Comparisons of transient evoked otoacoustic emissions using chirp and click stimuli

Human Olivocochlear Effects: A Statistical Detection Approach Applied to the Cochlear Microphonic Evoked by Swept Tones

The human medial olivocochlear (MOC) reflex was assessed by observing the effects of contralateral acoustic stimulation (CAS) on the cochlear microphonic (CM) across a range of probe frequencies. A frequency-swept probe tone (125-4757 Hz, 90 dB SPL) was presented in two directions (up sweep and down sweep) to normal-hearing young adults. This study assessed MOC effects on the CM in individual participants using a statistical approach that calculated minimum detectable changes in magnitude and phase based on CM signal-to-noise ratio (SNR). Significant increases in CM magnitude, typically 1-2 dB in size, were observed for most participants from 354 to 1414 Hz, where the size and consistency of these effects depended on participant, probe frequency, sweep direction, and SNR. CAS-related phase lags were also observed, consistent with CM-based MOC studies in laboratory animals. Observed effects on CM magnitude and phase were in the opposite directions of reported effects on otoacoustic emissions (OAEs). OAEs are sensitive to changes in the motility of outer hair cells located near the peak region of the traveling wave, while the effects of CAS on the CM likely originate from MOC-related changes in the conductance of outer hair cells located in the basal tail of the traveling wave. Thus, MOC effects on the CM are complementary to those observed for OAEs.

Swept Along: Measuring Otoacoustic Emissions Using Continuously Varying Stimuli

At the 2004 Midwinter Meeting of the Association for Research in Otolaryngology, Glenis Long and her colleagues introduced a method for measuring distortion-product otoacoustic emissions (DPOAEs) using primary-tone stimuli whose instantaneous frequencies vary continuously with time. In contrast to standard OAE measurement methods, in which emissions are measured in the sinusoidal steady state using discrete tones of well-defined frequency, the swept-tone method sweeps across frequency, often at rates exceeding 1 oct/s. The resulting response waveforms are then analyzed using an appropriate filter (e.g., by least-squares fitting). Although introduced as a convenient way of studying DPOAE fine structure by separating the total OAE into distortion and reflection components, the swept-tone method has since been extended to stimulus-frequency emissions and has proved an efficient and valuable tool for probing cochlear mechanics. One day-a long time coming-swept tones may even find their way into the audiology clinic.

Estimating cochlear impulse responses using frequency sweeps

Cochlear mechanics tends to be studied using single-location measurements of intracochlear vibrations in response to acoustical stimuli. Such measurements, due to their invasiveness and often the instability of the animal preparation, are difficult to accomplish and, thus, ideally require stimulus paradigms that are time efficient, flexible, and result in high resolution transfer functions. Here, a swept-sine method is adapted for recordings of basilar membrane impulse responses in mice. The frequency of the stimulus was exponentially swept from low to high (upward) or high to low (downward) at varying rates (from slow to fast) and intensities. The cochlear response to the swept-sine was then convolved with the time-reversed stimulus waveform to obtain first and higher order impulse responses. Slow sweeps of either direction produce cochlear first to third order transfer functions equivalent to those measured with pure tones. Fast upward sweeps, on the other hand, generate impulse responses that typically ring longer, as observed in responses obtained using clicks. The ringing of impulse response in mice was of relatively small amplitude and did not affect the magnitude spectra. It is concluded that swept-sine methods offer flexible and time-efficient alternatives to other approaches for recording cochlear impulse responses.

A point-wise artifact rejection method for estimating transient-evoked otoacoustic emissions and their group delay

Due to its low intensity, measurement of transient-evoked otoacoustic emission (TEOAE) requires repeated stimulation. When any acoustic artifact occurs, an entire click interval is typically abandoned. Here, a point-wise artifact rejection strategy is proposed, and it partially preserves the data when artifacts occur in an interval. At the noisiest setting (-46 dB signal-to-noise ratio) the proposed strategy retains four times more data and thereby reduces the root mean square signal estimation error by over 60%. Consequently, the group delay can be calculated more accurately. These findings might facilitate TEOAE measurement at home or in other noisy environments in the future.

Wideband Acoustic Reflex Growth in Adults With Cystic Fibrosis

Purpose Individuals with cystic fibrosis (CF) are often treated with intravenous (IV) aminoglycoside (AG) antibiotics to manage life-threatening bacterial infections. Preclinical animal data suggest that, in addition to damaging cochlear hair cells, this class of antibiotics may cause cochlear synaptopathy and/or damage to higher auditory structures. The acoustic reflex growth function (ARGF) is a noninvasive, objective measure of neural function in the auditory system. A shallow ARGF (small reflex-induced changes in middle ear function with increasing elicitor level) has been associated with synaptopathy due to noise exposure in rodent and human studies. In this study, the ARGF was obtained in CF patients with normal hearing, some of whom have been treated with IV AGs, and a control group without CF. The hypothesis was that patients with IV-AG exposure would have a shallow ARGF due to cochlear synaptopathy caused by ototoxicity. Method Wideband ARGFs were examined in four groups of normal-hearing participants: a control group of 29 individuals without CF; and in 57 individuals with CF grouped by lifetime IV-AG exposure: 15 participants with no exposure, 21 with low exposure, and 21 with high exposure. Procedures included pure-tone audiometry, clinical immittance, wideband acoustic immittance battery, including ARGFs, and transient evoked otoacoustic emissions. Results CF subjects with normal pure-tone thresholds and either high or low lifetime IV-AG exposure had enhanced ARGFs compared to controls and CF participants without IV-AG exposure. The groups did not differ in transient evoked otoacoustic emission signal-to-noise ratio. Conclusion These results diverge from the shallow ARGF pattern observed in studies of noise-induced cochlear synaptopathy and are suggestive of a central mechanism of auditory dysfunction in patients with AG-induced ototoxicity.

Reflection-Source Emissions Evoked with Clicks and Frequency Sweeps: Comparisons Across Levels

According to coherent reflection theory, otoacoustic emissions (OAE) evoked with clicks (clicked-evoked, CE) or tones (stimulus frequency, SF) originate via the same mechanism. We test this hypothesis in gerbils by investigating the similarity of CE- and SFOAEs across a wide range of stimulus levels. The results show that OAE transfer functions measured in response to clicks and sweeps have nearly equivalent time-frequency characteristics, particularly at low stimulus levels. At high stimulus levels, the two OAE types are more dissimilar, reflecting the different dynamic properties of the evoking stimulus. At mid to high stimulus levels, time-frequency analysis reveals contributions from at least two OAE source components of varying latencies. Interference between these components explains the emergence of strong spectral microstructure. Time-frequency filtering based on mean basilar-membrane (BM) group delays (τ_BM) shows that late-latency OAE components (latency ~ 1.6τ_BM) dominate at low stimulus intensities and exhibit highly compressive growth with increasing stimulus intensity. In contrast, early-latency OAE components (~ 0.7τ_BM) are small at low stimulus levels but can come to dominate the overall response at higher intensities. Although the properties of long-latency OAEs are consistent with an origin via coherent reflection near the peak of the traveling wave, the generation place and/or mechanisms responsible for the early-latency OAE components warrant further investigation. Because their delay remains in constant proportion to τ_BM across sound intensity, long-latency OAEs, whether evoked with tones or clicks, can be used to predict characteristics of cochlear processing, such as the sharpness of frequency tuning, even at high stimulus levels.

Asymmetry and Microstructure of Temporal-Suppression Patterns in Basilar-Membrane Responses to Clicks: Relation to Tonal Suppression and Traveling-Wave Dispersion

The cochlea's wave-based signal processing allows it to efficiently decompose a complex acoustic waveform into frequency components. Because cochlear responses are nonlinear, the waves arising from one frequency component of a complex sound can be altered by the presence of others that overlap with it in time and space (e.g., two-tone suppression). Here, we investigate the suppression of basilar-membrane (BM) velocity responses to a transient signal (a test click) by another click or tone. We show that the BM response to the click can be reduced when the stimulus is shortly preceded or followed by another (suppressor) click. More surprisingly, the data reveal two curious dependencies on the interclick interval, Δt. First, the temporal suppression curve (amount of suppression vs. Δt) manifests a pronounced and nearly periodic microstructure. Second, temporal suppression is generally strongest not when the two clicks are presented simultaneously (Δt = 0), but when the suppressor click precedes the test click by a time interval corresponding to one to two periods of the best frequency (BF) at the measurement location. By systematically varying the phase of the suppressor click, we demonstrate that the suppression microstructure arises from alternating constructive and destructive interference between the BM responses to the two clicks. And by comparing temporal and tonal suppression in the same animals, we test the hypothesis that the asymmetry of the temporal-suppression curve around Δt = 0 stems from cochlear dispersion and the well-known asymmetry of tonal suppression around the BF. Just as for two-tone suppression, BM responses to clicks are most suppressed by tones at frequencies just above the BF of the measurement location. On average, the frequency place of maximal suppressibility of the click response predicted from temporal-suppression data agrees with the frequency at which tonal suppression peaks, consistent with our hypothesis.

Causality-constrained measurements of aural acoustic reflectance and reflection functions

Causality-constrained procedures are described to measure acoustic pressure reflectance and reflection function (RF) in the ear canal or unknown waveguide, in which reflectance is the Fourier transform of the RF. Reflectance calibration is reformulated to generate causal outputs, with results described for a calibration based on a reflectance waveguide equation to calculate incident pressure and source reflectance in the frequency domain or source RF in the time domain. The viscothermal model RF of each tube is band-limited to the stimulus bandwidth. Results are described in which incident pressure is either known from long-tube measurements or calculated as a calibration output. Calibrations based on constrained nonlinear optimizations are simpler and more accurate when incident pressure is known. Outputs measured by causality-constrained procedures differ at higher frequencies from those using standard procedures with non-causal outputs. Evanescent-mode effects formulated in the time domain and incorporated into frequency-domain calibrations are negligible for long-tube calibrations. Causal reflectance and RFs are evaluated in an adult ear canal and time- and frequency-domain results are contrasted using forward and inverse Fourier transforms. These results contribute to the long-term goals of improving applications to calibrate sound stimuli in the ear canal at high frequencies and diagnose conductive hearing impairments.

Variable-rate frequency sweeps and their application to the measurement of otoacoustic emissions

Swept tones allow the efficient measurement of otoacoustic emissions (OAEs) with fine frequency resolution. Although previous studies have explored the influence of different sweep parameters on the measured OAE, none have directly considered their effects on the measurement noise floor. The present study demonstrates that parameters such as sweep type (e.g., linear or logarithmic), sweep rate, and analysis bandwidth affect the measurement noise and can be manipulated to control the noise floor in individual subjects. Although responses to discrete-tone stimuli can be averaged until the uncertainty of the measurement meets a specified criterion at each frequency, linear or logarithmic sweeps offer no such flexibility. However, measurements of the power spectral density of the ambient noise can be used to construct variable-rate sweeps that yield a prescribed (e.g., constant) noise floor across frequency; in effect, they implement a form of frequency-dependent averaging. The use of noise-compensating frequency sweeps is illustrated by the measurement of distortion-product OAEs at low frequencies, where the ear-canal noise is known to vary significantly.

Chirp-Evoked Otoacoustic Emissions and Middle Ear Absorbance for Monitoring Ototoxicity in Cystic Fibrosis Patients

OBJECTIVES

The goal of this study was to investigate the use of transient-evoked otoacoustic emissions (TEOAEs) and middle ear absorbance measurements to monitor auditory function in patients with cystic fibrosis (CF) receiving ototoxic medications. TEOAEs were elicited with a chirp stimulus using an extended bandwidth (0.71 to 8 kHz) to measure cochlear function at higher frequencies than traditional TEOAEs. Absorbance over a wide bandwidth (0.25 to 8 kHz) provides information on middle ear function. The combination of these time-efficient measurements has the potential to identify early signs of ototoxic hearing loss.

DESIGN

A longitudinal study design was used to monitor the hearing of 91 patients with CF (median age = 25 years; age range = 15 to 63 years) who received known ototoxic medications (e.g., tobramycin) to prevent or treat bacterial lung infections. Results were compared to 37 normally hearing young adults (median age = 32.5 years; age range = 18 to 65 years) without a history of CF or similar treatments. Clinical testing included 226-Hz tympanometry, pure-tone air-conduction threshold testing from 0.25 to 16 kHz and bone conduction from 0.25 to 4 kHz. Experimental testing included wideband absorbance at ambient and tympanometric peak pressure and TEOAEs in three stimulus conditions: at ambient pressure and at tympanometric peak pressure using a chirp stimulus with constant incident pressure level across frequency and at ambient pressure using a chirp stimulus with constant absorbed sound power across frequency.

RESULTS

At the initial visit, behavioral audiometric results indicated that 76 of the 157 ears (48%) from patients with CF had normal hearing, whereas 81 of these ears (52%) had sensorineural hearing loss for at least one frequency. Seven ears from four patients had a confirmed behavioral change in hearing threshold for ≥3 visits during study participation. Receiver operating characteristic curve analyses demonstrated that all three TEOAE conditions were useful for distinguishing CF ears with normal hearing from ears with sensorineural hearing loss, with an area under the receiver operating characteristic curve values ranging from 0.78 to 0.92 across methods for frequency bands from 2.8 to 8 kHz. Case studies are presented to illustrate the relationship between changes in audiometric thresholds, TEOAEs, and absorbance across study visits. Absorbance measures permitted identification of potential middle ear dysfunction at 5.7 kHz in an ear that exhibited a temporary hearing loss.

CONCLUSIONS

The joint use of TEOAEs and absorbance has the potential to explain fluctuations in audiometric thresholds due to changes in cochlear function, middle ear function, or both. These findings are encouraging for the joint use of TEOAE and wideband absorbance objective tests for monitoring ototoxicity, particularly, in patients who may be too ill for behavioral hearing tests. Additional longitudinal studies are needed in a larger number of CF patients receiving ototoxic drugs to further evaluate the clinical utility of these measures in an ototoxic monitoring program.

Enhanced Auditory Steady-State Response Using an Optimized Chirp Stimulus-Evoked Paradigm

Objectives: It has been reported recently that gamma measures of the electroencephalogram (EEG) might provide information about the candidate biomarker of mental diseases like schizophrenia, Alzheimer's disease, affective disorder and so on, but as we know it is a difficult issue to induce visual and tactile evoked responses at high frequencies. Although a high-frequency response evoked by auditory senses is achievable, the quality of the recording response is not ideal, such as relatively low signal-to-noise ratio (SNR). Recently, auditory steady-state responses (ASSRs) play an essential role in the field of basic auditory studies and clinical uses. However, how to improve the quality of ASSRs is still a challenge which researchers have been working on. This study aims at designing a more comfortable and suitable evoked paradigm and then enhancing the quality of the ASSRs in healthy subjects so as to further apply it in clinical practice. Methods: Chirp and click stimuli with 40 Hz and 60 Hz were employed to evoke the gamma-ASSR respectively, and the sound adjusted to 45 dB sound pressure level (SPL). Twenty healthy subjects with normal-hearing participated, and 64-channel EEGs were simultaneously recorded during the experiment. Event-related spectral perturbation (ERSP) and SNR of the ASSRs were measured and analyzed to verify the feasibility and adaptability of the proposed evoked paradigm. Results: The results showed that the evoked paradigm proposed in this study could enhance ASSRs with strong feasibility and adaptability. 1) ASSR waves in time domain indicated that 40 Hz stimuli could significantly induce larger peak-to-peak values of ASSRs compared to 60 Hz stimuli (p < 0.01**); ERSP showed that obvious ASSRs were obtained at each lead for both 40 Hz and 60 Hz, as well as the click and chirp stimuli. 2) The SNR of the ASSRs were ⁻3.23 ± 1.68, ⁻2.44 ± 2.90, ⁻4.66 ± 2.09, and ⁻3.53 ± 3.49 respectively for 40 Hz click, 40 Hz chirp, 60 Hz click and 60 Hz chirp, indicating the chirp stimuli could induce significantly better ASSR than the click, and 40 Hz ASSRs had the higher SNR than 60 Hz (p < 0.01**). Limitation: In this study, sample size was small and the age span was not large enough. Conclusions: This study verified the feasibility and adaptability of the proposed evoked paradigm to improve the quality of the gamma-ASSR, which is significant in clinical application. The results suggested that 40 Hz ASSR evoked by chirp stimuli had the best performance and was expected to be used in clinical practice, especially in the field of mental diseases such as schizophrenia, Alzheimer's disease, and affective disorder.

High frequency transient-evoked otoacoustic emission measurements using chirp and click stimuli

Transient-evoked otoacoustic emissions (TEOAEs) at high frequencies are a non-invasive physiological test of basilar membrane mechanics at the basal end, and have clinical potential to detect risk of hearing loss related to outer-hair-cell dysfunction. Using stimuli with constant incident pressure across frequency, TEOAEs were measured in experiment 1 at low frequencies (0.7-8 kHz) and high frequencies (7.1-14.7 kHz) in adults with normal hearing up to 8 kHz and varying hearing levels from 9 to 16 kHz. In combination with click stimuli, chirp stimuli were used with slow, medium and fast sweep rates for which the local frequency increased or decreased with time. Chirp TEOAEs were transformed into equivalent click TEOAEs by inverse filtering out chirp stimulus phase, and analyzed similarly to click TEOAEs. To improve detection above 8 kHz, TEOAEs were measured in experiment 2 with higher-level stimuli and longer averaging times. These changes increased the TEOAE signal-to-noise ratio (SNR) by 10 dB. Slower sweep rates were investigated but the elicited TEOAEs were detected in fewer ears compared to faster rates. Data were acquired in adults and children (age 11-17 y), including children with cystic fibrosis (CF) treated with ototoxic antibiotics. Test-retest measurements revealed satisfactory repeatability of high-frequency TEOAE SNR (median of 1.3 dB) and coherence synchrony measure, despite small test-retest differences related to changes in forward and reverse transmission in the ear canal. The results suggest the potential use of such tests to screen for sensorineural hearing loss, including ototoxic loss. Experiment 2 was a feasibility study to explore TEOAE test parameters that might be used in a full-scale study to screen CF patients for risk of ototoxic hearing loss.

Identifying Otosclerosis with Aural Acoustical Tests of Absorbance, Group Delay, Acoustic Reflex Threshold, and Otoacoustic Emissions

BACKGROUND

Otosclerosis is a progressive middle-ear disease that affects conductive transmission through the middle ear. Ear-canal acoustic tests may be useful in the diagnosis of conductive disorders. This study addressed the degree to which results from a battery of ear-canal tests, which include wideband reflectance, acoustic stapedius muscle reflex threshold (ASRT), and transient evoked otoacoustic emissions (TEOAEs), were effective in quantifying a risk of otosclerosis and in evaluating middle-ear function in ears after surgical intervention for otosclerosis.

PURPOSE

To evaluate the ability of the test battery to classify ears as normal or otosclerotic, measure the accuracy of reflectance in classifying ears as normal or otosclerotic, and evaluate the similarity of responses in normal ears compared with ears after surgical intervention for otosclerosis.

RESEARCH DESIGN

A quasi-experimental cross-sectional study incorporating case control was used. Three groups were studied: one diagnosed with otosclerosis before corrective surgery, a group that received corrective surgery for otosclerosis, and a control group.

STUDY SAMPLE

The test groups included 23 ears (13 right and 10 left) with normal hearing from 16 participants (4 male and 12 female), 12 ears (7 right and 5 left) diagnosed with otosclerosis from 9 participants (3 male and 6 female), and 13 ears (4 right and 9 left) after surgical intervention from 10 participants (2 male and 8 female).

DATA COLLECTION AND ANALYSIS

Participants received audiometric evaluations and clinical immittance testing. Experimental tests performed included ASRT tests with wideband reference signal (0.25-8 kHz), reflectance tests (0.25-8 kHz), which were parameterized by absorbance and group delay at ambient pressure and at swept tympanometric pressures, and TEOAE tests using chirp stimuli (1-8 kHz). ASRTs were measured in ipsilateral and contralateral conditions using tonal and broadband noise activators. Experimental ASRT tests were based on the difference in wideband-absorbed sound power before and after presenting the activator. Diagnostic accuracy to classify ears as otosclerotic or normal was quantified by the area under the receiver operating characteristic curve (AUC) for univariate and multivariate reflectance tests. The multivariate predictor used a small number of input reflectance variables, each having a large AUC, in a principal components analysis to create independent variables and followed by a logistic regression procedure to classify the test ears.

RESULTS

Relative to the results in normal ears, diagnosed otosclerosis ears more frequently showed absent TEOAEs and ASRTs, reduced ambient absorbance at 4 kHz, and a different pattern of tympanometric absorbance and group delay (absorbance increased at 2.8 kHz at the positive-pressure tail and decreased at 0.7-1 kHz at the peak pressure, whereas group delay decreased at positive and negative-pressure tails from 0.35-0.7 kHz, and at 2.8-4 kHz at positive-pressure tail). Using a multivariate predictor with three reflectance variables, tympanometric reflectance (AUC = 0.95) was more accurate than ambient reflectance (AUC = 0.88) in classifying ears as normal or otosclerotic.

CONCLUSIONS

Reflectance provides a middle-ear test that is sensitive to classifying ears as otosclerotic or normal, which may be useful in clinical applications.

Assessing Sensorineural Hearing Loss Using Various Transient-Evoked Otoacoustic Emission Stimulus Conditions

OBJECTIVES

An important clinical application of transient-evoked otoacoustic emissions (TEOAEs) is to evaluate cochlear outer hair cell function for the purpose of detecting sensorineural hearing loss (SNHL). Double-evoked TEOAEs were measured using a chirp stimulus, in which the stimuli had an extended frequency range compared to clinical tests. The present study compared TEOAEs recorded using an unweighted stimulus presented at either ambient pressure or tympanometric peak pressure (TPP) in the ear canal and TEOAEs recorded using a power-weighted stimulus at ambient pressure. The unweighted stimulus had approximately constant incident pressure magnitude across frequency, and the power-weighted stimulus had approximately constant absorbed sound power across frequency. The objective of this study was to compare TEOAEs from 0.79 to 8 kHz using these three stimulus conditions in adults to assess test performance in classifying ears as having either normal hearing or SNHL.

DESIGN

Measurements were completed on 87 adult participants. Eligible participants had either normal hearing (N = 40; M F = 16 24; mean age = 30 years) or SNHL (N = 47; M F = 20 27; mean age = 58 years), and normal middle ear function as defined by standard clinical criteria for 226-Hz tympanometry. Clinical audiometry, immittance, and an experimental wideband test battery, which included reflectance and TEOAE tests presented for 1-min durations, were completed for each ear on all participants. All tests were then repeated 1 to 2 months later. TEOAEs were measured by presenting the stimulus in the three stimulus conditions. TEOAE data were analyzed in each hearing group in terms of the half-octave-averaged signal to noise ratio (SNR) and the coherence synchrony measure (CSM) at frequencies between 1 and 8 kHz. The test-retest reliability of these measures was calculated. The area under the receiver operating characteristic curve (AUC) was measured at audiometric frequencies between 1 and 8 kHz to determine TEOAE test performance in distinguishing SNHL from normal hearing.

RESULTS

Mean TEOAE SNR was ≥8.7 dB for normal-hearing ears and ≤6 dB for SNHL ears for all three stimulus conditions across all frequencies. Mean test-retest reliability of TEOAE SNR was ≤4.3 dB for both hearing groups across all frequencies, although it was generally less (≤3.5 dB) for lower frequencies (1 to 4 kHz). AUCs were between 0.85 and 0.94 for all three TEOAE conditions at all frequencies, except for the ambient TEOAE condition at 2 kHz (0.82) and for all TEOAE conditions at 5.7 kHz with AUCs between 0.78 and 0.81. Power-weighted TEOAE AUCs were significantly higher (p < 0.05) than ambient TEOAE AUCs at 2 and 2.8 kHz, as was the TPP TEOAE AUC at 2.8 kHz when using CSM as the classifier variable.

CONCLUSIONS

TEOAEs evaluated in an ambient condition, at TPP and in a power-weighted stimulus condition, had good test performance in identifying ears with SNHL based on SNR and CSM in the frequency range from 1 to 8 kHz and showed good test-retest reliability. Power-weighted TEOAEs showed the best test performance at 2 and 2.8 kHz. These findings are encouraging as a potential objective clinical tool to identify patients with cochlear hearing loss.

Pressurized transient otoacoustic emissions measured using click and chirp stimuli

Transient-evoked otoacoustic emission (TEOAE) responses were measured in normal-hearing adult ears over frequencies from 0.7 to 8 kHz, and analyzed with reflectance/admittance data to measure absorbed sound power and the tympanometric peak pressure (TPP). The mean TPP was close to ambient. TEOAEs were measured in the ear canal at ambient pressure, TPP, and fixed air pressures from 150 to -200 daPa. Both click and chirp stimuli were used to elicit TEOAEs, in which the incident sound pressure level was constant across frequency. TEOAE levels were similar at ambient and TPP, and for frequencies from 0.7 to 2.8 kHz decreased with increasing positive and negative pressures. At 4-8 kHz, TEOAE levels were larger at positive pressures. This asymmetry is possibly related to changes in mechanical transmission through the ossicular chain. The mean TEOAE group delay did not change with pressure, although small changes were observed in the mean instantaneous frequency and group spread. Chirp TEOAEs measured in an adult ear with Eustachian tube dysfunction and TPP of -165 daPa were more robust at TPP than at ambient. Overall, results demonstrate the feasibility and clinical potential of measuring TEOAEs at fixed pressures in the ear canal, which provide additional information relative to TEOAEs measured at ambient pressure.

Differentiating Middle Ear and Medial Olivocochlear Effects on Transient-Evoked Otoacoustic Emissions

The response of the inner ear is modulated by the middle ear muscle (MEM) and olivocochlear (OC) efferent systems. Both systems can be activated reflexively by acoustic stimuli delivered to one or both ears. The acoustic middle ear muscle reflex (MEMR) controls the transmission of acoustic signals through the middle ear, while reflex activation of the medial component of the olivocochlear system (the MOCR) modulates cochlear mechanics. The relative prominence of the two efferent systems varies widely between species. Measuring the effect of either of these systems can be confounded by simultaneously activating the other. We describe a simple, sensitive online method that can identify the effects both systems have on otoacoustic emissions (OAEs) evoked by transient stimuli such as clicks or tone pips (TEOAEs). The method detects directly in the time domain the changes in the stimulus and/or emission pressures caused by contralateral noise. Measurements in human participants are consistent with other reports that the threshold for MOCR activation is consistently lower than for MEMR. The method appears to control for drift and subject-generated noise well enough to avoid the need for post hoc processing, making it promising for application in animal experiments (even if awake) and in the hearing clinic.

Comparing otoacoustic emissions evoked by chirp transients with constant absorbed sound power and constant incident pressure magnitude

Human ear-canal properties of transient acoustic stimuli are contrasted that utilize measured ear-canal pressures in conjunction with measured acoustic pressure reflectance and admittance. These data are referenced to the tip of a probe snugly inserted into the ear canal. Promising procedures to calibrate across frequency include stimuli with controlled levels of incident pressure magnitude, absorbed sound power, and forward pressure magnitude. An equivalent pressure at the eardrum is calculated from these measured data using a transmission-line model of ear-canal acoustics parameterized by acoustically estimated ear-canal area at the probe tip and length between the probe tip and eardrum. Chirp stimuli with constant incident pressure magnitude and constant absorbed sound power across frequency were generated to elicit transient-evoked otoacoustic emissions (TEOAEs), which were measured in normal-hearing adult ears from 0.7 to 8 kHz. TEOAE stimuli had similar peak-to-peak equivalent sound pressure levels across calibration conditions. Frequency-domain TEOAEs were compared using signal level, signal-to-noise ratio (SNR), coherence synchrony modulus (CSM), group delay, and group spread. Time-domain TEOAEs were compared using SNR, CSM, instantaneous frequency and instantaneous bandwidth. Stimuli with constant incident pressure magnitude or constant absorbed sound power across frequency produce generally similar TEOAEs up to 8 kHz.