Analysis of transient-evoked otoacoustic emissions in normal-hearing and hearing-impaired ears

Transient-evoked otoacoustic emissions (TEOAEs) were measured in 113 normal-hearing and hearing-impaired ears to examine repeatability within a test session, which TEOAE parameter (level, TEOAE level-to-noise or reproducibility) best identified hearing loss and if the TEOAE separated into frequency-specific bands identified hearing loss in a corresponding frequency region. TEOAEs and stimulus levels were found to be very repeatable. For broadband TEOAEs, TEOAE level, TEOAE-to-noise, and % reproducibility were found to identify hearing loss equally well, based on measurement of the area underlying relative operator characteristic curves. Analysis for frequency-specific bands showed that separation of normal-hearing and hearing-impaired ears depended on frequency, with best identification at 2000 and 4000 Hz, identification at 1000 Hz slightly worse, and virtually no separation between normal-hearing and hearing-impaired ears at 500 Hz. Again, all three parameters were essentially equal in identifying hearing loss. Subjective evaluations of presence or absence of TEOAEs was highly correlated between two judges, with good agreement for TEOAEs at 1000, 2000, and 4000 Hz. The findings from this study suggest that TEOAEs will be valuable for clinical use because of their repeatability and identification of hearing-impaired ears.