Clinical interpretations of transient otoacoustic emissions

Abstract

Purpose: The purpose of this study was to characterize the relation of different ordinal patterns of transient otoacoustic emissions (TEOAES) with respect to underlying otologic disorders and auditory status. Patients and Methods: The results of TEOAEs in 225 patients with various auditory disorders were investigated and compared with normative data established from 90 subjects of various ages. TEOAEs were categorized according to four patterns: (1) normal (general response level within 90% of normative data, (2) reduced amplitude (general response level was ≥2 dB peak sound pressure level (pSPL), but less than the mean −1.64 SD of the normative data), (3) abnormal morphology of frequency spectrum (general response level was within normal limits, but reduced at ≥2 individual octave frequencies between 1,000 and 5,000 Hz), and (4) total absence (response level <2 dB pSPL). Results: This study showed that the normal pattern of TEOAEs, in terms of response amplitude, varied with age. Our results further indicated that a reduced amplitude pattern of TEOAEs was noted in patients with a mild sensorineural hearing loss (SNHL), negative tympanometric pressure, a pressure-equalization tube, and Meniere's disease. TEOAEs provided good frequency-specific information for patients with a noise-induced hearing loss. All patients with ossicular chain abnormalities, more than moderate SNHL, and a middle ear mass or effusion had total absence of TEOAEs. Patients with acoustic neuroma and brainstem lesions presented a complex profile of TEOAEs. In the follow-up of auditory function in patients undergoing otologic surgery, different patterns of TEOAEs between the preoperative and postoperative recordings were evident, which correlated with the hearing thresholds and middle ear status. The abnormal findings of TEOAEs due to specific auditory diseases were discussed. Conclusion: The interpretation of TEOAEs can be facilitated through an analysis of specific patterns and in combination with other audiologic tests.