Suppression of distortion product otoacoustic emissions and hearing threshold

A distortion product otoacoustic emission (DPOAE) suppression tuning curve (STC) shows the minimum level of suppressor tone that is required to reduce DPOAE level by a fixed amount, as a function of suppressor frequency. Several years ago, Mills [J. Acoust. Soc. Am. 103, 507-523 (1998)] derived, theoretically, an approximately linear relationship between the tip-to-tail suppressor level difference on a DPOAE STC, and the gain of the cochlear amplifier, defined as the maximum increase in the active over the passive basilar membrane (BM) response. In this paper, preliminary data from adult human subjects are presented that establish a correlation between this tip-to-tail DPOAE STC difference and the threshold of hearing, the latter measured at the frequency of the f2 primary tone. Assuming that both suppression and the DPOAE are by-products of active, nonlinear BM dynamics, the above result suggests that threshold elevation in mild levels of hearing loss may be attributed, in part, to a reduction of cochlear amplifier gain, which is detectable with the suppression paradigm.