Efficient Otoacoustic Emission Protocols Employed in a Hospital-based Neonatal Screening Program

Within the context of a hospital-based newborn hearing screening program, we have studied the application of two OAE protocols (TEOAE and DPOAE) on a group of 250 well babies. The main goal of this study was to evaluate the performance of DPOAE protocol in a relatively large population sample, using a preset number of five tested frequencies, in comparison with a default TEOAE screening protocol. The data were collected on the second day of life and during spontaneous sleep. The TEOAE recordings were acquired with linear protocols using click stimuli of 70-75 dB SPL and were used as indicators of normal cochlear function. The cubic distortion product DPOAE responses were evoked by an asymmetrical 75-65 dB SPL protocol, with a frequency ratio of 1.22. Five frequencies (referring to F₂) were tested at 1.5, 2.0, 3.0, 4.0 and 5.0 kHz. The data from the DPOAE responses show a similar pass rate (similarity=0.98) to the linear TEOAE protocol. The data presented suggest that a DPOAE cochlear evaluation, at 5 pre-selected frequencies, has clinical potential.     

The effect of various durations of noise exposure on auditory brainstem response, distortion product otoacoustic emissions and transient evoked otoacoustic emissions in rats

This study was designed to investigate the effect of various durations of noise exposure in animals on physiological responses from the cochlea which are also used clinically in humans: auditory brainstem response (ABR), transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs). Rats were exposed to 113 dB SPL broad-band noise (12 h on/12 h off) for durations of 3, 6, 9, 12, 15 and 21 days, and tested 24 h after cessation of the noise and again after a period of 6 weeks. ABR threshold to click stimuli and to a 2-kHz tone burst (TB), TEOAE energy content and DPOAE amplitude in the exposed rats were compared to those in a group of control rats not exposed to noise. ABR thresholds (click and TB) were significantly elevated in all exposure duration groups compared to control rats. DPOAE amplitudes and TEOAE energy content were significantly reduced. The mean ABR thresholds following 21 days exposure were significantly greater (click = 100 dB pe SPL; TB = 115 dB pe SPL) than those following 3 days exposure (click = 86 dB pe SPL; TB = 91 dB pe SPL). Linear regression analysis between recorded responses and duration of noise exposure (days) showed a significant increase in ABR thresholds of approximately 0.8-- 1.4 dB/day. TEOAE and DPOAE responses showed no such dependence on noise duration and were already maximally reduced after only 3 days of exposure. This can be explained by the possibility that short noise exposures may cause damage to the early, more active stages of cochlear transduction (as shown by TEOAEs and DPOAEs). As the noise exposure continues, further damage may be induced at additional, later stages of the cochlear transduction cascade (as shown by ABR). Thus, ABR seems more sensitive to noise duration than OAE measures.     

Comparison of neonatal transient evoked otoacoustic emission responses recorded with linear and QuickScreen protocols

Linear and QuickScreen (non-linear) transient evoked otoacoustic emission (TEOAE) protocols were compared in terms of standardized clinical parameters in order to define the protocol producing recordings with the highest signal quality. Neonatal responses (520) were obtained from three different screening sites. The linear recordings were evoked by 69 and 75-dB p.e. SPL clicks. All responses were post-windowed by a 3.5- to 12.5-ms window, chosen by time-frequency analysis as the segment representing 97.35 per cent (linear) and 95.6 per cent (quick) of the total cumulative spectral energy. Evidence from hearing loss cases and the high similarity between the profile contours of the QuickScreen and the linear normal recordings have strongly suggested that a linear response evoked by a 75-dB p.e. SPL stimulus and post-processed by a 3.5 to 12.5 window is free of stimulus artefacts. The data indicate that the 75-dB linear protocol produces higher signal to noise ratios at 2.0, 3.0, and 4.0 kHz, higher wave reproducibility, and lower TEOAE noise values than the QuickScreen protocol.     

The relationship between auditory threshold and evoked otoacoustic emissions

The aim of this study was to compare transiently evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) in normal hearing ears (n = 44) and ears with cochlear hearing loss (HL) to obtain defined data on qualitative and quantitative correlations. In addition, we wanted to determine the reliability with which a clinical examiner could predict a typical, idealized audiometric configuration from TEOAE measurements. In the hearing-impaired subjects (n = 149), a 50% reduction of OAE incidence was caused by a mean HL of 10.5 dB for TEOAE compared to 27 dB SPL for DPOAE. A 90% incidence reduction was found at a mean threshold elevation of 33 dB for TEOAE and 51 dB for DPOAE. Correlation between TEOAE amplitudes and HL was in general rather low (r = –0.1 to –0.5), while DPOAE amplitudes showed a slightly better correlation with HL (r = –0.3 to –0.6). In general, efforts to derive an audiogram from evoked OAE have been more promising for DPOAE than for TEOAE. However, our studies showed that approximately 40% of the ears with HL could be categorized correctly into one of five typical audiometric patterns from TEOAE measurements. Additionally, a cochlear HL in or near the medium frequency range was much more likely to cause a reduction in TEOAE than an isolated low- or high-frequency lesion. Accordingly, TEOAE were often preserved in ears with isolated HL in the high or low frequencies. Received: 7 May 1998 / Accepted: 25 September 1998     

Reference data for DPOAE in healthy newborns

Distortion Product Otoacoustic Emissions (DPOAE) can be used as an alternative to Transient Evoked Otoacoustic Emissions (TEOAE). This study aims to establish normal values for DPOAE in healthy newborns. DPOAE were determined with the Madsen Celesta 503 at 0.5, 1, 2, 4 and 8 kHz with an unequal stimulus level of the primaries (L1 = 65 dB SPL, L2 = 50 dB SPL). DPOAE were present in 92.4% of the ears of the 185 babies tested at 4 days after birth. The 5% quantile and the median of the DPOAE of the right and left ears were calculated for the five frequencies tested. At 4 kHz there was a significant sex effect (mean amplitude of DPOAE was higher in female than in male babies) and at 2 kHz a significant interaction effect was found between sex and side. The calculated reference limits are open to comparison with data obtained using other commercial equipment.     

TEOAE recording protocols revised: data from adult subjects

The objective of this study was the experimental re-evaluation of the current clinical transiently evoked otoacoustic emission (TEOAE) protocols, based on linear and non-linear protocol paradigms from a population of 42 adult subjects serving as a normative database. The linear and non-linear TEOAE responses were elicited by clicks with average intensities of 72 and 84 dB p.e. SPL respectively. An initial comparison between non-processed non-linear and linear recordings, at early recording segments from 3.2 to 5.2 ms, showed that the responses had highly similar contours and no statistically significant mean differences. The stimulus-induced artefact in the linear TEOAE responses was suppressed by post-processing the data with a window function (3.8-13.8 ms) and by a high-pass filter at 830 Hz. A repeated-measures model was used to evaluate the differences between post-processed linear and non-linear responses across clinical variables of interest (such as TEOAE response, noise, correlation, and signal-to-noise ratios (SNRs) at 1.0-5.0 kHz). The data indicated that the linear recordings demonstrate significantly lower levels of noise (and thus superior SNRs) and higher values of reproducibility. Normative adult scoring criteria were calculated from free distribution tolerance intervals for the TEOAE correlation and the SNRs at 2.0 and 3.0 kHz.     

A TEOAE screening protocol based on linear click stimuli: performance and scoring criteria.

In order to improve the quality of current TEOAE recording methodologies, we have conducted a comparison of TEOAE neonatal recordings acquired with linear protocols using click stimuli of 68 dB SPL and non-linear protocols using the ILO default stimulus values. From a theoretical standpoint it was expected that the linear recordings would generate responses characterized by higher S/N ratios due to the fact that the stimulus sequence contains four clicks of the same intensity and polarity. The project included recordings from 1,416 neonatal ears (age 48 h). The TEOAE data were compared in terms of correlation, response amplitude, noise, corrected response and S/N ratio in the 1.0-, 2.0-, 3.0-, 4.0- and 5.0-kHz bands, using a paired t-test criterion. We found that windowed (4-14 ms) responses evoked by a linear TEOAE protocol generated superior S/N estimates in the 2.0-, 3.0-, 4.0- and 5.0-kHz TEOAE bands, in addition to superior correlation estimates, and demonstrated lower levels of noise. Clear-cut scoring criteria were established for the S/N ratios at 2.0, 3.0 and 4.0 kHz, by constructing one-sided distribution-free tolerance boundaries.     

自发性耳声发射与耳蜗传出调控的关系探讨

OBJECTIVE: To study the relationship between spontaneous otoacoustic emissions(SOAE) and efferent control of cochlea and their clinical significance. METHODS: SOAE, transient evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE) and contralateral white noise (60 dB SPL) suppression of TEOAE and DPOAE experiments were conducted in 312 ears of 95 patients with retrocochlear impairment and/or MOCS dysfunction and 64 normal young adults. RESULTS: MOCS dysfunction was shown in 126 ears of 65 patients (130 ears) with auditory neuropathy, 2 ears of 2 patients with unilateral acoustic neuroma, 4 ears of 2 patients with hyperacusis, 14 ears of 26 patients(48 ears) with normal hearing level in unilateral or bilateral tinnitus. Stronger EOAE could be recorded in total 146 ears with MOCS dysfunction at any pure tone hearing level. SOAE could be recorded in 126 of 146 ears (86.3%) with MOCS dysfunction and 44 of 128 ears (34.3%) with normal hearing. SOAE of ears with MOCS dysfunction was mainly at frequencies from 0.693 to 3.055 kHz and SOAE of normal ears was at frequencies from 1.135 to 2.746 kHz. Average value of maximum amplitude of SOAE spectrum (-3.4 +/- 6.4) dB SPL was significantly greater than that in normal ears (-6.8 +/- 7.8) dB SPL (P < 0.01). The major frequency range of SOAE (0.693-3.055 kHz) in MOCS dysfunction ears was essentially consistent with that of efferent suppression in normal ears (0.7-3 kHz). CONCLUSION: The modulation of the cochlear active mechanisms by MOCS mainly presents in the low- and mid-frequency regions, these frequencies correspond to the frequency range of SOAE. Stronger SOAE indicates pathophysiological significance. There is a clear clinical relationship between SOAE and the efferent modulation of the cochlea.     

Middle ear and cochlear disorders result in different DPOAE growth behaviour: implications for the differentiation of sound conductive and cochlear hearing loss

Input/output functions of distortion product otoacoustic emissions (DPOAE I/O-functions) give an insight into the compressive, non-linear sound processing of the cochlea. With an inner ear dysfunction a steeper I/O-function is observed. Due to the linear sound processing of the middle ear, one can assume that the DPOAE growth behaviour remains unaltered with a sound conduction dysfunction. If that is true, a differentiation between middle and inner ear dysfunction will be possible by using the slope of DPOAE I/O-functions as a means for assessing cochlear compression. In order to test that hypothesis, DPOAE I/O-functions were recorded in a wide primary tone level range at up to 8 f2 frequencies between 2.0 and 8.0 kHz (15 dB SPL < L2< 60 dB SPL; L1=0.46 L2 + 41 dB SPL; f2/f1=1.2) in guinea pigs in which middle (saline solution in the bulla) and inner ear (exposure to loud broadband noise) disorders were induced. Middle ear dysfunction resulted in a reduction of the DPOAE amplitude independent of the primary tone level. Consequently, DPOAE growth behaviour was not affected. In contrast to that, during cochlear impairment, steepened DPOAE I/O-functions were observed reflecting loss of compression of the cochlear amplifier. Accordingly, DPOAE I/O-functions allow a differentiation between middle and inner ear dysfunction. Further studies will have to show the usability of this method for clinical diagnostics, e.g. for detecting sound conduction disturbances in newborn hearing screening due to amniotic fluid or Eustachian tube dysfunctions during the early postnatal period.     

Quantitative analysis of cochlear active mechanisms in tinnitus subjects with normal hearing sensitivity: multiparametric recording of evoked otoacoustic emissions and contralateral suppression

Objective

Aim of this study was to investigate the possible role played by outer hair cells and cochlear efferent system functionality when tinnitus develops in normal hearing ears. A multiparametric approach was used, entailing recording and analysis of a set of otoacoustic emissions (OAEs): distortion product (DPOAEs), transient evoked (TEOAEs) and efferent-mediated TEOAE suppression in the presence of contralateral acoustic stimulation (CAS).

Methods

Fifty-four subjects with normal hearing sensitivity participated in the study. Twenty-three suffered from chronic subjective tinnitus whereas thirty-one did not have tinnitus and acted as control subjects. DPOAEs were measured with eliciting tones of frequency ratio 1.22 and intensity 65 and 55 dB SPL in the frequency range 0.5–8 kHz. TEOAEs were recorded with the ‘linear’ protocol using clicks at 60 dB peak SPL both in the absence and in the presence of CAS at two different intensities. DPOAE amplitude, TEOAE amplitude, and TEOAE suppression were analysed as relevant parameters.

Results

Significantly reduced DPOAE amplitude in the frequency range 1.5–8 kHz, lower TEOAE amplitude, and slightly decreased TEOAE suppression were measured in tinnitus subjects compared to non-tinnitus controls. In particular, 74% of tinnitus subjects exhibited abnormal DPOAEs, 13% had abnormal TEOAEs, whereas abnormal TEOAE suppression was found in 9% of patients.

Conclusion

Overall, the present work revealed the presence of abnormal OAEs, in particular at higher frequencies, in tinnitus subjects with normal hearing sensitivity. A minor (i.e., sub-clinical) outer hair cell dysfunction, particularly in high-frequency cochlear regions, might thus be assumed in normal hearing tinnitus subjects. In order to better put in light the possible role played by outer hair cells in low-frequency cochlear regions, or by the cochlear efferent system, additional analyses would be needed.     

一家系遗传性进行性感音神经性聋耳声发射测试分析

目的 :探讨耳声发射 ( OAE)测试对遗传性进行性感音神经性聋的诊断意义。方法 :对一家系 6代中 5 4例 ( 10 8耳 )和 5 0例正常人进行了纯音测听、瞬态诱发耳声发射 ( TEOAE)和畸变产物耳声发射 ( DPOAE)测试 ,了解其耳蜗功能。结果 :本家系纯音听阈 >2 0 d B HL组中 ,84%出现 TEOAE反应幅度下降或消失 ,82 %出现DPOAE振幅下降或消失 ;纯音听阈正常组中 ,75 %出现 TEOAE反应幅度下降 ,6 4%出现 DPOAE某个频率的振幅下降或缺失 ;对照组 TEOAE和 DPOAE的检出率均为 10 0 %。结论 :OAE测试有助于遗传性进行性感音神经性聋的早期诊断     

Electrophysiological findings in the Sprague-Dawley rat induced by moderate-dose carboplatin

Carboplatin is a second generation platinum-containing anti-tumor drug which selectively alters the micromechanical function of the inner hair cells (IHCs) of the organ of Corti in the chinchilla. Data from a recent study [Wake et al., Acta Otolaryngol. 116 (1996) 374-381], using the chinchilla model, have suggested that a moderate dose of carboplatin alters the efferent feedback loop gain of the OHCs. The present study was designed to evaluate the possible 'efferent feedback alteration mechanism' in the Sprague-Dawley rat using distortion product otoacoustic emissions (DPOAEs). A moderate dose of carboplatin (50 mg/kg body weight) was administered by a 30 min i.p. infusion. Pre- and 72-h post-treatment DPOAE and auditory brainstem response (ABR) recordings were acquired from a group of 12 rats. The animals were anesthetized with a ketamine-atropin anesthesia administered in two consecutive phases. The DPOAE responses (cubic distortion products) were recorded with four asymmetrical protocols: P1=60-50, P2=50-40, P3=40-30 and P4=30-20 dB SPL (sound pressure level), in the frequency range from 4.0 to 16 kHz. ABR responses were obtained for bipolar clicks and tone pips at the frequencies 8.0, 10.0, 20.0 and 30 kHz using stimuli in the range from 100 to 30 dB SPL. Significant ABR threshold shifts of 15 dB were observed at 30 kHz, and shifts of 10 dB at 20, 16 and 10 kHz. The comparison of pre- and post-treatment DPOAE responses did not reveal any significant changes for protocols P1, P2 and P4. Data from the P3 protocol indicated a decrease of the DPOAE amplitude. The findings from the rat model suggest that (a) moderate doses of carboplatin do not affect the efferent feedback loop OHC function and (b) the cochlear susceptibility to carboplatin across species is different, even at moderate-dose regimes.     

TEOAE monitoring of Cisplatin induced ototoxicity in guinea pigs: the protective effect of vitamin B treatment

OBJECTIVE: To evaluate Cisplatin (CP) induced ototoxicity and the effects of vitamin B treatment on ototoxicity in guinea pigs by using the Transient Evoked Otoacoustic Emission (TEOAE) technique. METHODS: Eleven guinea pigs were divided into two groups and they were tested by TEOAE before and after the experiment. A TEOAE response was regarded as positive when all of the following criteria were met: 1. The mean amplitude of the cochlear response in dB pe SPL should be greater than that of the noise in the external auditory canal; 2. The reproducibility rate of the response should be greater than 50%; 3. The stimulus stability rate should be greater than 65%; 4. The signal to noise ratio of the response in 1, 2, 3, 4 and 5 kHz band frequencies should be greater than 3 dB pe SPL in at least two bands. The first group included five animals that had only CP injections. Six animals in the second group received additional 0.2 ml/kg combined vitamin B preparations for 7 consecutive days. Thereafter, the right and left ears of all animals in both groups were tested by TEOAE. RESULTS: TEOAE responses recorded from 22 ears of 11 guinea pigs before drug administrations showed that the responses with maximum amplitude were originated from the mid-frequency region. Positive TEOAE responses were significantly reduced after CP administrations in both groups when compared with their respective pretreatment results (P<0.01). However, vitamin B injections, in addition to a single large dose of CP, resulted in significantly better TEOAE responses than those obtained after only CP injections (P<0.05). CONCLUSIONS: The routine use of TEOAE monitoring is recommended in clinical CP treatment protocols for the early detection and follow up of ototoxicity. Also, prospective clinical trials are needed in order to validate the protective effects of vitamin B treatment against ototoxicity.     

Influence of Ketamine–Xylazine Anaesthesia on Cubic and Quadratic High-Frequency Distortion-Product Otoacoustic Emissions

Ketamine is a dissociative anaesthetic, analgesic drug as well as an N-methyl-d-aspartate receptor antagonist and has been reported to influence otoacoustic emission amplitudes. In the present study, we assess the effect of ketamine–xylazine on high-frequency distortion-product otoacoustic emissions (DPOAE) in the bat species Carollia perspicillata, which serves as model for sensitive high-frequency hearing. Cubic DPOAE provide information about the nonlinear gain of the cochlear amplifier, whereas quadratic DPOAE are used to assess the symmetry of cochlear amplification and potential efferent influence on the operating state of the cochlear amplifier. During anaesthesia, maximum cubic DPOAE levels can increase by up to 35 dB within a medium stimulus level range from 35 to 60 dB SPL. Close to the -10 dB SPL threshold, at stimulus levels below about 20-30 dB SPL, anaesthesia reduces cubic DPOAE amplitudes and raises cubic DPOAE thresholds. This makes DPOAE growth functions steeper. Additionally, ketamine increases the optimum stimulus frequency ratio which is indicative of a reduction of cochlear tuning sharpness. The effect of ketamine on cubic DPOAE thresholds becomes stronger at higher stimulus frequencies and is highly significant for f2 frequencies above 40 kHz. Quadratic DPOAE levels are increased by up to 25 dB by ketamine at medium stimulus levels. In contrast to cubic DPOAEs, quadratic DPOAE threshold changes are variable and there is no significant loss of sensitivity during anaesthesia. We discuss that ketamine effects could be caused by modulation of middle ear function or a release from ipsilateral efferent modulation that mainly affects the gain of cochlear amplification.     

A longitudinal study of changes in evoked otoacoustic emissions and pure-tone thresholds as measured in a hearing conservation program

Non-linear transient-evoked otoacoustic emissions (TEOAEs) at 74dB pSPL, distortion-product otoacoustic emissions (DPOAEs) at 65/45dB SPL and pure-tone audiometry were used to detect noise-induced, inner car changes in a longitudinal study. Repeated-measures ANOVAs were made on the Noise (n=69) and Quiet (n=42) groups. The Noise group's hearing thresholds increased by 1.2 dB and DPOAE amplitude decreased by -0.9 dB. For both groups, TEOAE amplitude decreased by approximately -0.6 dB. Eight of 12 ears with permanent threshold shift (PTS) and 10 of 13 ears with temporary threshold shift (TTS) showed TEOAE decrements or low baseline TEOAE amplitudes. Fewer TTS and PTS ears also showed DPOAE decrements, and there was never a DPOAE decrement without a corresponding TEOAE decrement or low TEOAE baseline. Some TTS ears showed permanent emission decrements. Although otoacoustic emissions show promise in detecting noise-induced inner ear changes, it is premature to use them in hearing conservation programs.     

畸变产物耳声发射测试对噪声性聋诊断的敏感度和特异度

目的 探讨畸变产物耳声发射测试对噪声性聋的诊断价值。方法 对115名军人（204耳）进行DPOAE幅值测试,采用两个等强度L1＝L2＝70dB SPL的纯音信号f1、f2＝1．2。测试1、2、4kHz和6kHz DPOAE幅值,根据DPOAE幅值是否大于或小于标准值,判断听力正常与否。并同纯音听阈进行对照。结果 1、2、4和6kHz各频率的敏感度分别是70％、67％、85％和73％;特异度分别是71％、66％、84％和75％。结论 DPOAE幅值测试用于诊断噪声性聋,缺乏足够的敏感性和特异性,单一的DPOAE幅值测试,不能诊断噪声性聋。     

Distortion product otoacoustic emission response characteristics in older adults

OBJECTIVE: The primary purpose of this study was to determine the distortion product otoacoustic emission (DPOAE) and noise response characteristics in a large sample of older adults. Another purpose was to evaluate how specific absolute DPOAE levels or DPOAE/Noise ratios differentiated hearing status in these individuals. DESIGN: A cross-sectional design was utilized for this study. As a part of the Epidemiology of Hearing Loss Study (EHLS), DPOAEs were measured in 937 of the 3,429 participants aged 48 to 92 yr. The DPOAE and noise response characteristics were evaluated at 1,000, 2,000, 4,000, and 8,000 Hz. Absolute DPOAE level and DPOAE/Noise ratios were measured in the participants. The DPOAE data were compared with individual pure-tone frequencies (1,000, 2,000, 4,000, and 8,000 Hz) in the participants to investigate how DPOAE responses differentiated ears with normal hearing from impaired ears. Sensitivity, specificity, positive and negative predictive values, and accuracies were calculated for various absolute DPOAE levels and DPOAE/Noise ratios. RESULTS: Due to the considerable overlap between DPOAE responses and the noise levels at 1,000 Hz, this frequency was not used for any analyses. Sensitivity and specificity were calculated for various DPOAE responses. Sensitivity and specificity varied by frequency for absolute DPOAE levels and DPOAE/Noise ratios. Receiver operator characteristic (ROC) analyses were used to determine which DPOAE responses differentiated normal hearing from hearing loss. The ROC analyses demonstrated that -6 dB SPL at 2,000 Hz, -14 dB SPL at 4,000 Hz, and -22 dB SPL at 8,000 Hz and a +9 dB DPOAE/Noise ratio at each of these frequencies yielded the highest discrimination. CONCLUSIONS: Sensitivity and specificity varied by DPOAE response characteristics and frequency. The decision as to which DPOAE response criterion used should be based on careful consideration of objectives and the possible consequences of misdiagnosis. The results of this study support the use of DPOAEs as a clinical measure for older adults.     

Optimum primary tone level setting for measuring high amplitude DPOAEs in guinea pigs

A special stimulus paradigm needs to be applied when distortion product otoacoustic emission (DPOAE) input/output functions are used to investigate the loss of sensitivity and loss of compression of outer hair cell cochlear amplifiers during noise exposure, drug treatment, etc. This stimulus paradigm should be able to reflect cochlear non-linear compressive sound processing known from direct basilar membrane measurements. Such a paradigm has already been established for humans that accounts for the different compression of the primary tones at the DPOAE generation site at f2 with L1 = 0.4 L2 + 39 dB SPL ('scissor paradigm'). The purpose of the present study was to develop an equivalent parameter setting for guinea pigs. Ninety-six different L1 - L2 combinations were presented to 24 ears in 18 pigmented guinea pigs at seven f2 frequencies between 2 and 16 kHz. L2 ranged from 20 to 60 dB SPL, L1 from 20 to 65 dB SPL. An extreme value analysis was performed to achieve the maximum DPOAE level for L1 in relation to L2. Linear regression analysis yielded a scissor paradigm specific to guinea pigs (L1 = 0.46 L2 + 41 dB SPL) which is similar to that of humans.     

Cisplatin ototoxicity in the Sprague Dawley rat evaluated by distortion product otoacoustic emissions.

The present study has evaluated the use of distortion product otoacoustic emission (DPOAE) responses in the detection of cisplatin-induced ototoxicity in a Sprague Dawley rat animal model. The cisplatin was administered as a 16 mg/kg, dose introduced by a slow 30-min intraperitoneal infusion. Data from three DP-gram protocols, DPOAE input-output responses at 8 kHz, and auditory brainstem responses (ABRs) at 8, 12 and 16 kHz were collected before and 72 h after treatment. The post-treatment ABRs at 16 kHz showed the greatest mean threshold shift of 33.6 dB. The post-treatment DP-gram data showed significant reduction of the signal to noise ratios in the majority of the frequencies tested, across all tested protocols. The data suggest that the most sensitive DPOAE procedure for the early detection of the cisplatin-induced ototoxic damage is the DPOAE I/O protocol. Morphological analyses indicated that the inner hair cells remained intact, while several types of alterations were observed in the arrangement of the stereocilia in the outer hair cells.     

A longitudinal study of changes in evoked otoacoustic emissions and pure-tone thresholds as measured in a hearing conservation program

Non-linear transient-evoked otoacoustic emissions (TEOAEs) at 74 dB pSPL, distortion-product otoacoustic emissions (DPOAEs) at 65/45 dB SPL and pure-tone audiometry were used to detect noise-induced, inner ear changes in a longitudinal study. Repeated-measures ANOVAs were made on the Noise (n=69) and Quiet (n=42) groups. The Noise group's hearing thresholds increased by 1.2 dB and DPOAE amplitude decreased by ?0.9 dB. For both groups, TEOAE amplitude decreased by approximately ?0.6 dB. Eight of 12 ears with permanent threshold shift (PTS) and 10 of 13 ears with temporary threshold shift (TTS) showed TEOAE decrements or low baseline TEOAE amplitudes. Fewer TTS and PTS ears also showed DPOAE decrements, and there was never a DPOAE decrement without a corresponding TEOAE decrement or low TEOAE baseline. Some TTS ears showed permanent emission decrements. Although otoacoustic emissions show promise in detecting noise-induced inner ear changes, it is premature to use them in hearing conservation programs.