The Ins and Outs of Distortion Product Otoacoustic Emission Growth: A Review

Otoacoustic emissions (OAEs) are low-level signals generated from active processes related to outer hair cell transduction in the cochlea. In current clinical applications, OAEs are typically used to detect the presence or absence of hearing loss. However, their potential extends far beyond hearing screenings. Dr. Glenis Long realized this unfulfilled potential decades ago. She subsequently devoted a large portion of her storied scientific career to understanding OAEs and cochlear mechanics, particularly at the intersection of OAEs and perceptual measures. One specific application of OAEs that has yet to be translated from research laboratories to the clinic is using them to non-invasively characterize cochlear nonlinearity-a hallmark feature of a healthy cochlea-across a wide dynamic range. This can be done by measuring OAEs across input levels to obtain an OAE growth, or input-output (I/O), function. In this review, we describe distortion product OAE (DPOAE) growth and its relation to cochlear nonlinearity and mechanics. We then review biological and measurement factors that are known to influence OAE growth and finish with a discussion of potential applications. Throughout the review, we emphasize Dr. Long's many contributions to the field.