Suppression and enhancement of distortion-product otoacoustic emissions by interference tones above f(2). I. Basic findings in rabbits.

The present study measured interference-response areas (IRAs) for distortion-product otoacoustic emissions (DPOAEs) at 2f(1)-f(2), 3f(1)-2f(2), and 2f(2)-f(1). The IRAs were obtained in either awake or anesthetized rabbits, or in anesthetized guinea pigs and mice, by sweeping the frequencies and levels of an interference tone (IT) around a set of f(1) and f(2) primary tones, at several fixed frequencies and levels, while plotting the effects of the IT on DPOAE level. An unexpected outcome was the occurrence of regions of suppression and/or enhancement of DPOAE level when the IT was at a frequency slightly less than to more than an octave above f(2). The IRA of the 2f(1)-f(2) DPOAE typically displayed a high-frequency (HF) lobe of suppression, while the 2f(2)-f(1) emission often exhibited considerable amounts of enhancement. Moreover, for the 2f(2)-f(1) DPOAE, when enhancement was absent, its IRA usually tuned to a region above f(2). Whether or not suppression/enhancement was observed depended upon primary-tone level and frequency separation, as well as on the relative levels of the two primaries. Various physiological manipulations involving anesthesia, eighth-nerve section, diuretic administration, or pure-tone overstimulation showed that these phenomena were of cochlear origin, and were not dependent upon the acoustic reflex or cochlear-efferent activity. The aftereffects of applying diuretics or over-exposures revealed that suppression/enhancement required the presence of sensitive, low-level DPOAE-generator sources. Additionally, suppression/enhancement were general effects in that, in addition to rabbits, they were also observed in mice and guinea pigs. Further, corresponding plots of DPOAE phase often revealed areas of differing phase change in the vicinity of the primary tones as compared to regions above f(2). These findings, along with the effects of tonal exposures designed to fatigue regions above f(2), and instances in which DPOAE level was dependent upon the amount of suppression/enhancement, suggested that the interactions of two DPOAE-generator sources contributed, in some manner, to these phenomena.     

Detection of hearing loss using 2f2-f1 and 2f1-f2 distortion-product otoacoustic emissions.

Although many distortion-product otoacoustic emissions (DPOAEs) may be measured in the ear canal in response to 2 pure tone stimuli, the majority of clinical studies have focused exclusively on the DPOAE at the frequency 2f1-f2. This study investigated another DPOAE, 2f2-f1, in an attempt to determine the following: (a) the optimal stimulus parameters for its clinical measurement and (b) its utility in differentiating between normal-hearing and hearing-impaired ears at low-to-mid frequencies (相似文献   

Suppression of the 2f1-f2 otoacoustic emission in humans.

Suppression of the 2f1-f2 distortion-product otoacoustic emission (DPOAE), stimulated with primaries, f1 and f2, in the frequency regions of 1, 2, and 4 kHz was measured in one ear of 14 human subjects with normal hearing. Suppression rate functions were generated with a suppressor at either 1, 2, or 4 kHz increasing in level from 30 to 76 dB SPL for the corresponding f1 and f2 combinations. Stimulus levels for DPOAEs were L1 = 70 dB SPL and L2 adjusted to produce the highest amplitude DPOAE for each ear (range, 0 to 6 dB below L1). Results indicated that DPOAEs were reduced 3 dB in amplitude for a mean suppressor level of 61 dB SPL. Maximum amplitude reduction occurred at a mean suppressor level of 69 dB SPL. These levels varied little for the three stimulus frequency regions. Mean slopes of the rate functions decreased as stimulus frequency region increased. Suppression tuning curves (STCs) were generated in the same three frequency regions and with L1 at either 70 or 55 dB SPL and L2 adjusted individually for each ear. The tips of the STCs were at frequencies associated with f1 and f2. The tip regions of the STCs for the 4-kHz stimulus condition were more complex in that they contained more multiple minima than did those for the 1- and 2-kHz regions. Results confirm that optimal suppression of the 2f1-f2 DPOAE occurs for frequencies in the vicinity of f1 and f2 rather than at 2f1-f2.     

Suppression of evoked otoacoustic emissions by contralateral noise exposure in humans

The effects of contralateral noise exposure on evoked otoacoustic emission (e-OAE) were investigated in 10 normal hearing subjects and 3 cases with unilateral deafness. The e-OAE was recorded by ILO88 and weighting noise was given to the contralateral ear (impaired side in unilateral deafness cases). The air conducted noise exposure showed suppressive effect on e-OAE along with the increase of noise stimulus intensity in normal hearing subjects, but did not in unilateral deafness cases. The degree of suppression in e-OAE was most remarkable in highest peak power between 1 kHz and 2 kHz in FFT picture and the mean value of maximal suppression in 10 normal hearing subjects was 2.2 dB. The bone conducted noise exposure showed no effects on e-OAE in either normal hearing subjects or unilateral deafness cases. It was suggested that the contralateral noise exposure could suppress the function of cochlear micromechanics probably via crossed olivocochlear bundle.     

Components of the 2f(1)-f(2) distortion-product otoacoustic emission in a moth.

The noctuoid moth Empyreuma affinis has a simple tympanal organ with only two receptor cells attached to the eardrum. As in vertebrates, the growth of distortion-product otoacoustic emissions (DPOAE) with increasing stimulus level is characterized by two distinct components. An initial increase of DPOAE level for f(2) levels in the range of 30-65 dB SPL is followed by a second steep growth of the DPOAE at f(2) levels above 65 dB SPL. Both components increase at a slope of about 2 dB/dB and the difference between both components was used to assess a mechanical gain of the tympanal organ of 17 dB (n=23). At around 65 dB SPL, a notch in the level function coincides with an abrupt phase change of up to 180 degrees. The sensitive component induced by f(2) levels below 65 dB SPL is selectively affected by application of ethyl ether and disappears more quickly than the high-level component during ongoing deterioration of the moth preparation.     

Test/retest reliability of distortion-product and transiently evoked otoacoustic emissions.

Otoacoustic emissions can be used to study cochlear function in an objective and noninvasive manner. These features of emitted responses have stimulated a great deal of investigation into the utility of evoked emissions as clinical tests of hearing. One practical and essential aspect of any clinical measure is the consistency of its result upon repeated testing of the same individual (i.e., its test/retest reliability). The goal of the present work was to conduct a systematic study of the test/retest reliability of the two evoked emission types, the transiently evoked and the distortion-product otoacoustic emissions, that have the greatest promise of becoming clinically useful. Toward this end, the short- and long-term reliabilities of these two response measures were examined in 12 normally hearing adults. The results of these experiments showed that the consistency of both measures of evoked otoacoustic emissions was generally excellent.     

Magnitudes and phases of human distortion-product otoacoustic emissions at 2f(1)-f(2) against f(2)/f(1): effects of an audiometric notch

The influence of the frequency ratio f(2)/f(1) of two pure-tone stimuli on the distortion-product otoacoustic emissions (DPOAEs) at 2f(1)-f(2) was assessed in 14 hearing-impaired human ears exhibiting a narrow audiometric notch at 4 kHz, whereas 11 normally hearing ears served as controls. A fixed-f(2) paradigm was used, with f(2) values varying from 2 to 8 kHz in 1-kHz steps. The intensities of the two stimuli were either 60 or 70 dB SPL. The magnitudes and phases of DPOAEs were extracted so that the bandpass filter-like profile of DPOAE magnitude against f(2)/f(1) (f(2)/f(1) magnitude function) could be characterized by the presence and position of its maximum, and DPOAE group delays were derived from the phase gradient of the DPOAE when f(1) varied. The main difference between normal and impaired ears occurred at 4 kHz in that, in contrast with normal ears, nine impaired ears out of 14 did not present any peak in their f(2)/f(1) magnitude function, while the remaining five ears only differed from normal ones by a slightly shifted maximum toward larger f(2)/f(1)s. Group delays were significantly shortened in all impaired ears, with a tendency to be shorter in the subset of ears with flat DPOAE magnitude profiles with f(2)/f(1). No clear effect of notch depth was observed, and with the chosen stimulus characteristics, no abnormal DPOAE result was observed whenever f(2) fell outside the audiometric notch. It is concluded that DPOAE group delays apparently provide useful objective clues of cochlear dysfunction, more sensitive than DPOAE magnitudes inasmuch as many of them remained near the normal range. Although a majority of f(2)/f(1) magnitude functions were clearly flattened when f(2) was impaired, this feature was less systematic.     

Reliability of distortion-product otoacoustic emissions in the common marmoset (Callithrix jacchus)

This study examines the test-retest reliability of distortion-product otoacoustic emissions (DPOAEs) in ketamine-anesthetized common marmosets (Callithrix jacchus). DPOAE gain functions were measured at 16 f(2)-frequencies between 3 and 24?kHz. Test-retest reliability was assessed at the following time intervals: (1) Interleaved, in which two gain functions were obtained at each frequency before advancing to the next frequency, (2) Immediate, wherein one gain function was collected at all f(2)-frequencies and the retest was immediately performed without removing the probe tip, (3) Short-term, in which the retest followed a 10-min period with the probe removed, and (4) Long-term, wherein the retest was performed at least one week after the initial test. Reliability was assessed using four correlation coefficients used in the literature. Test-retest reliability was best in the interleaved interval and worst in the short-term interval. In general, reliability was best when primary-tone levels were high. Correlation coefficients decreased at frequencies above 12-kHz in the short-term and long-term intervals, but the decrease was more substantial in females than in males in the long-term interval. At frequencies below 12?kHz, same-day measurements (2, 3) were less repeatable, regardless of whether the probe was removed, which may be due to time under anesthesia. These results have implications for DPOAE studies where repeated measures are required and when treatment or group differences are small.     

Test-retest variability of distortion-product otoacoustic emissions in human ears with normal hearing.

In the present study, the test-retest variability of distortion product otoacoustic emissions (DPOAEs) due to various causes has been assessed quantitatively at individual frequencies using the ILO88/92 system. The short-term variance was generally lower than 3 dB2. Changing the position and the fit of the probe may affect the level of background noise in the ear canal, which interferes with the responses of the DPOAEs mainly at low frequencies and can also influence the interaction of the resonances of the outer ear and acoustic stimuli. The long-term variance was significantly greater than short-term variance, but did not differ significantly from variance of refitting the probe. The total DPOAE variance was small across all the frequencies above 1000 Hz except for a small peak in the 2500 Hz range. This may be related to the low response amplitudes in this region. The limitation of DPOAE detection at frequencies below 1000 Hz must lead to caution in the interpretation of results in this frequency range. The magnitude of the total variance was similar to that found in audiometric studies.     

Transmission pathways of vibratory stimulation as measured by subjective thresholds and distortion-product otoacoustic emissions

To clarify the contribution of the skull contents to the transmission of bone vibratory stimuli, and to examine the characteristics of such stimuli, we compared auditory thresholds and distortion-product otoacoustic emission (DPOAE) levels with a bone vibrator placed on various sites of the head, including the eye. The best audiometric thresholds and the highest DPOAE levels were obtained with the vibrator placed on the mastoid of the measuring side, or on the "ultrasound-window" of the temple. The audiometric thresholds obtained with the bone vibrator on the eye were similar to those of the forehead, and about 10 dB higher than at the best sites. DPOAEs were clearly present when elicited by a combination of air-conducted stimuli presented through an insert earphone and with the bone vibrator placed on the eye. These results indicate that vibratory sounds can be transmitted through the skull contents to the inner ear. The intracranial transmission pathway of the vibratory stimuli may play a significant role, particularly at low frequencies, and possibly also when the vibratory stimuli are applied on the skull bone.     

Vasospasm of labyrinthine artery in cerebellopontine angle surgery: evidence brought by distortion-product otoacoustic emissions

In cerebellopontine angle (CPA) surgery, postoperative deafness can be due to alteration of cochlear blood flow that is supplied by the labyrinthine artery (LA). In particular, vasospasm is likely to occur and, if so, can be reversed. This work attempted to track down vascular events occurring during CPA surgery. Twenty consecutive patients with vestibular schwannoma were tested with useful preoperative hearing and presence of otoacoustic emissions (OAEs). Distortion-product otoacoustic emissions (DPOAEs), well-known to react within seconds to cochlear ischemia, were used intraoperatively to indirectly monitor cochlear blood flow. Continuous intraoperative monitoring of DPOAEs revealed three different time patterns associated with distinct auditory outcomes. Pattern P1-acute (n = 4) happened when the LA was severed: DPOAEs immediately and irreversibly foundered and led to postoperative deafness. Pattern P2-protracted (n = 7) revealed a progressive deterioration of DPOAEs from the beginning of tumor debulking, likely due to a steady decrease of cochlear blood flow, with postoperative deafness. Pattern P3-unstable (n = 5) corresponded to large DPOAE oscillations between their normal level and noise floor. It was due to acute LA vasospasm that could be reversed in three cases by topical nimodipin. Last, four patients had uneventful cochlear monitoring. In conclusion, cochlear ischemia can occur in vestibular schwannoma surgery, giving three different patterns among which vasospasm can be reversed if detected early.     

effects of glutamate on distortion-product otoacoustic emissions and auditory brainstem responses in guinea pigs

Objective To investigate changes in evoked potentials and structure of the guinea pig cochleae during whole cochlear perfusion with glutamate. Methods CM, CAP, DPOAE, and ABR were recorded as indicators of cochlear functions during whole cochlear perfusion. The morphology of the cochlea was studied via transmission electron microscopy. Results There were no significant changes in DPOAE amplitude before and after glutamate perfusion. CM I/O function remained nonlinear during perfusion. ABR latencies were delayed following glutamate perfusion. The average CAP threshold was elevated 35 dB SPL following glutamate perfusion.. The OHCs appeared normal, but the IHCs and afferent dendrites showed cytoplasmic blebs after glutamate perfusion. Conclusions While being a primary amino acid neurotransmitter at the synapses between hair cells and spiral ganglion neurons, excessive glutamate is neurotoxic and can destroy IHCs and spiral ganglion neurons. The technique used in this study can also be used to build an animal model of auditory neuropathy.     

Intra- and intersubject variability of acoustically evoked otoacoustic emissions. II. Distortion product otoacoustic emissions]

BACKGROUND: Distortion product otoacoustic emissions (DPOAEs) are evoked by simultaneously stimulating the cochlea with two tones. The DPOAE with the highest amplitude (at the frequency 2f1-f2) is usually used for routine audiological evaluation. Any interpretation of DPOAEs in a clinical setting must consider their intra- and intersubject variability. METHODS: DPOAE measurements were performed in 36 normally hearing adults in three weekly test sessions. Each ear was tested twice per session, and the results were statistically analyzed. RESULTS: All test candidates had measurable DPOAEs. Statistically significant differences in absolute DPOAE amplitudes were neither found between two measurements at the same day, nor at weekly intervals, nor between right and left ear of the same candidate. Absolute DPOAE amplitudes in women were significantly higher in the 2-6 kHz range whereas they presented with significantly lower amplitudes below 2 kHz when compared to men. CONCLUSIONS: The present results indicate that monitoring of the inner ear status can be reliably performed using DPOAE measurements. Change in DPOAE amplitudes effectively indicate changes in the cochlear function with high sensitivity. Compared to TEOAE measurements, DPOAEs offer a higher frequency resolution in a broader frequency band and thus more detailed information about the cochlear condition.     

Development of 2f1-f2 otoacoustic emissions in the rat

2f1-f2 otoacoustic emissions have been recorded from the rat cochlea during its development. Acoustic responses were recorded at 3, 5 and 7 kHz using a fixed value of the f2/f1 ratio (= 1.17). The first 2f1-f2 acoustic responses were obtained at 12 days after birth for 2f1-f2 = 7 and 5 kHz, and 2 days later for 2f1-f2 = 3 kHz. Adult-like patterns of the acoustic responses were achieved by day 18 for 2f1-f2 = 3 kHz, by day 20 for 2f1-f2 = 5 kHz and by day 28 for 2f1-f2 = 7 kHz. These results are discussed in relation to the available anatomical and functional data on the cochlear development of the rat. The delayed appearance of the 3 kHz acoustic responses might be related to the basal-to-apical gradient of morphological cochlear maturation. The fact that the 2f1-f2 otoacoustic emissions reached adult characteristics from the low to high frequencies is consistent with the development of the tuning properties of the basilar membrane. The long development of the 2f1-f2 acoustic responses at 7 kHz suggests that the organ of Corti undergoes subtle changes well after the end of its apparent maturation.     

Hearing loss in vestibular schwannomas: analysis of cochlear function by means of distortion-product otoacoustic emissions

Objective

We investigated cochlear function in a group of patients affected by vestibular schwannoma (VS), by means of recording distortion-product otoacoustic emissions (DPOAEs).

Methods

Between January 1996 and January 2007, we observed 183 patients affected by unilateral VS. DPOAEs, compared to the corresponding hearing thresholds, were subjectively classified into three categories: “compatible” with hearing function, “cochlear” and “retro-cochlear”. We also related the responses to some clinical variables (tumor size, intracanalicular tumor and radiologic appearance of the internal auditory canal). Statistical analysis was performed.

Results

In 137 cases (74.9%), DPOAEs were as expected based on audiometry responses, while in 11 patients (6%) a “cochlear” DP-gram was recorded and in 35 patients (19.1%) DPOAEs evidenced a “retro-cochlear” pattern. In eight cases we detected acoustic responses despite a profound hearing loss. No statistically significant data merged from the comparison between “cochlear” and “retro-cochlear” responses and the clinical variables.

Conclusion

Our results confirm that sensorineural hearing loss due to VS can be of sensory and/or neural origin. DPOAEs still remain just a complementary auditory test; nevertheless, in case of severe or profound unilateral hearing loss, recorded acoustic responses may be suspicious for the presence of a vestibular schwannoma.     

Racial and gender effects on pure-tone thresholds and distortion-product otoacoustic emissions (DPOAEs) in normal-hearing young adults

This study examined racial and gender effects on behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) in the same subjects. Pure-tone behavioral thresholds and DPOAEs were measured in 60 young normal-hearing adult subjects (20 Caucasian, 20 Asian, 20 African-American, with ten females and ten males in each group). Behavioral thresholds were measured from 1000 through 16 000 Hz using Békèsy tracking. A DPOAE frequency sweep was measured with primary stimulus levels of L₁/L₂=60/45 dB SPL, and an f₂/f₁ of 1.2 at discrete f₂ frequencies between 2000 through 12 000 Hz for each subject. Significant racial and gender differences in behavioral thresholds were found at 14 000 and 16 000 Hz, with the African Americans and females having the best hearing sensitivity. Based on the current results, similar findings for DPOAE frequency sweeps can be expected amongst different racial groups given that no significant differences were identified between the groups. To further define the effects of race and gender on auditory measures, future studies should include larger numbers of subjects, measurement of body size and middle ear reflectance, and examine emission generators.     

Influence of contralateral acoustic stimulation on distortion-product and spontaneous otoacoustic emissions in the barn owl

The avian auditory papilla provides an interesting object on which to study efferent influences, because whereas a significant population of hair cells in birds is not afferently innervated, all hair cells are efferently innervated (Fischer, 1992, 1994a, b). Previous studies in mammals using contralateral sound to stimulate the efferent system demonstrated a general suppressive effect on spontaneous and click-evoked, as well as on distortion-product otoacoustic emissions (DPOAE). As little is known about the effects of contralateral stimulation on hearing in birds, we studied the effect of such stimuli (broadband noise, pure tones) on the amplitude of the DPOAE 2f(1)-f(2) and on spontaneous otoacoustic emissions (SOAE) in the barn owl, Tyto alba. For the DPOAE measurements, fixed primary-tone pairs [f(1)=8.875 kHz (ratio=1.2), f(1)=8.353 kHz (ratio=1.15) and f(1)=7.889 kHz (ratio=1.1)] were presented and the DPOAE measured in the presence and absence of continuous contralateral stimulation. The DPOAE often declined in amplitude but in some cases we observed DPOAE enhancement. The changes in amplitude were as large as 9 dB. The influence of the contralateral noise changed over time, however, and the effects of contralateral tones were frequency-dependent. SOAE were suppressed in amplitude and shifted in frequency by contralateral broadband noise. Control measurements in animals after middle-ear muscle resection showed that these phenomena were not attributable to the acoustic middle-ear reflex. The finding of DPOAE enhancement is interesting, because a type of efferent fiber that suppressed its discharge rate during stimulation has been described in birds (Kaiser and Manley, 1994).     

Effect of ageing on otoacoustic emissions and efferent suppression in humans.

Transiently evoked otoacoustic emissions (TEOAEs) without and with contralateral acoustical stimulation, were recorded on 52 subjects ranging from 20 to 78 years. Subject selection was based on the hearing levels from 0.5 to 4 kHz being better than 25 dB HL, normal tympanograms and stapedial reflexes, presence of TEOAEs in at least one ear and no history of otological disease, noise exposure, ototoxic drugs, metabolic disease associated with hearing loss or a family history of hearing loss. The ear with better audiological thresholds was selected as the test ear. If there was no difference between the ears, the ear with stronger TEOAEs was selected. Subjects were divided into five age groups: 20-34 years (n=12, mean age 23.7), 35-44 (n=11, mean age 39.7), 45-54 (n=8, mean age 48.1), 55-64 (n=10, mean age 60), 65-78 (n=11, mean age 71). TEOAEs were never absent in the first two groups, but they were absent in two ears in the 45-54 group, and in one ear of the 55-64 and 65-78 groups. Mean TEOAE amplitude decreased with age, but the differences between the five groups were not significant. Contralateral white noise suppressed emission amplitude, but the amount of suppression was not significantly different between the five groups. A linear regression analysis showed a significant correlation between age and hearing levels, and a negative correlation between age and TEOAE amplitude. In addition, a significant negative correlation between hearing threshold and TEOAE amplitude was evident. No effect of age on the amplitude of the efferent suppression was found.     

Racial and gender effects on pure-tone thresholds and distortion-product otoacoustic emissions (DPOAEs) in normal-hearing young adults

This study examined racial and gender effects on behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) in the same subjects. Pure-tone behavioral thresholds and DPOAEs were measured in 60 young normal-hearing adult subjects (20 Caucasian, 20 Asian, 20 African-American, with ten females and ten males in each group). Behavioral thresholds were measured from 1000 through 16,000 Hz using Békèsy tracking. A DPOAE frequency sweep was measured with primary stimulus levels of L(1)/L(2)=60/45 dB SPL, and an f(2)/f(1) of 1.2 at discrete f(2) frequencies between 2000 through 12,000 Hz for each subject. Significant racial and gender differences in behavioral thresholds were found at 14,000 and 16,000 Hz, with the African Americans and females having the best hearing sensitivity. Based on the current results, similar findings for DPOAE frequency sweeps can be expected amongst different racial groups given that no significant differences were identified between the groups. To further define the effects of race and gender on auditory measures, future studies should include larger numbers of subjects, measurement of body size and middle ear reflectance, and examine emission generators.