Stimulus-frequency Otoacoustic Emissions Research Articles

Maximising the ability of stimulus-frequency otoacoustic emissions to predict hearing status and thresholds using machine-learning models

Objective This study aimed to maximise the ability of stimulus-frequency otoacoustic emissions (SFOAEs) to predict hearing status and thresholds based on machine-learning models. Design SFOAE data and audiometric thresholds were collected at octave frequencies from 0.5 to 8 kHz. Support vector machine, k-nearest neighbour, back propagation neural network, decision tree, and random forest algorithms were used to build classification models for status identification and to develop regression models for threshold prediction. Study sample About 230 ears with normal hearing and 737 ears with sensorineural hearing loss. Results All classification models yielded areas under the receiver operating characteristic curve of 0.926–0.994 at 0.5–8 kHz, superior to the previous SFOAE study. The regression models produced lower standard errors (8.1–12.2 dB, mean absolute errors: 5.53–8.97 dB) as compared to those for distortion-product and transient-evoked otoacoustic emissions previously reported (8.6–19.2 dB). Conclusions SFOAEs using machine-learning approaches offer promising tools for the prediction of hearing capabilities, at least at 0.5–4 kHz. Future research may focus on further improvements in accuracy and reductions in test time to improve clinical utility.

Analyzing Stimulus-frequency Otoacoustic Emission Fine Structure Using an Additive Model.

A good understanding of the origin of stimulus-frequency otoacoustic emission (SFOAE) fine structure in human ears and its probe level-dependency has potential clinical significance. In this study, we develop a two-component additive model, with total SFOAE unmixed into short- and long-latency components (or reflections) using time windowing method, to investigate the origin of SFOAE fine structure in humans from 40 to 70 dB SPL. The two-component additive model predicts that a spectral notch seen in the amplitude fine structure is produced when short- and long-latency components have opposite phases and comparable magnitudes. And the depth of spectral notch is significantly correlated with the amplitude difference between the two separated components, as well as their degree of opposite phase. Our independent evidence for components contributing to SFOAE fine structure suggests that amplitude, phase and delay fine structure in the human SFOAEs are a construct of the complex addition of two or more internal reflections with different phase slops in the cochlea.

Nonlinear reflection as a cause of the short-latency component in stimulus-frequency otoacoustic emissions simulated by the methods of compression and suppression.

Stimulus-frequency otoacoustic emissions (SFOAEs) are generated by coherent reflection of forward traveling waves by perturbations along the basilar membrane. The strongest wavelets are backscattered near the place where the traveling wave reaches its maximal amplitude (tonotopic place). Therefore, the SFOAE group delay might be expected to be twice the group delay estimated in the cochlear filters. However, experimental data have yielded steady-state SFOAE components with near-zero latency. A cochlear model is used to show that short-latency SFOAE components can be generated due to nonlinear reflection of the compressor or suppressor tones used in SFOAE measurements. The simulations indicate that suppressors produce more pronounced short-latency components than compressors. The existence of nonlinear reflection components due to suppressors can also explain why SFOAEs can still be detected when suppressors are presented more than half an octave above the probe-tone frequency. Simulations of the SFOAE suppression tuning curves showed that phase changes in the SFOAE residual as the suppressor frequency increases are mostly determined by phase changes of the nonlinear reflection component.

Relationship Between Behavioral and Stimulus Frequency Otoacoustic Emissions Delay-Based Tuning Estimates.

Purpose The phase delay of stimulus frequency otoacoustic emissions (SFOAEs) has been proposed as a noninvasive, objective, and fast source for estimating cochlear mechanical tuning. However, the implementation of SFOAEs clinically has been thwarted by the gaps in understanding of the stability of SFOAE delay-based tuning estimates and their relationship to behavioral measures of tuning. Therefore, the goals of this study were (a) to investigate the relationship between delay-based tuning estimates from SFOAEs and simultaneously masked psychophysical tuning curves (PTCs) and (b) to assess the across- and within-session repeatability of tuning estimates from behavioral and OAE measures. Method Three sets of behavioral and OAE measurements were collected in 24 normal-hearing, young adults for two probe frequencies, 1 and 4 kHz. For each participant, delay-based tuning estimates were derived from the phase gradient of SFOAEs. SFOAE-based and behavioral estimates of tuning obtained using the fast-swept PTC paradigm were compared within and across sessions. Results In general, tuning estimates were sharper at 4 kHz compared to 1 kHz for both PTCs and SFOAEs. Statistical analyses revealed a significant correlation between SFOAE delay-based tuning and PTCs at 4 kHz, but not 1 kHz. Lastly, SFOAE delay-based tuning estimates showed better intra- and intersession repeatability compared to PTCs. Conclusions SFOAE phase-gradient delays reflect aspects of cochlear mechanical tuning, in that a frequency dependence similar to that of basilar membrane tuning was observed. Furthermore, the significant correlation with PTCs at 4 kHz and the high repeatability of SFOAE-based tuning measures offer promise of an objective, nonbehavioral assay of tuning in human ears.

The Spatial Origins of Cochlear Amplification Assessed by Stimulus-Frequency Otoacoustic Emissions

Cochlear amplification of basilar membrane traveling waves is thought to occur between a tone’s characteristic frequency (CF) place and within one octave basal of the CF. Evidence for this view comes only from the cochlear base. Stimulus-frequency otoacoustic emissions (SFOAEs) provide a noninvasive alternative to direct measurements of cochlear motion that can be measured across a wide range of CF regions. Coherent reflection theory indicates that SFOAEs arise mostly from the peak region of the traveling wave, but several studies using far-basal suppressor tones claimed that SFOAE components originate many octaves basal of CF. We measured SFOAEs while perfusing guinea pig cochleas from apex to base with salicylate or KCl solutions that reduced outer-hair-cell function and SFOAE amplification. Solution effects on inner hair cells reduced auditory nerve compound action potentials (CAPs) and provided reference times for when solutions reached the SFOAE-frequency CF region. As solution flowed from apex to base, SFOAE reductions generally occurred later than CAP reductions and showed that the effects of cochlear amplification usually peaked ∼1/2 octave basal of the CF region. For tones ≥2 kHz, cochlear amplification typically extended ∼1.5 octaves basal of CF, and the data are consistent with coherent reflection theory. SFOAE amplification did not extend to the basal end of the cochlea, even though reticular lamina motion is amplified in this region, which indicates that reticular lamina motion is not directly coupled to basilar membrane traveling waves. Previous reports of SFOAE-frequency residuals produced by suppressor frequencies far above the SFOAE frequency are most likely due to additional sources created by the suppressor. For some tones <2 kHz, SFOAE amplification extended two octaves apical of CF, which highlights that different vibratory motions produce SFOAEs and CAPs, and that the amplification region depends on the cochlear mode of motion considered. The concept that there is a single “cochlear amplification region” needs to be revised.

Estimating Hearing Thresholds From Stimulus-Frequency Otoacoustic Emissions.

It is of clinical interest to estimate pure-tone thresholds from potentially available objective measures, such as stimulus-frequency otoacoustic emissions (SFOAEs). SFOAEs can determine hearing status (normal hearing vs. hearing loss), but few studies have explored their further potential in predicting audiometric thresholds. The current study investigates the ability of SFOAEs to predict hearing thresholds at octave frequencies from 0.5 to 8 kHz. SFOAE input/output functions and pure-tone thresholds were measured from 230 ears with normal hearing and 737 ears with sensorineural hearing loss. Two methods were used to predict hearing thresholds. Method 1 is a linear regression model; Method 2 proposed in this study is a back propagation (BP) network predictor built on the bases of a BP neural network and principal component analysis. In addition, a BP network classifier was built to identify hearing status. Both Methods 1 and 2 were able to predict hearing thresholds from 0.5 to 8 kHz, but Method 2 achieved better performance than Method 1. The BP network classifiers achieved excellent performance in determining the presence or absence of hearing loss at all test frequencies. The results show that SFOAEs are not only able to identify hearing status with great accuracy at all test frequencies but, more importantly, can predict hearing thresholds at octave frequencies from 0.5 to 8 kHz, with best performance at 0.5 to 4 kHz. The BP network predictor is a potential tool for quantitatively predicting hearing thresholds, at least at 0.5 to 4 kHz.

The Association Between Physiological Noise Levels and Speech Understanding in Noise.

Traditionally, elevated hearing thresholds have been considered to be the main contributors to difficulty understanding speech in noise; yet, patients will often report difficulties with speech understanding in noise despite having audiometrically normal hearing. The purpose of this cross-sectional study was to critically evaluate the relationship of various metrics of auditory function (behavioral thresholds and otoacoustic emissions) on speech understanding in noise in a large sample of audiometrically normal-hearing individuals. Behavioral hearing thresholds, distortion product otoacoustic emission (DPOAE) levels, stimulus-frequency otoacoustic emission levels, and physiological noise (quantified using OAE noise floors) were measured from 921 individuals between 10 and 68 years of age with normal pure-tone averages. The quick speech-in-noise (QuickSIN) test outcome, quantified as the signal-to-noise ratio (SNR) loss, was used as the metric of speech understanding in noise. Principle component analysis (PCA) and linear regression modeling were used to evaluate the relationship between the measures of auditory function and speech in noise performance. Over 25% of participants exhibited mild or worse degree of SNR loss. PCA revealed DPOAE levels at 12.5 to 16 kHz to be significantly correlated with the variation in QuickSIN scores, although correlations were weak (R = 0.017). Out of all the metrics evaluated, higher levels of self-generated physiological noise accounted for the most variance in QuickSIN performance (R = 0.077). Higher levels of physiological noise were associated with worse QuickSIN performance in listeners with normal hearing sensitivity. We propose that elevated physiological noise levels in poorer speech in noise performers could diminish the effective SNR, thereby negatively impacting performance as seen by poorer QuickSIN scores.

Comparison of distortion-product otoacoustic emission and stimulus-frequency otoacoustic emission two-tone suppression in humans

Distortion-product otoacoustic emission (DPOAE) and stimulus-frequency otoacoustic emission (SFOAE) are two types of acoustic signals emitted by the inner ear in response to tonal stimuli. The levels of both emission types may be reduced by the inclusion of additional (suppressor) tones with the stimulus. Comparison of two-tone suppression properties across emission type addresses a clinically relevant question of whether these two types of emission provide similar information about cochlear status. The purpose of this study was to compare DPOAE suppression to SFOAE suppression from the same ear in a group of participants with normal hearing. Probe frequency was approximately 1000 Hz, and the suppressor frequency varied from -1.5 to 0.5 octaves relative to the probe frequency. DPOAE and SFOAE suppression were compared in terms of (1) suppression growth rate (SGR), (2) superimposed suppression tuning curves (STCs), and (3) STC-derived metrics, such as high-frequency slope, cochlear amplifier gain, and QERB (ERB, equivalent rectangular bandwidth). Below the probe frequency, the SGR was slightly greater than one for SFOAEs and slightly less than two for DPOAEs. There were no differences in STC metrics across emission types. These observations may provide useful constraints on physiology-based models of otoacoustic emission suppression.

Characteristic of Stimulus Frequency Otoacoustic Emissions: Detection Rate, Musical Training Influence, and Gain Function.

Stimulus frequency otoacoustic emission (SFOAE) is an active acoustic signal emitted by the inner ear providing salient information about cochlear function and dysfunction. To provide a basis for laboratory investigation and clinical use, we investigated the characteristics of SFOAEs, including detection rate, musical training influence, and gain function. Sixty-five normal hearing subjects (15 musicians and 50 non-musicians, aged 16–45 years) were tested and analyzed at the probe level of 30 and 50 dB sound pressure levels (SPL) in the center frequency of 1 and 4 kHz in the study. The results indicate that (1) the detection rates of SFOAE are sensitive to the gender, (2) musicians reveal enhanced hearing capacity and SFOAE amplitudes compared with non-musicians, and (3) probe frequency has a significant effect on the compression threshold of SFOAE. Our findings highlight the importance of SFOAE in the clinical hearing screening and diagnosis and emphasize the use of musical training for the rehabilitation enhancement of the auditory periphery and hearing threshold.

No effects of attention or visual perceptual load on cochlear function, as measured with stimulus-frequency otoacoustic emissions.

The effects of selectively attending to a target stimulus in a background containing distractors can be observed in cortical representations of sound as an attenuation of the representation of distractor stimuli. The locus in the auditory system at which attentional modulations first arise is unknown, but anatomical evidence suggests that cortically driven modulation of neural activity could extend as peripherally as the cochlea itself. Previous studies of selective attention have used otoacoustic emissions to probe cochlear function under varying conditions of attention with mixed results. In the current study, two experiments combined visual and auditory tasks to maximize sustained attention, perceptual load, and cochlear dynamic range in an attempt to improve the likelihood of observing selective attention effects on cochlear responses. Across a total of 45 listeners in the two experiments, no systematic effects of attention or perceptual load were observed on stimulus-frequency otoacoustic emissions. The results revealed significant between-subject variability in the otoacoustic-emission measure of cochlear function that does not depend on listener performance in the behavioral tasks and is not related to movement-generated noise. The findings suggest that attentional modulation of auditory information in humans arises at stages of processing beyond the cochlea.

Exploring the Role of Medial Olivocochlear Efferents on the Detection of Amplitude Modulation for Tones Presented in Noise.

The medial olivocochlear reflex has been hypothesized to improve the detection and discrimination of dynamic signals in noisy backgrounds. This hypothesis was tested here by comparing behavioral outcomes with otoacoustic emissions. The effects of a precursor on amplitude-modulation (AM) detection were measured for a 1- and 6-kHz carrier at levels of 40, 60, and 80dB SPL in a two-octave-wide noise masker with a level designed to produce poor, but above-chance, performance. Three types of precursor were used: a two-octave noise band, an inharmonic complex tone, and a pure tone. Precursors had the same overall level as the simultaneous noise masker that immediately followed the precursor. The noise precursor produced a large improvement in AM detection for both carrier frequencies and at all three levels. The complex tone produced a similarly large improvement in AM detection at the highest level but had a smaller effect for the two lower carrier levels. The tonal precursor did not significantly affect AM detection in noise. Comparisons of behavioral thresholds and medial olivocochlear efferent effects on stimulus frequency otoacoustic emissions measured with similar stimuli did not support the hypothesis that efferent-based reduction of cochlear responses contributes to the precursor effects on AM detection.

Neural Encoding of Amplitude Modulations in the Human Efferent System.

Most natural sounds, including speech, exhibit temporal amplitude fluctuations. This information is encoded as amplitude modulations (AM)-essential for auditory and speech perception. The neural representation of AM has been studied at various stages of the ascending auditory system from the auditory nerve to the cortex. In contrast, research on neural coding of AM in the efferent pathway has been extremely limited. The objective of this study was to investigate the encoding of AM signals in the medial olivocochlear system by measuring the modulation transfer functions of the efferent response in humans. A secondary goal was to replicate the controversial findings from the literature that efferent stimulation produces larger effects for the AM elicitor with 100Hz modulation frequency in comparison with the unmodulated elicitor. The efferent response was quantified by measuring changes in stimulus-frequency otoacoustic emission magnitude due to various modulated and unmodulated elicitors. Unmodulated, broadband noise elicitors yielded either slightly larger or similar efferent responses relative to modulated elicitors depending on the modulation frequency. Efferent responses to the unmodulated and modulated elicitors with 100Hz modulation frequency were not significantly different. The efferent system encoding of AM sounds-modulation transfer functions-can be modeled with a first-order Butterworth low-pass filter with different cutoff frequencies for ipsilateral and contralateral elicitors. The ipsilateral efferent pathway showed a greater sensitivity to AM information comparted to the contralateral pathway. Efferent modulation transfer functions suggest that the ability of the system to follow AM decreases with increasing modulation frequency and that efferents may not be fully operating on the envelope of the speech.

Swept-Tone Stimulus-Frequency Otoacoustic Emissions in Human Newborns.

Several types of otoacoustic emissions have been characterized in newborns to study the maturational status of the cochlea at birth and to develop effective tests of hearing. The stimulus-frequency otoacoustic emission (SFOAE), a reflection-type emission elicited with a single low-level pure tone, is the least studied of these emissions and has not been comprehensively characterized in human newborns. The SFOAE has been linked to cochlear tuning and is sensitive to disruptions in cochlear gain (i.e., hearing loss) in adult subjects. In this study, we characterize SFOAEs evoked with rapidly sweeping tones in human neonates and consider the implications of our findings for human cochlear maturation. SFOAEs were measured in 29 term newborns within 72 hr of birth using swept tones presented at 2 oct/s across a four-octave frequency range (0.5–8 kHz); 20 normal-hearing young adults served as a control group. The prevalence of SFOAEs in newborns was as high as 90% (depending on how response “presence” was defined). Evidence of probe-tip leakage and abnormal ear-canal energy reflectance was observed in those ears with absent or unmeasurable SFOAEs. Results in the group of newborns with present stimulus-frequency emissions indicate that neonatal swept-tone SFOAEs are adult-like in morphology but have slightly higher amplitude compared with adults and longer SFOAE group delays. The origin of these nonadult-like features is probably mixed, including contributions from both conductive (ear canal and middle ear) and cochlear immaturities.

Effects of Forward- and Emitted-Pressure Calibrations on the Variability of Otoacoustic Emission Measurements Across Repeated Probe Fits.

The stimuli used to evoke otoacoustic emissions (OAEs) are typically calibrated based on the total SPL measured at the probe microphone. However, due to the acoustics of the ear-canal space (i.e., standing-wave interference), this method can underestimate the stimulus pressure reaching the tympanic membrane at certain frequencies. To mitigate this effect, stimulus calibrations based on forward pressure level (FPL) can be applied. Furthermore, the influence of ear-canal acoustics on measured OAE levels can be compensated by expressing them in emitted pressure level (EPL). To date, studies have used artificial shallow versus deep probe fits to assess the effects of calibration method on changes in probe insertion. In an attempt to better simulate a clinical setting, the combined effects of FPL calibration of stimulus level and EPL compensation of OAE level on response variability during routine (noncontrived) probe fittings were examined. The distortion component of the distortion-product OAE (DPOAE) and the stimulus-frequency OAE (SFOAE) were recorded at low and moderate stimulus levels in 20 normal-hearing young-adult subjects across a five-octave range. In each subject, three different calibration approaches were compared: (1) the conventional SPL-based stimulus calibration with OAE levels expressed in SPL; (2) FPL stimulus calibration with OAEs expressed in SPL; and (3) FPL stimulus calibration with OAEs expressed in EPL. Test and retest measurements were obtained during the same session and, in a subset of subjects, several months after the initial test. The effects of these different procedures on the inter- and intra-subject variability of OAE levels were assessed across frequency and level. There were no significant differences in the inter-subject variability of OAE levels across the three calibration approaches. However, there was a significant effect on OAE intra-subject variability. The FPL/EPL approach resulted in the overall lowest test-rest differences in DPOAE level for frequencies above 4 kHz, where standing-wave interference is strongest. The benefit was modest, ranging on average from 0.5 to 2 dB and was strongest at the lower stimulus level. SFOAE level variability did not show significant differences among the three procedures, perhaps due to insufficient signal-to-noise ratio and nonoptimized stimulus levels. Correlations were found between the short-term replicability of DPOAEs and the benefit derived from the FPL/EPL procedure: the more variable the DPOAE, the stronger the benefit conferred by the advanced calibration methods. Stimulus and response calibration procedures designed to mitigate the effects of standing-wave interference on both the stimulus and the OAE enhance the repeatability of OAE measurements and reduce their dependence on probe position, even when probe shifts are small. Modest but significant improvements in short-term test-retest repeatability were observed in the mid- to high-frequency region when using combined FPL/EPL procedures. The authors posit that the benefit will be greater in a more heterogeneous group of subjects and when different testers participate in the fitting and refitting of subjects, which is a common practice in the audiology clinic. The impact of calibration approach on OAE inter-subject variability was not significant, possibly due to a homogeneous subject population and because factors other than probe position are at play.

Spectral Ripples in Round-Window Cochlear Microphonics: Evidence for Multiple Generation Mechanisms.

The cochlear microphonic (CM) results from the vector sum of outer hair cell transduction currents excited by a stimulus. The classical theory of CM generation-that the response measured at the round window is dominated by cellular sources located within the tail region of the basilar membrane (BM) excitation pattern-predicts that CM amplitude and phase vary little with stimulus frequency. Contrary to expectations, CM amplitude and phase-gradient delay measured in response to low-level tones in chinchillas demonstrate a striking, quasiperiodic pattern of spectral ripples, even at frequencies > 5kHz, where interference with neurophonic potentials is unlikely. The spectral ripples were reduced in the presence of a moderate-level saturating tone at a nearby frequency. When converted to the time domain, only the delayed CM energy was diminished in the presence of the saturator. We hypothesize that the ripples represent an interference pattern produced by CM components with different phase gradients: an early-latency component originating within the tail region of the BM excitation and two delayed components that depend on active cochlear processing near the peak region of the traveling wave. Using time windowing, we show that the early, middle, and late components have delays corresponding to estimated middle-ear transmission, cochlear forward delays, and cochlear round-trip delays, respectively. By extending the classical model of CM generation to include mechanical and electrical irregularities, we propose that middle components are generated through a mechanism of "coherent summation" analogous to the production of reflection-source otoacoustic emissions (OAEs), while the late components arise through a process of internal cochlear reflection related to the generation of stimulus-frequency OAEs. Although early-latency components from the passive tail region typically dominate the round-window CM, at low stimulus levels, substantial contributions from components shaped by active cochlear processing provide a new avenue for improving CM measurements as assays of cochlear health.

Interrelationships among microstructures of otoacoustic emissions and hearing thresholds

Otoacoustic emission (OAE) amplitudes, phases, and delays often exhibit ripples with small changes in stimulus frequency. Similar microstructure patterns are observed in behavioral hearing thresholds and loudness judgements for pure tones. Here, we summarize work demonstrating that there is a common microstructure in hearing thresholds and OAEs elicited by single tones—referred to as stimulus-frequency OAEs (SFOAEs)—when presented at near-threshold levels. The periodicity and strength of this microstructure are related to SFOAE delay and magnitude, respectively. Such relationships are consistent with this microstructure arising from multiple intracochlear reflections of SFOAE energy between its region of generation and the middle ear boundary—an idea proposed by David Kemp in his first reports describing the discovery of emissions from the ear. The details of OAE generation and propagation explain why similar but not identical microstructures are also observed in the ear canal pressure in response to tones (which is the vector sum of the stimulus and SFOAE pressures) and in two-tone evoked distortion-product OAE spectra, as well as why microstructures shift in frequency as the result of cochlear or middle ear manipulations.Otoacoustic emission (OAE) amplitudes, phases, and delays often exhibit ripples with small changes in stimulus frequency. Similar microstructure patterns are observed in behavioral hearing thresholds and loudness judgements for pure tones. Here, we summarize work demonstrating that there is a common microstructure in hearing thresholds and OAEs elicited by single tones—referred to as stimulus-frequency OAEs (SFOAEs)—when presented at near-threshold levels. The periodicity and strength of this microstructure are related to SFOAE delay and magnitude, respectively. Such relationships are consistent with this microstructure arising from multiple intracochlear reflections of SFOAE energy between its region of generation and the middle ear boundary—an idea proposed by David Kemp in his first reports describing the discovery of emissions from the ear. The details of OAE generation and propagation explain why similar but not identical microstructures are also observed in the ear canal pressure in response to tone...

Is there a relationship between perceptual difficulties and auditory functioning at the periphery and the brainstem in children suspected with auditory processing disorder?

The test battery typically used for the diagnosis of auditory processing disorder (APD) is highly heterogeneous, with an emphasis on the central auditory nervous system. As such, the peripheral auditory system is typically only screened for the presence of an overt hearing loss. Our previous work suggested that children suspected of APD (sAPD) have atypically sharp cochlear tuning when measured using stimulus frequency otoacoustic emission (SFOAE) group delay. In the present work, we extend our previous findings and test the hypothesis that cochlear tuning influences auditory brainstem response (ABR) latencies. Our hypothesis is based on filter theory, which suggests that a sharper filter will take longer to build-up and ring longer. We predicted that sharper cochlear filters in sAPD should result in delayed ABR wave latencies and will be associated with poorer performance on speech perception tests. Preliminary data from 16 sAPD and 6 typically developing children show a positive correlation between cochlear tuning and ABR peak I latency. Cochlear tuning explains a significant proportion of the variance in ABR peak I latency (R2 = 0.25). Further behavioral results and implications for inclusion of auditory peripheral examination in APD tests will be discussed.

Efferent-induced alterations in distortion and reflection otoacoustic emissions in children.

The medial olivocochlear efferent fibers control outer hair cell responses and inhibit the cochlear-amplifier gain. Measuring efferent function is both theoretically and clinically relevant. In humans, medial efferent inhibition can be assayed via otoacoustic emissions (OAEs). OAEs arise by two fundamentally different mechanisms-nonlinear distortion and coherent reflection. Distortion and reflection emissions are typically applied in isolation for studying the efferent inhibition. Such an approach inadvertently assumes that efferent-induced shifts in distortion and reflection emissions provide redundant information. In this study, efferent-induced shifts in distortion and reflection emissions (click-evoked and stimulus frequency OAEs) were measured in the same subjects-5- to 10-yr-old children. Consistent with the OAE generation theory, efferent-induced shifts in distortion and reflection emissions did not correlate, whereas the two reflection emission shifts correlated. This suggests that using either OAE types provides fragmented information on efferent inhibition and highlights the need to use both distortion and reflection emissions for describing efferent effects.

Swept-tone stimulus-frequency otoacoustic emissions: Normative data and methodological considerations.

Stimulus-frequency otoacoustic emissions (SFOAEs) are reflection-source emissions, and are the least familiar and perhaps most underutilized otoacoustic emission. Here, normative SFOAE data are presented from a large group of 48 young adults at probe levels from 20 to 60 dB sound pressure level (SPL) across a four-octave frequency range to characterize the typical SFOAE and describe recent methodological advances that have made its measurement more efficient. In young-adult ears, SFOAE levels peaked in the low-to-mid frequencies at mean levels of ∼6-7 dB SPL while signal-to-noise ranged from 23 to 34 dB SPL and test-retest reliability was ±4 dB for 90% of the SFOAE data. On average, females had ∼2.5 dB higher SFOAE levels than males. SFOAE input/output functions showed near linear growth at low levels and a compression threshold averaging 35 dB SPL across frequency. SFOAE phase accumulated ∼32-36 cycles across four octaves on average, and showed level effects when converted to group delay: low-level probes produced longer SFOAE delays. A "break" in the normalized SFOAE delay was observed at 1.1 kHz on average, elucidating the location of the putative apical-basal transition. Technical innovations such as the concurrent sweeping of multiple frequency segments, post hoc suppressor decontamination, and a post hoc artifact-rejection technique were tested.

Sweep-tone evoked stimulus frequency otoacoustic emissions in humans: Development of a noise-rejection algorithm and normative features

In recent years, there has been a growing interest to measure stimulus frequency otoacoustic emissions (SFOAEs) using sweep tones. While there are several advantages of the sweep-tone technique, one of the major problems with sweep-tone methodologies is the lack of an objective analysis procedure that considers and rejects individual noisy recordings or noisy segments. A new efficient data-driven method for rejecting noisy segments in SFOAE analysis is proposed and the normative features of SFOAEs are characterized in fifty normal-hearing young adults. The automated procedure involved phase detrending with a low-order polynomial and application of median and interquartile ranges for data outlier rejection from individual recordings. The SFOAE level and phase were analyzed using the least-squared fit method, and the noise floor was estimated using the error of the mean of the sweep level. Overall, the results of this study demonstrated the effectiveness of the automated noise rejection procedure and described the normative features of sweep-tone evoked SFOAEs in human adults.