Distortion Product Otoacoustic Emissions Phase Research Articles

Distortion-product otoacoustic emissions measured using synchronized swept-sines.

Swept-sines provide a tool for fast and high-resolution measurement of evoked otoacoustic emissions. During the measurement, a response to swept-sine(s) is recorded by a probe placed in the ear canal. Otoacoustic emissions can then be extracted by various techniques, e.g., Fourier analysis, the heterodyne method, and the least-square-fitting (LSF) technique. This paper employs a technique originally proposed with exponential swept-sines, which allows for direct emission extraction from the measured intermodulation impulse response. It is shown here that the technique can be used to extract distortion-product otoacoustic emissions (DPOAEs) evoked with two simultaneous swept-sines. For proper extraction of the DPOAE phase, the technique employs previously proposed adjusted formulas for exponential swept-sines generating so-called synchronized swept-sines (SSSs). Here, the SSS technique is verified using responses derived from a numerical solution of a cochlear model and responses measured in human subjects. Although computationally much less demanding, the technique yields comparable results to those obtained by the LSF technique, which has been shown in the literature to be the most noise-robust among the emission extraction methods.

Extended low-frequency phase of the distortion-product otoacoustic emission in human newborns.

At constant ratios, the phase of the nonlinear distortion component of the distortion-product otoacoustic emission (DPOAE) has a steep low-frequency segment and a flat high-frequency segment in adults and newborns. In adults, recent work found that a third segment characterizes the phase at even lower frequencies. The present study tests whether the same is true of the newborn DPOAE phase. Newborn and adult phase curves are generally similar. However, as previously reported, phase-gradient delays at mid frequencies (the region of steepest phase slope) are 50% longer in newborns.

Distortion-product otoacoustic emission phase shift test (Shift-DPOAE) – methodology of measurements and interpretation of results in example cases

Aim: The aim was to present methodology and interpretation of results of phase shift distortion-product otoacoustic emissions (Shift-DPOAE) in healthy subjects and patients with Meniere’s disease in remission stage and at the time of attack. Material and methods: Shift-DPOAE was performed in two healthy subjects without any otologic or neurologic problems and in six patients diagnosed with Meniere’s disease. Results obtained in eight subjects are oresented. The following tests were performed in all subjects: detailed otoscopy, impedance audiometry, pure tone audiometry, DPOAE, and Shift-DPOAE. Results: The normal Shift-DPOAE results obtained in two healthy subjects as well as the normal (two subjects) and abnormal (four subjects) Shift-DPOAE results obtained in patients with Meniere's disease are presented in order to thoroughly discuss the methodology and interpretation of the Shift-DPOAE study. Conclusions: The Shift-OAE is a promising diagnostic tool with great clinical potential in the diagnosis and monitoring of Meniere's disease in patients whose hearing has not yet been damaged. This examination is completely non-invasive, it can be carried out immediately after an attack of the disease with symptoms present at the time of the test, and it takes just a few minutes.

Slow oscillatory changes of DPOAE magnitude and phase after exposure to intense low-frequency sounds.

Sensitive sound detection within the mammalian cochlea is performed by hair cells surrounded by cochlear fluids. Maintenance of cochlear fluid homeostasis and tight regulation of intracellular conditions in hair cells are crucial for the auditory transduction process but can be impaired by intense sound stimulation. After a short, intense low-frequency sound, the cochlea shows the previously described "bounce phenomenon," which manifests itself as slow oscillatory changes of hearing thresholds and otoacoustic emissions. In this study, distortion product otoacoustic emissions (DPOAEs) were recorded after Mongolian gerbils were exposed to intense low-frequency sounds (200 Hz, 100 dB SPL) with different exposure times up to 1 h. After all sound exposure durations, a certain percentage of recordings (up to 80% after 1.5-min-long exposure) showed oscillatory DPOAE changes, similar to the bounce phenomenon in humans. Changes were quite uniform with respect to size and time course, and they were independent from sound exposure duration. Changes showed states of hypo- and hyperactivity with either state preceding the other. The direction of changes was suggested to depend on the static position of the cochlear operating point. As assessed with DPOAEs, no indication for a permanent damage after several or long exposure times was detected. We propose that sensitivity changes occur due to alterations of the mechanoelectrical transduction process of outer hair cells. Those alterations could be induced by different challenged homeostatic processes with slow electromotility of outer hair cells being the most plausible source of the bounce phenomenon. NEW & NOTEWORTHY Low-frequency, high-intensity sound can cause slowly cycling activity changes in the mammalian cochlea. We examined the effect of low-frequency sound duration on the degree of these alterations. We found that cochlear changes showed a stereotypical biphasic pattern independent of sound exposure duration, but the probability that significant changes occurred decreased with increasing sound duration. Despite exposure durations of up to 1 h, no permanent or transient impairments of the cochlea were detected.

Noninvasive intracranial pressure assessment using otoacoustic emissions: An application in glaucoma.

The theory that glaucoma patients have a lower intracranial pressure (ICP) than healthy subjects is a controversial one. The aim of this study was to assess ICP noninvasively by determining the relationship between distortion product otoacoustic emission (DPOAE) phase and body position and to compare this relationship between patients with primary open angle glaucoma (POAG), patients with normal tension glaucoma (NTG), and controls. The relationship was also calibrated using published data regarding invasive measurements of ICP versus body position. DPOAEs were measured in 30 controls and 32 glaucoma patients (17 POAG, 15 NTG) at the following body positions (assuming 90° as upright): 45, 30, 20, 10, 0 (supine), -10, and -20°. DPOAE phase had a clear, nonlinear relationship with body position. The mean DPOAE phase shifts between the two most extreme body positions (45 to -20°) were 73.6, 80.7, and 66.3° for healthy, POAG, and NTG, respectively (P = 0.73), and the groups showed the same, nonlinear behaviour. This indicates that there is no evidence that glaucoma patients have a reduced ICP. When calibrated with invasive data, ICP and DPOAE phase were linearly related over an ICP of 3 mmHg. This suggests that, more broadly, DPOAEs could be used in the future to monitor changes in ICP in a clinical setting and to measure dynamic changes in ICP such as diurnal fluctuations or changes induced by certain medications.

Probing Apical-Basal Differences in the Human Cochlea Using Distortion-Product Otoacoustic Emission Phase.

Distortion-product otoacoustic emission (DPOAE) phase is shaped by interaction between the evoking stimulus waves. Near-invariant at high frequencies, DPOAE phase-vs-frequency functions measured at fixed ratios bend into sloping functions at low frequencies. The different phase behaviors observed suggest that the mechanics underlying the generation of OAEs differ in the halves of the cochlea. To map out the phenomenological extent of low-to-mid frequency phase bends, this study recorded DPOAE responses from 20 normal-hearing human adult ears for a wide range of stimulus frequencies, f1 and f2, where f2 frequency sweeps from 0.25 to 8 kHz, and the f2/ f1 ratio varies from 1.05 to 1.49. Our preliminary results show two transitions in the phase slopes. One near 2.6 kHz in agreement with the literature, and another of opposite polarity near 0.75 kHz which has not been reported before. We find that the f2 frequencies marking these defining phase features are invariant with stimulus ratio. Even as the underlying mechanics remain unknown, the invariance opens the door for DPOAE phase to reliably characterize apical-basal differences across age groups and species.

Distortion-Product Otoacoustic Emission Measured Below 300Hz in Normal-Hearing Human Subjects.

Physiological noise levels in the human ear canal often exceed naturally low levels of otoacoustic emissions (OAEs) near the threshold of hearing. Low-frequency noise, and electronic filtering to cope with it, has effectively limited the study of OAE to frequencies above about 500Hz. Presently, a custom-built low-frequency acoustic probe was put to use in 21 normal-hearing human subjects (of 34 recruited). Distortion-product otoacoustic emission (DPOAE) was measured in the enclosed ear canal volume as the response to two simultaneously presented tones with frequencies f 1 and f 2. The stimulus-frequency ratio f 2/f 1 was varied systematically to find the "optimal" ratio evoking the largest level at 2 f 1-f 2 frequencies 87.9, 176, and 264Hz. No reference data exist in this frequency region. Results show that DPOAE exists down to at least 87.9Hz, maintaining the bell-shaped dependence on the f 2/f 1 ratio known from higher frequencies. Toward low frequencies, however, the bell broadens and the optimal ratio increases proportionally to the bandwidth of an auditory filter as defined by the equivalent rectangular bandwidth. The DPOAE phase rotates monotonously as a function of the stimulus ratio, and its slope trend supports the notion of a lack of scaling symmetry in the apex of the cochlea.

Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in Menière's disease

The responses of cochlear hair cells to sound stimuli depend on the resting position of their stereocilia bundles, which is sensitive to the chemical and mechanical environment. Cochlear hydrops, a hallmark of Menière's disease (MD), which is likely to come with disruption of this environment, results in hearing symptoms and electrophysiological signs, such as excessive changes in the cochlear summating potential (SP) and in the postural shifts of distortion-product otoacoustic emissions (DPOAEs). Here, SP from the basal part of the cochlea and DPOAEs from the apical part of the cochlea were recorded concomitantly in 73 patients with a definite MD, near an attack (n = 40) or between attacks with no clinical symptoms (n = 33), to compare their sensitivities to posture and evaluate their stability. The phase of the 2f1-f2 DPOAEs was monitored during body tilt, with stimuli f1 = 1 kHz and f2 = 1.2 kHz at 72 dB SPL. Extratympanic electrocochleography was performed in response to 95-dBnHL clicks. The normal limits of the DPOAE phase shift with body tilt, [−18°, +38°], and of the SP to action-potential (AP) ratio, <0.40, were exceeded in 75% and 60% of patients, respectively, near an attack. In these patients, but not in the asymptomatic ones, both tests reveal fluctuating cochlear responses from one data sample to the next. They emphasize how hydrops hinders normal hair-cell operation and may generate fast fluctuations in inner-ear functioning. If these fluctuations also occur on shorter time scales, it might explain the imperfect diagnostic sensitivity of SP and DPOAE tests, as averaging procedures would tend to level out transient fluctuations characteristic of hydrops.

Stability of the Medial Olivocochlear Reflex as Measured by Distortion Product Otoacoustic Emissions

The purpose of this study was to assess the repeatability of a fine-resolution, distortion product otoacoustic emission (DPOAE)-based assay of the medial olivocochlear (MOC) reflex in normal-hearing adults. Data were collected during 36 test sessions from 4 normal-hearing adults to assess short-term stability and 5 normal-hearing adults to assess long-term stability. DPOAE level and phase measurements were recorded with and without contralateral acoustic stimulation. MOC reflex indices were computed by (a) noting contralateral acoustic stimulation-induced changes in DPOAE level (both absolute and normalized) at fine-structure peaks, (b) recording the effect as a vector difference, and (c) separating DPOAE components and considering a component-specific metric. Analyses indicated good repeatability of all indices of the MOC reflex in most frequency ranges. Short- and long-term repeatability were generally comparable. Indices normalized to a subject's own baseline fared best, showing strong short- and long-term stability across all frequency intervals. These results suggest that fine-resolution DPOAE-based measures of the MOC reflex measured at strategic frequencies are stable, and natural variance from day-to-day or week-to-week durations is small enough to detect between-group differences and possibly to monitor intervention-related success. However, this is an empirical question that must be directly tested to confirm its utility.

Intracranial pressure modulates distortion product otoacoustic emissions: a proof-of-principle study.

There is an important need to develop a noninvasive method for assessing intracranial pressure (ICP). We report a novel approach for monitoring ICP using cochlear-derived distortion product otoacoustic emissions (DPOAEs), which are affected by ICP. We hypothesized that changes in ICP may be reflected by altered DPOAE responses via an associated change in perilymphatic pressure. We measured the ICP and DPOAEs (magnitude and phase angle) during opening and closing in 20 patients undergoing lumbar puncture. We collected data on 18 patients and grouped them based on small (<4 mm Hg), medium (5-11 mm Hg), or large (≥15 mm Hg) ICP changes. A permutation test was applied in each group to determine whether changes in DPOAEs differed from zero when ICP changed. We report significant changes in the DPOAE magnitudes and angles, respectively, for the group with the largest ICP changes and no changes for the group with the smallest changes; the group with medium changes had variable DPOAE changes. We report, for the first time, systematic changes in DPOAE magnitudes and phase in response to acute ICP changes. Future studies are warranted to further develop this new approach. DPOAE, distortion product otoacoustic emissionICP, intracranial pressureIIH, idiopathic intracranial hypertensionLP, lumbar punctureTBI, traumatic brain injury.

Frequency shifts in distortion product otoacoustic emission evoked by fast sweeping primaries in adults and newborns

Distortion product otoacoustic emissions (DPOAEs) are a vector sum of two components, generator and reflection, which produce overall DPOAE levels with a pattern of minima and maxima across frequency referred to as fine structure. The pattern of maxima and minima shifts higher or lower in frequency dependent on sweep direction (Henin et al., 2011), consistent with cochlear scaling invariance. A break from scaling invariance occurs between 1 and 1.4 kHz in human adults. DPOAE phase at frequencies below the “break” are steeper in newborns than adults. We probed frequency shifts to up- and down-swept primaries of 1 octave/s in adults and newborns. Frequency shifts were examined for DPOAEs evoked by up-sweeps and down-sweeps using a covariate correlation function across the entire DPOAE frequency range, and above and below 2 kHz. Newborns had significantly greater frequency shifts in the reflection component below 2 kHz than adults. There was a significantly different fine structure frequency shift between the low- and high-frequency ranges in adults. In newborns, this difference in the frequency shifts for the low- and high- frequencies was significant for the reflection component. These preliminary findings suggest that frequency shifts can be used to assess potential maturational differences in cochlear mechanics.

Total and component distortion product otoacoustic emission analysis in persons with induced negative middle ear pressure

Distortion product otoacoustic emissions (DPOAEs) are generated when two primary tones (f1, f2 with f2 > f1) are presented simultaneously to the ear. Inter-modulation between primary tones produces distortion products at predictable frequencies not present in the original signal (e.g., 2f1 − f2). In persons with negative middle ear pressure (NMEP), the tympanic membrane is retracted and pulled inward, compressing structures in the middle ear. NMEP is expected to modify DPOAE level and phase. Performing the Toynbee maneuver can artificially induce NMEP. Changes in DPOAE primary f1 and f2 level and phase and energy reflectance measures were used to confirm that 8 subjects had artificially induced NMEP using the Toynbee maneuver. DPOAEs were obtained using 1 s/octave duration logarithmic frequency sweeping primaries, f2/f1 = 1.22 producing 2f1 − f2 from 320–2560 Hz, L1 = L2 = 65, 70, 75 dB SPL. There was a significant effect of condition, primary level, and frequency on total DPOAE and component amplitude. S...

Demonstrating True DPOAE Modulation by the Efferent Pathway

Objective: 1) To isolate the distortion product otoacoustic emission (DPOAE) components using an ipsilateral and individualized suppressor tone. 2) To demonstrate the modulation of DPOAEs by the medial olivocochlear efferent pathway once component interference has been eliminated. Method: DPOAE (2f1-f2 ) recordings using a frequency-sweep paradigm with ipsilateral suppressor tones and CAS were made on 8 normal-hearing subjects in a sound-treated audiology booth from January to February 2012. Estimates of DPOAE level and phase were obtained using fast Fourier transform and least-squares-fit techniques. Results: Fine structure depth was significantly reduced with the use of an ideal ipsilateral suppressor tone, demonstrating the effectiveness of the suppressor tone at separating DPOAE components. In addition, once the DPOAE components were separated to remove phase interference, MOC activation resulted in consistent suppression of DPOAE level as compared to nonseparated DPOAE level which showed enhancement as well as suppression. These results help to support the theory of DPOAE component interference leading to enhancements often seen with efferent activation and to demonstrate a more consistent way to view DPOAE modulation by the efferent pathway. Conclusion: This study demonstrates that DPOAE fine structure enhancement seen with activation of the MOC pathway is likely due to DPOAE component interference as opposed to true DPOAE modulation. In addition, the results show that DPOAE component isolation can be achieved by an ipsilateral suppressor tone, however it must be individualized.

The breaking of cochlear scaling symmetry in human newborns and adults

Scaling symmetry appears to be a fundamental property of the cochlea as evidenced by invariant distortion product otoacoustic emission (DPOAE) phase above ∼1-1.5 kHz when using frequency-scaled stimuli. Below this frequency demarcation, phase steepens. Cochlear scaling and its breaking have been described in the adult cochlea but have not been studied in newborns. It is not clear whether immaturities in cochlear mechanics exist at birth in the human neonate. In this study, DPOAE phase was recorded with a swept-tone protocol in three, octave-wide segments from 0.5 to 4 kHz. The lowest-frequency octave was targeted with increased signal averaging to enhance signal-to-noise ratio (SNR) and focus on the apical half of the newborn cochlea where breaks from scaling have been observed. The results show: (1) the ear canal DPOAE phase was dominated by the distortion-source component in the low frequencies; thus, the reflection component cannot explain the steeper slope of phase; (2) DPOAE phase-frequency functions from adults and infants showed an unambiguous discontinuity around 1.4 and 1 kHz when described using two- and three-segment fits, respectively, and (3) newborns had a significantly steeper slope of phase in the low-frequency portion of the function which may suggest residual immaturities in the apical half of the newborn cochlea.

Level dependence of distortion product otoacoustic emission phase is attributed to component mixing

Distortion product otoacoustic emissions (DPOAEs) measured in the ear canal represent the vector sum of components produced at two regions of the basilar membrane by distinct cochlear mechanisms. In this study, the effect of stimulus level on the 2f(1) - f(2) DPOAE phase was evaluated in 22 adult subjects across a three-octave range. Level effects were examined for the mixed DPOAE signal measured in the ear canal and after unmixing components to assess level effects individually on the distortion (generated at the f(1), f(2) overlap) and reflection (at f(dp)) sources. Results show that ear canal DPOAE phase slope becomes steeper with decreasing level; however, component analysis further explicates this result, indicating that interference between DPOAE components (rather than a shift in mechanics related to distortion generation) drives the level dependence of DPOAE phase measured in the ear canal. The relative contribution from the reflection source increased with decreasing level, producing more component interference and, at times, a reflection-dominated response at the lowest stimulus levels. These results have implications for the use of DPOAE phase to study cochlear mechanics and for the potential application of DPOAE phase for clinical purposes.

Breaking away: Violation of distortion emission phase-frequency invariance at low frequencies

The phase versus frequency function of the distortion product otoacoustic emission (DPOAE) at 2f(1) - f(2) is approximately invariant at frequencies above 1.5 kHz in human subjects when recorded with a constant f(2)/f(1). However, a secular break from this invariance has been observed at lower frequencies where the phase-gradient becomes markedly steeper. Apical DPOAEs, such as 2f(1) - f(2), are known to contain contributions from multiple sources. This experiment asked whether the phase behavior of the ear canal DPOAE at low frequencies is driven by the phase of the component from the distortion product (DP) region at 2f(1) - f(2), which exhibits rapid phase accumulation. Placing a suppressor tone close in the frequency to 2f(1) - f(2) reduced the contribution of this component to the ear canal DPOAE in normal-hearing adult human ears. When the contribution of this component was reduced, the phase behavior of the ear canal DPOAE was not altered, suggesting that the breaking from DPOAE phase invariance at low frequencies is an outcome of apical-basal differences in cochlear mechanics. The deviation from DPOAE phase invariance appears to be a manifestation of the breaking from approximate scaling symmetry in the human cochlear apex.

Unstable distortion-product otoacoustic emission phase in Menière’s disease

The presence of endolymphatic hydrops as a marker of Menière’s disease (MD) suggests abnormal pressure in the intralabyrinthine compartments of patients and excessive stiffness of sound-sensitive structures. Otoacoustic emissions (OAEs) have been reported to respond to changes in the ear’s stiffness, including those produced by intracranial pressure steps, by a characteristic phase shift around 1 kHz, thereby suggesting a noninvasive means of monitoring MD. Here, body tilt was used for modulating intracranial pressure in forty-one patients with definite MD who were tentatively measured at two stages, with and without active symptoms. Their distortion-product OAEs (DPOAEs) were dynamically monitored around 1 kHz every few seconds in response to body tilt. In a control sample of thirty normal ears, the maximum phase rotation of DPOAEs produced by body tilt was between −18° and +37°. In MD ears with the complete set of symptoms, the posture-induced phase shifts in 32 out of 35 tests fell outside the normative interval, and in 10 tests, although DPOAEs were well above noise floor, their phase was always so abnormally erratic that body tilt produced hardly any additional effect. When MD ears were asymptomatic, nine out of 32 posture tests were abnormal. The excessive DPOAE phase shift is consistent with either a too stiff cochlear partition or a displacement of the operating point of outer hair cells by endolymphatic hydrops.

Deviations from Scaling Symmetry in the Apical Half of the Human Cochlea.

Invariant distortion product otoacoustic emission (DPOAE) phase elucidates scaling symmetry in the cochlea. Below some low-frequency boundary, DPOAE phase slope steepens. The origin of this break in phase invariance is not clear. Stimulus frequency (SF)OAE delays computed from the slope of phase also manifest discontinuities at low frequencies, though the relationship between the breaking of cochlear scaling as defined by SFOAE and DPOAE metrics has not been examined. In this study, OAEs were recorded in normal-hearing human adults to probe cochlear scaling and its breaking and to examine the correspondence between two OAE metrics of scaling. Results indicate: (1) the apical break in DPOAE phase invariance cannot be explained by contributions from the reflection-source component; (2) DPOAE phase signals a break from scaling near 1.5 kHz and (3) DPOAE and SFOAE metrics of cochlear scaling produce phase discontinuities within approximately one-quarter octave of each other and show comparable rates of breaking, suggesting a common underlying origin.

Differences in distortion product otoacoustic emission phase recorded from human neonates using two popular probes

DPOAE (2f(1)-f(2)) phase was measured across a 3-octave frequency range from two groups of newborns using ER10B+ and ER10C probe microphones. A marked phase shift was noted in the mid-to-high frequency range for newborn data recorded with the ER10C only. In contrast, the ER10B+ produced phase that was approximately invariant as a function of frequency for most of the range. Probe-related phase shifts can be effectively eliminated by correcting for variations in the phases of the primary tones. Results highlight the importance of detecting and correcting for system-related phase shifts so they are not misinterpreted as cochlear in origin.

Distortion product otoacoustic emission phase and component analysis in human newborns

Apical distortion product otoacoustic emissions (DPOAEs) are comprised of at least two components, as evidenced by the interference pattern of alternating maxima and minima known as fine structure. DPOAE fine structure is produced by the shifting phase relationship in the ear canal, between the generator and characteristic frequency (CF) component of the response. Each component arises from a different cochlear region and, according to theory, reflects a distinct generation mechanism. The analysis of DPOAE components and phase in newborns may provide a window into targeted aspects of cochlear physiology during development. 2f(1)-f(2) DPOAE fine structure was recorded from 15 adults and 14 newborns using a swept-tone technique. DPOAE group delay, as well as magnitude and phase of each component, was compared between age groups. Results show narrower fine structure spacing, a longer group delay (steeper phase gradient) in low frequencies, and a stronger relative contribution from the CF component in newborns. The prolonged group delay for low-frequency DPOAEs could indicate immature basilar membrane motion in the apex of the cochlea and warrants further investigation. The enhanced contribution from the CF component may have implications for clinical practice as well as for theories of cochlear maturation.