In normal-hearing listeners, fine-resolution thresholds were obtained over a narrow frequency range centered on the frequency of an SOAE, both in the absence and presence of 60-dB SPL broadband CAS. While CAS shifted threshold fine structure patterns and SOAEs upward in frequency by a comparable amount, little reduction in the presence or depth of fine structure was observed at frequencies near those of SOAEs. In fact, CAS typically improved thresholds, particularly at threshold minima, and increased fine structure depth when reductions in the amplitude of the associated SOAE were less than 10 dB. Additional measurements made at frequencies distant from SOAEs, or near SOAEs that were more dramatically reduced in amplitude by the CAS, revealed that CAS tended to elevate thresholds and reduce threshold fine structure depth. The results suggest that threshold fine structure is sensitive to MOC-mediated changes in cochlear gain, but that SOAEs complicate the interpretation of threshold measurements at nearby frequencies, perhaps due to masking or other interference effects. Both threshold fine structure and SOAEs may be significant sources of intersubject and intrasubject variability in psychoacoustic investigations of MOC function.

Otoacoustic emissions, auditory evoked potentials and self-reported gender in people affected by disorders of sex development (DSD)

Both otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are sexually dimorphic, and both are believed to be influenced by prenatal androgen exposure. OAEs and AEPs were collected from people affected by 1 of 3 categories of disorders of sex development (DSD) - (1) women with complete androgen insensitivity syndrome (CAIS); (2) women with congenital adrenal hyperplasia (CAH); and (3) individuals with 46,XY DSD including prenatal androgen exposure who developed a male gender despite initial rearing as females (men with DSD). Gender identity (GI) and role (GR) were measured both retrospectively and at the time of study participation, using standardized questionnaires. The main objective of this study was to determine if patterns of OAEs and AEPs correlate with gender in people affected by DSD and in controls. A second objective was to assess if OAE and AEP patterns differed according to degrees of prenatal androgen exposure across groups. Control males, men with DSD, and women with CAH produced fewer spontaneous OAEs (SOAEs) - the male-typical pattern - than control females and women with CAIS. Additionally, the number of SOAEs produced correlated with gender development across all groups tested. Although some sex differences in AEPs were observed between control males and females, AEP measures did not correlate with gender development, nor did they vary according to degrees of prenatal androgen exposure, among people with DSD. Thus, OAEs, but not AEPs, may prove useful as bioassays for assessing early brain exposure to androgens and predicting gender development in people with DSD.

Spontaneous otoacoustic emissions, threshold microstructure, and psychophysical tuning over a wide frequency range in humans

Hearing thresholds have been shown to exhibit periodic minima and maxima, a pattern known as threshold microstructure. Microstructure has previously been linked to spontaneous otoacoustic emissions (SOAEs) and normal cochlear function. However, SOAEs at high frequencies (>4 kHz) have been associated with hearing loss or cochlear pathology in some reports. Microstructure would not be expected near these high-frequency SOAEs. Psychophysical tuning curves (PTCs), the expression of frequency selectivity, may also be altered by SOAEs. Prior comparisons of tuning between ears with and without SOAEs demonstrated sharper tuning in ears with emissions. Here, threshold microstructure and PTCs were compared at SOAE frequencies ranging between 1.2 and 13.9 kHz using subjects without SOAEs as controls. Results indicate: (1) Threshold microstructure is observable in the vicinity of SOAEs of all frequencies; (2) PTCs are influenced by SOAEs, resulting in shifted tuning curve tips, multiple tips, or inversion. High frequency SOAEs show a greater effect on PTC morphology. The influence of most SOAEs at high frequencies on threshold microstructure and PTCs is consistent with those at lower frequencies, suggesting that high-frequency SOAEs reflect the same cochlear processes that lead to SOAEs at lower frequencies.

Moments of click-evoked otoacoustic emissions in human ears: group delay and spread, instantaneous frequency and bandwidth

A click-evoked otoacoustic emission (CEOAE) has group delay and spread as first- and second-order temporal moments varying over frequency, and instantaneous frequency and bandwidth as first- and second-order spectral moments varying over time. Energy-smoothed moments were calculated from a CEOAE database over 0.5-15 kHz bandwidth and 0.25-20 ms duration. Group delay and instantaneous frequency were calculated without phase unwrapping using a coherence synchrony measure that accurately classified ears with hearing loss. CEOAE moment measurements were repeatable in individual ears. Group delays were similar for CEOAEs and stimulus-frequency OAEs. Group spread is a frequency-specific measure of temporal spread in an emission, related to spatial spread across tonotopic generation sites along the cochlea. In normal ears, group delay and spread increased with frequency and decreased with level. A direct measure of cochlear tuning above 4 kHz was analyzed using instantaneous frequency and bandwidth. Synchronized spontaneous OAEs were present in most ears below 4 kHz, and confounded interpretation of moments. In ears with sensorineural hearing loss, group delay and spread varied with audiometric classification and amount of hearing loss; group delay differed between older males and females. CEOAE moments reveal clinically relevant information on cochlear tuning in ears with normal and impaired hearing.

Interrelationships between spontaneous and low-level stimulus-frequency otoacoustic emissions in humans

It has been proposed that OAEs be classified not on the basis of the stimuli used to evoke them, but on the mechanisms that produce them (Shera and Guinan, 1999). One branch of this taxonomy focuses on a coherent reflection model and explicitly describes interrelationships between spontaneous emissions (SOAEs) and stimulus-frequency emissions (SFOAEs). The present study empirically examines SOAEs and SFOAEs from individual ears within the context of model predictions, using a low stimulus level (20 dB SPL) to evoke SFOAEs. Emissions were recorded from ears of normal-hearing young adults, both with and without prominent SOAE activity. When spontaneous activity was observed, SFOAEs demonstrated a localized increase about the SOAE peaks. The converse was not necessarily true though, i.e., robust SFOAEs could be measured where no SOAE peaks were observed. There was no significant difference in SFOAE phase-gradient delays between those with and without observable SOAE activity. However, delays were larger for a 20 dB SPL stimulus level than those previously reported for 40 dB SPL. The total amount of SFOAE phase accumulation occurring between adjacent SOAE peaks tended to cluster about an integral number of cycles. Overall, the present data appear congruous with predictions stemming from the coherent reflection model and support the notion that such comparisons ideally are made with emissions evoked using relatively lower stimulus levels.

Frequency shifts with age in click-evoked otoacoustic emissions of preterm infants

A previous study [Brienesse et al. (1997). Pediatr. Res. 42, 478-483] demonstrated a positive shift with increasing postmenstrual age (PMA) in the frequencies of synchronized spontaneous otoacoustic emissions (SSOAEs) in preterm infants. We used a mixed model approach to describe a shift with PMA in the spectra of click-evoked otoacoustic emissions (CEOAEs) measured in a group of 22 preterm infants. The rate in shift in CEOAE spectral components was found to be frequency dependent, with a mean estimate of 10 Hz/week for frequencies around 2 kHz and 30 Hz/week for frequencies around 4.25 kHz. This rate decreased with increasing PMA. Because SSOAEs are often part of the CEOAE response, a comparison was made between the shifts in SSOAEs and CEOAEs in a sub-group of 16 preterm infants. The results indicate that the shifts found for both types of OAE are similar, which supports a common mechanism for this change in OAE-characteristic. At present it is not clear to what extent developmental processes in the cochlea and the middle ear can account for these frequency shifts in the spectra of CEOAEs and SSOAEs during the preterm period.

Sexual orientation and the auditory system

The auditory system exhibits differences by sex and by sexual orientation, and the implication is that relevant auditory structures are altered during prenatal development, possibly by exposure to androgens. The otoacoustic emissions (OAEs) of newborn male infants are weaker than those of newborn females, and these sex differences persist through the lifespan. The OAEs of nonheterosexual females also are weaker than those of heterosexual females, suggesting an atypically strong exposure to androgens some time early in development. Auditory evoked potentials (AEPs) also exhibit sex differences beginning early in life. Some AEPs are different for heterosexual and nonheterosexual females, and other AEPs are different for heterosexual and nonheterosexual males. Research on non-humans treated with androgenic or anti-androgenic agents also suggests that OAEs are masculinized by prenatal exposure to androgens late in gestation. Collectively, the evidence suggests that prenatal androgens, acting globally or locally, affect both nonheterosexuality and the auditory system.

Specification of absorbed-sound power in the ear canal: application to suppression of stimulus frequency otoacoustic emissions

An insert ear-canal probe including sound source and microphone can deliver a calibrated sound power level to the ear. The aural power absorbed is proportional to the product of mean-squared forward pressure, ear-canal area, and absorbance, in which the sound field is represented using forward (reverse) waves traveling toward (away from) the eardrum. Forward pressure is composed of incident pressure and its multiple internal reflections between eardrum and probe. Based on a database of measurements in normal-hearing adults from 0.22 to 8 kHz, the transfer-function level of forward relative to incident pressure is boosted below 0.7 kHz and within 4 dB above. The level of forward relative to total pressure is maximal close to 4 kHz with wide variability across ears. A spectrally flat incident-pressure level across frequency produces a nearly flat absorbed power level, in contrast to 19 dB changes in pressure level. Calibrating an ear-canal sound source based on absorbed power may be useful in audiological and research applications. Specifying the tip-to-tail level difference of the suppression tuning curve of stimulus frequency otoacoustic emissions in terms of absorbed power reveals increased cochlear gain at 8 kHz relative to the level difference measured using total pressure.