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Subclinical Auditory Dysfunction: Relationship Between Distortion Product Otoacoustic Emissions and the Audiogram
Naomi F Bramhall1,2, Garnett P McMillan1,2, Amy N Mashburn1,3
1VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.
American Journal of Audiology
|January 19, 2021
Summary
Distortion product otoacoustic emissions (DPOAEs) modestly predict audiometric thresholds in normal-hearing adults. DPOAEs were more predictive for individuals with tinnitus, Veterans, and older adults, suggesting complex relationships with hearing health.
Area of Science:
- Audiology and Hearing Science
- Otoacoustic Emissions and Auditory Physiology
- Outer Hair Cell Function
Background:
- Distortion product otoacoustic emissions (DPOAEs) and audiometric thresholds assess outer hair cell (OHC) function.
- The precise relationship between DPOAEs and audiogram results, especially in subclinical cases, remains unclear.
- Understanding this link is crucial for accurately diagnosing early-stage auditory dysfunction.
Purpose of the Study:
- To investigate the predictive power of DPOAE levels for audiometric thresholds in individuals with clinically normal hearing.
- To evaluate how age, noise exposure history, and tinnitus perception influence the DPOAE-audiogram relationship.
- To determine the extent to which DPOAEs can predict pure-tone thresholds across a wide frequency range.
Main Methods:
- Measured suprathreshold DPOAE levels (1-10 kHz) and pure-tone thresholds (0.25-16 kHz) in 366 ears from 194 young adults (19-35 years).
- Utilized DPOAE levels to predict pure-tone thresholds, comparing model performance with and without DPOAE data.
- Analyzed prediction accuracy across participant subgroups based on age, Veteran status (noise exposure proxy), and tinnitus presence.
Main Results:
- Incorporating DPOAE levels modestly improved pure-tone threshold predictions across all tested frequencies (0.25-16 kHz).
- DPOAE levels at 4-5 kHz (f2) were particularly influential for predicting thresholds above 4 kHz.
- Prediction accuracy varied, with better threshold predictions observed in Veterans, individuals with tinnitus, and the oldest age group.
Conclusions:
- A complex relationship exists between DPOAE levels and audiometric thresholds, not solely explained by OHC damage.
- Underestimation of thresholds in certain groups suggests other factors influence hearing sensitivity beyond OHC function.
- DPOAEs and pure-tone thresholds may reflect subclinical OHC dysfunction differently, necessitating nuanced interpretation.
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