Clinical relevance of medial efferent auditory pathways

Evoked otoacoustic emissions have been shown to be suppressed by sounds applied in the contralateral ear and this effect can be largely explained by the involvement of medial olivocochlear efferent fibers. Thus, EOAE recording during contralateral stimulation provides a non-invasive means of investigating auditory efferent system functioning in humans. The question remains, however, as to whether this test provides a tool, which could be useful in a variety of clinical applications. This review describes current clinical applications for this test, showing that it may prove useful for improving identification of retrocochlear pathologies. Some new areas are also identified. Methodological topics are discussed and suggestions for maximizing the value of this test are proposed.