Otoacoustic emissions as an indicator of hearing loss
Otoacoustic emissions (OAE) are generated as a by-product of the nonlinear cochlear ampli cation process involving the electro-motile properties of the outer hair cells. Most sensorineural hearing losses arise predominantly from reduced cochlear amplification and hence are associated with reduced or absent OAEs. This means that OAE amplitude is a potential indicator of sensorineural hearing loss. However, there is substantial variation in OAE characteristics between individuals with similar hearing threshold, which limits their ability to predict hearing threshold levels (HTL) absolutely. Nonetheless, OAEs are stable within individuals and offer the possibility to predict changes in HTL from changes in OAE amplitude. Prediction of changes in HTL requires knowledge of the relationship between OAE amplitude and HTL as well as the test-retest reliability of OAEs. These parameters were established for a range of transiently evoked and distortion product OAE measures (TEOAE and DPOAE) by testing 43 subjects with HTL across a range from normal hearing to mild hearing loss. Results suggested that TEOAE elicited by a maximum length sequence approach would be most sen- sitive to changes in HTL, having the largest change in amplitude relative to the test-retest reliability. These ideas were further explored by monitoring auditory function in 17 normal hearing subjects over 7 days in whom a reversible hear- ing loss was induced by administering aspirin at maximum therapeutic dose. Further ongoing research is evaluating the potential of TEOAEs for monitor- ing auditory function in people exposed to noise at work. More than 200 new recruits to noisy industry and non-exposed controls have had TEOAEs measured over a 3-year interval to examine whether OAEs are a more sensitive indicator of noise-induced hearing disorder than conventional pure tone audiometry. Preliminary conclusions suggest that OAEs provide a useful physiological correlate of hearing impairment when used in the context of longitudinal monitoring.
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