Effect of temperature on the transient evoked and distortion product otoacoustic emissions in rats

In order to study the energy dependence of the cochlear amplifier, transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were recorded in rats during gradual cooling to 27 degrees C and heating to 40 degrees C. In the range 33-39 degrees C, the TEOAEs and DPOAEs were maximal in amplitude and almost insensitive to temperature. However, they were significantly depressed (reversibly) at higher and lower temperatures. Intensity functions were plotted at 37, 27 and 40 degrees C for both types of oto-acoustic emissions. At 37 degrees C intensity functions were nonlinear, with a notch at mid-intensity regions. At 27 degrees C, the magnitudes were depressed more at the lower intensities and threshold elevations were observed. As a result, the intensity functions were more linear and the notch was no longer seen. This result provides further evidence for a more active, energy-dependent component of the otoacoustic emissions at lower intensities for both TEOAEs and DPOAEs. The cooling probably affects the lower intensity otoacoustic emissions by inducing a depression in the endocochlear potential, by reducing the motility of the outer hair cells and by introducing a small conductive hearing loss.     

An uncrossed tectopontine pathway mediates ipsiversive circling

Otoacoustic emissions have great promise for use in clinical tests of the functional status of outer hair cells, which represent cochlear structures that make a major contribution to the hearing process. A substantial literature is available concerning the evaluation of outer hair cell function by transiently evoked otoacoustic emissions. However, relatively little attention has been focused on the benefits of testing with distortion-product otoacoustic emissions. The purpose of this presentation is to provide knowledge of the principal advantages offered by distortion-product emissions testing.     

The effects of crossed olivocochlear bundle section on transient evoked otoacoustic emissions

The purpose of this study was to investigate the effect of sectioning the crossed olivocochlear bundle (COCB) on transient evoked otoacoustic emissions (TEOAEs) in anesthetized adult chinchillas. Of particular interest is the role of cochlear efferents to the outer haircells (OHCs) and how they control mechanisms responsible for otoacoustic emissions. Specifically the experiment addressed whether a tonic level of inhibitory control is reduced by COCB section. The nonlinear component of TEOAEs was measured before and after COCB section. Analysis was made of the 1, 2, 3, 4, and 5 kHz frequency components and of the total emission, as quantified by fast Fourier transform (FFT) of the raw (time domain) response. After COCB section, the amplitude of the total response and of the 2, 3, 4, and 5 kHz components increased whereas the amplitude of the 1 kHz component decreased. The results indicate that COCB section reduces inhibitory control of the OHC mechanisms responsible for nonlinear TEOAE generation. It is not clear whether the nerve section eliminates a spontaneous level of activity in COCB efferents, or whether it results in the interruption of a stimulus-evoked feedback loop.     

Transient-evoked and 2F1-F2 distortion product oto-acoustic emissions in dogs: preliminary findings

Transient (click)-evoked oto-acoustic emissions (TEOAEs) and distortion product oto-acoustic emissions (DPOAEs) were recorded in a feasibility study in 7 healthy mixed-breed dogs using the ILO 92 OAE analyser (Otodynamics, Hartfield, UK). Five dogs were found to have normal hearing in both ears and 2 dogs in the left ear only following otoscopy, tympanometry and auditory brainstem response audiometry. Twelve sets of TEOAEs (click-evoked) to 80 dB peSPL click stimulus and 9 sets of DPOAEs (2F1-F2) to 8 different stimulus levels of the primary tones (L1/L2) were collected at 11 test frequencies (F2) in these normal-hearing dogs. TEOAEs were successfully recorded in 11 of the 12 ears using the default user setting and in all 12 ears using the quickscreen program. DPOAEs were successfully recorded in all 9 ears tested. While the TEOAEs parameters matched those for humans, the average signal-to-noise ratio of DPOAEs was considerably higher in the dogs. Stimulus levels at 55/55, 55/45 and 55/35 dB SPL were demonstrated to produce DPOAEs that seem to reflect the active dynamic status of the outer hair cell system. Postmortem DPOAEs at these stimulus levels and TEOAEs at 80 Db peSPL could not be elicited 5 min following euthanasia of dogs. However, DPOAEs could still be recorded albeit with reduced amplitude at stimulus levels where L1 > 55 dB SPL. The results suggest that TEOAEs and DPOAEs in dogs have the potential to provide valuable insights into their mechanisms of generation, and the specific role and behaviour of outer hair cells of the cochlea in certain pathological conditions, particularly in drug-induced ototoxicity, in humans.     

Animal pharmacokinetics and interspecies scaling of Ro 25-6833 and related (lactamylvinyl)cephalosporins

To evaluate the potential of distortion product otoacoustic emissions (DPOAEs) in differential diagnosis of hearing loss, these were routinely measured in 232 ears of severe or profound sensorineural hearing loss. Normally recordable DPOAEs were found in 16 ears (8 patients) and the results were confirmed through retests after intervals; positive responses of transiently evoked otoacoustic emissions (TEOAEs) were additionally tested. The findings suggest that nerve deafness and hair cell deafness may be partly distinguishable.     

Changes in cochlear function after double-membrane rupture in the guinea pig

We measured the transiently evoked otoacoustic emissions (TEOAEs), compound action potentials (CAPs) and cochlear microphonics (CMs) in guinea pigs after rupture of the round window membrane alone (n = 5) or of the round window membrane with localized cochlear damage (n = 10). The localized cochlear damage entailed rupture of Reissner's membrane with damage to the stria vascularis. We determined the time course of changes in the total echo power (TEP) in TEOAEs and the minimal detectable levels of CAPs and CMs. The endocochlear potential (EP) was measured in the cochlea with localized damage. There were no changes in TEOAEs, CAPs or CMs in the guinea pigs subjected to round window membrane rupture alone, but the minimal detectable levels of CAPs and CMs were increased in all the guinea pigs in which TEOAEs were absent after rupture of the round window membrane with localized cochlear damage. Our results suggest that double-membrane rupture (rupture of the round window membrane with localized cochlear damage) produces acute sensorineural hearing loss. The hearing loss appeared to be related to damage to the cochlea, which may be induced by influx of potassium-rich endolymph into the perilymph, and by morphological damage to the scala media.     

Otoacoustic emissions in the human

Otoacoustic emissions are sounds emitted by the cochlea, basically deriving from the active micromechanical properties of the outer hair cells of the organ of Corti. As they can be recorded painlessly and non-intrusively, they provide a good means of studying human cochlear functioning. In this report, the main types of otoacoustic emission are described, with their characteristics and relation to cochlear functioning. The contribution of otoacoustic emission studies to the physiology of the medial olivocochlear system is discussed, this being the only sensitive and non-intrusive way of studying this system, the function of which remains uncertain.     

Basal cochlear lesions result in increased amplitude of otoacoustic emissions

We have measured the changes in transient otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) during and after ototoxic amikacin treatment in an animal (chinchilla) model. TEOAE and DPOAE were recorded from 6 adult chinchillas over a 6-week time course starting just before a 5-day or 7-day treatment period with amikacin sulphate (400 mg/kg/day, i.m.). After final recordings, cochlear morphology was assessed by scanning electron microscopy. Generally, both DPOAE and TEOAE amplitudes change during and after treatment in a systematic fashion. High-frequency components change first, followed by lower-frequency components. We note that there is often a long latency to the onset of changes in otoacoustic emissions (OAE), and that these changes can continue for weeks after treatment. Most importantly we report that when the basal region of the cochlea is damaged in the frequency region above the OAE recording bandwidth (0.6-6 kHz for TEOAE; 1-6.7 kHz for DPOAE), we often find an increase in OAE amplitudes. More specifically, we note that as a cochlear lesion progresses apically, there is often a transient increase in a frequency-specific OAE before it reduces or is lost. Our results suggest that the increase in OAE amplitudes precedes the expression of detectable cochlear pathology.     

Changes in otoacoustic emissions in patients with idiopathic sudden deafness

Transiently click-evoked (TEOAE), distortion product (DPOAE) and spontaneous otoacoustic emissions (SOAE) were recorded and changes in these tests were studied during the recovery process in 15 cases of idiopathic sudden deafness (ISD). In all these cases the amplitudes of TEOAEs and DPOAEs increased concurrently with the recovery of the hearing threshold. Ears with ISD were not different in their OAE characteristics from ears with other forms of sensorineural hearing loss (SNHL). In 4 of the 15 cases, SOAEs could be detected when hearing had recovered. These results suggest that the function of outer hair cells (OHCs) had deteriorated when the hearing threshold was elevated and that OHC activity recovered as hearing improved to nearly normal levels in ISD cases with good outcome.     

Pudendal nerve somatosensory evoked potentials in probable multiple sclerosis

One of the most frequent causes of sensorineural hearing loss in childhood is damage to outer hair cells of the cochlea. The presence of otoacoustic emissions, generated by outer hair cells, provides evidence for normal hearing. This finding, however, may give rise to false reassurance, because even severe hearing loss, localized behind the cochlea, can be associated with normal otoacoustic emissions. The coexistence of otoacoustic emissions and hearing loss calls for the prompt exclusion of neurological disease.     

IL-15 induces the release of soluble IL-2Ralpha from human peripheral blood mononuclear cells

The present study was designed to investigate the applicability of transient evoked otoacoustic emissions (TEOAEs) as a method of screening for hearing losses among recruits attending obligatory military service. TEOAEs, tympanometry and puretone audiometry were recorded in 95 male recruits. Sixty-one recruits were tested after a 2-month period of gunfire exposure in order to document any permanent change in cochlear function. Screening by pure-tone audiometry showed an unexpectedly high prevalence of hearing losses > 20 dBHL, probably due to technical reasons. Thresholds were corrected using lower thresholds obtained at the end of service or by ENT specialists. The accuracy with which normal and impaired ears could be identified with TEOAEs analysed in frequency bands was determined by decision theory. Impairment was defined as mean hearing thresholds > or = 30 dBHL averaged from three neighbouring frequencies. Adequate accuracy was obtained in the middle frequencies. Further improvement of the technique is needed before it can be deemed suitable for detecting hearing losses at low and high frequencies. TEOAEs are quicker to measure and offer greater objectivity than pure-tone audiometry. A small decrease in TEOAE level was found after the training period. The TEOAEs were highly repeatable and had a higher sensitivity than pure-tone audiometry to detection of small changes in cochlear function under conditions normally found when testing recruits.     

Are normal hearing thresholds a sufficient condition for click-evoked otoacoustic emissions?

Transiently evolked otoacoustic emissions (TEOAE) have been reported in several studies as absent in a small minority of normal ears. Other studies have reported TEOAEs in all normal ears. Differences between studies may arise directly from criteria for TEOAE identification, criteria for selection of normals, or statistically due to limited sample sizes. In order to understand and model cochlear processes involved in TEOAE generation, it needs to be known whether the presence of normal hearing leads automatically to generation of TEOAEs. The present study set out to establish in a large sample if any ears could be found that lacked TEOAEs despite normal hearing threshold levels (HTL). A total of 397 ears from highly cooperative adult subjects were examined under laboratory conditions. Using cross correlation between replicate nonlinear waveforms as the criterion, TEOAEs were present in 99.2% of the sample (lower CI 98.1%). However, careful visual assessment of the recorded waveforms for the remaining ears did not unequivocally show absence of TEOAE characteristics in any ear with normal HTLs. While TEOAE strength varies widely among ears, no clear evidence was found to show that TEOAEs can be absent when HTLs are normal.     

Cost of illness: an inextricable maze or an aid in decision making? The case of schizophrenia

Distortion-product otoacoustic emissions (DPOAEs) are still undergoing evaluation for clinical use. Although the effects of ageing on otoacoustic emissions have been studied quite extensively in the past, DPOAE response-growth or input-output (I-O) measures, which are well suited as an objective method for monitoring cochlear function at specific frequencies, have been less thoroughly examined. The aim of the present study was to assess the 2f1-f2 DPOAEs in a clinical setting in order to examine the response of 20 normally hearing middle-aged adults and to compare the results with those of 20 people of the same age with ears of sensorineural high-frequency hearing loss (HL). The experiment consisted of two stages. First, the DPOAE-gram was recorded in 1-4-octave steps at a stimulus level of 70 dB SPL over a frequency range of the f2 primary tone which extended from 1.001 to 6.299 kHz. Secondly, in order to elicit DPOAE I-O functions, the two primary stimuli were presented at equilevel intensities ranging from 20 to 71 dB SPL. The stimulus-level step size was 3 dB. The I-O functions were recorded at five separate DPOAE frequencies, with the f2 frequency most closely related to the clinical audiogram (f2 = 1.0, 1.5, 2.0, 4.0 and 6.0 kHz). Two clearly separated portions in the form of the I-O function for normally hearing ears were found. The first portion, in response to primary levels of 60 dB SPL and below, showed a plateau (saturating) behaviour. If primary levels exceeded 60 dB SPL, I-O functions became more linear. The attenuation of the saturation portion of the I-O function in ears with high-frequency HL across the frequency-test range is difficult to explain because elevated behavioural thresholds were observed only for frequencies > 1.5 kHz. Thus, the more linear I-Os associated with the hearing-loss frequencies may indicate deficiencies in the active properties of outer hair cells (OHCs), whereas those for I-Os < 1.5 kHz, where hearing was normal, may indicate a beginning of damage to active OHC micromechanical processes prior to their clinical manifestation. DPOAE recordings from people with high-frequency HL, possibly age-related, supplement recordings of TEOAEs and give complementary information on degenerative changes in the outer hair-cells. DPOAE I-O functions may reveal discrete pathological alterations both in the active cochlear signal processing and in the passive mechanisms of the cochlea prior to their detection by clinical audiometric tests.     

Interrelations between transiently evoked otoacoustic emissions, spontaneous otoacoustic emissions and acoustic distortion products in normally hearing subjects

Active cochlear mechanisms and especially outer hair cells seem to be involved in oto-acoustic emissions (OAEs) genesis. This study sought to investigate basic characteristics of spontaneous otoacoustic emissions (SOAEs), click-evoked otoacoustic emissions (TOAEs) and interrelations between SOAEs, TOAEs and 2f1-f2 and 2f2-f1 distortion product OAEs (DPOAEs) in 135 normally hearing subjects. A gender effect was shown on TOAEs and DPOAEs amplitude, and is attributed to the higher incidence of SOAEs in women (58%) than in men (22%). Moreover, SOAEs presence seems to mask the age effect found, especially at high frequency components, on TOAEs amplitude. A general influence of SOAEs on TOAEs and DPOAEs is shown, especially at frequencies ranging from 1 kHz to 3 kHz, collecting more than 66% of the SOAEs peaks recorded. Lastly, correlations between TOAEs frequency band amplitude and 2f1-f2 DPOAEs amplitude, shows frequency specificity, at least at low frequencies (i.e., from 0.5 to 2 kHz) in agreement with previous works suggesting that the 2f1-f2 DPOAEs generation site is at the geometric mean of the primaries. The same correlations calculated with 2f2-f1 DPOAEs amplitude show frequency specificity at low frequencies i.e., at 800 Hz and 1600 Hz. 2f2-f1 DPOAEs in humans are shown to be generated near the 2f2-f1 frequency region on the cochlear partition.     

Functional maturation of cochlear active mechanisms and of the medial olivocochlear system in humans

The aim of this study was to investigate the functional development of cochlear active mechanisms and of the medial efferent olivocochlear system. Otoacoustic emissions (evoked and spontaneous) were recorded in 42 preterm neonates (conceptional age ranging form 33 to 39 weeks) and a control group of 20 young normal-hearing adults. Medial olivocochlear system activity was examined by coupling evoked otoacoustic emission recording to a contralateral stimulation. Otoacoustic emission recordings were carried out using the Otodynamic ILO88 software and hardware. The stimuli were unfiltered clicks and the contralateral stimulation was broad band noise of 50 and 70 dBSPL delivered by an Adam generator. The results revealed the presence of EOAEs and SOAEs from at least 33 weeks in humans, suggesting that the functional maturation of the outer hair cells is nearly complete at that age. The study further revealed that the contralateral stimulation had no effect on evoked otoacoustic emissions in preterm neonates. The lack of activity observed in medial olivocochlear system indicated functional immaturity here, at least before full-term birth.     

Contralateral auditory stimulation alters acoustic distortion products in humans

It is now generally accepted that otoacoustic emissions (OAE) represent the only objective and non-intrusive means of functional exploration of the active micromechanical characteristics of the outer hair cells of the organ of Corti. Previous studies showed a decrease of the transiently evoked otoacoustic emissions and spontaneous otoacoustic emissions in humans, during acoustic stimulation of the contralateral ear, and attributed this effect to the medial efferent system. Such an effect has been shown on acoustic distortion product otoacoustic distortion emissions (DPOAE) in guinea pigs, but has not been investigated for DPOAEs recorded in humans, although DPOAEs represent the easiest means of exploring active micromechanical cochlear properties both in humans and in laboratory animals. The present study sought to investigate the existence and characteristics of a contralateral auditory stimulation effect on DPOAEs recorded in humans. This study shows that contralateral broad-band noise (BBN) has a suppressive effect on DPOAEs recorded from 0.5 kHz to 5 kHz. This effect is not due to air conduction, as no change in the noise floor occurred under increasing contralateral stimulation, and as no reduction in DPOAE amplitude was obtained in subjects whose contralateral ear was sealed with a plastic ear plug. Moreover, cross-over attenuation by bone transmission has been ruled out, as no change in DPOAE amplitude was recorded in the healthy ear of total unilaterally deaf patients during acoustic stimulation of the deaf ear. The effect seen was not entirely due to the acoustic reflex, as it was found and could indeed be even greater in subjects with no acoustic reflex. Results presented here show that the contralateral BBN effect is greater at low levels of ipsilateral stimulation, which leads us to discuss the involvement of both passive and active mechanisms in DPOAE generation at high stimulation levels. The contralateral BBN effect seems to be greater in mid frequency cochlear regions. There is strong evidence that the medial efferent system is involved and that afferent and efferent inputs are, at least partly, integrated at a brainstem level in order to ensure cochlear interaction. DPOAEs provide an interesting model for functional exploration of the efferent system, since they seem to be the only type of otoacoustic emission that can be recorded in both humans and in the majority of animals, and since results are obtained in the same way from both animals and humans, which allows experimental animal models very close to the human model.     

Time-frequency distributions of click-evoked otoacoustic emissions

Emissions evoked by broad-band stimuli, such as clicks, show a 'frequency dispersion' reminiscent of the place-frequency distribution along the cochlea. Analysis of the time-frequency properties of transiently evoked otoacoustic emissions (TEOAEs) is therefore of considerable interest due to their close relation with cochlear mechanisms. In particular, since OAEs in response to click stimuli are expected to evoke a cumulative response from the whole cochlea, the analysis of click-evoked OAEs can yield a global view of cochlear function. Wavelet analysis is performed to obtain time-frequency distributions of click-evoked OAEs at various intensity levels from normal ears. By means of the inverse wavelet transform, the recorded responses are decomposed into elementary components representing the contribution within a narrow frequency band to the cumulative OAE. The relationship between the frequency of the elementary components, latency and level of stimulation is described.     

Transitory evoked and distortion products of otoacoustic emissions in absent auditory evoked potentials

Transient click-evoked otoacoustic emissions (TEOAE) and distortion-product otoacoustic emissions (DPOAE) are produced by an active biomechanical process in the cochlea, presumably related to outer hair-cell activity. Although it is generally accepted that in most cases of hearing loss with absent auditory evoked potentials neither TEOAE nor DPOAE can be found, some cases with such a constellation have been described. Here we report another four cases of children with severe to profound hearing loss where we discovered reproducible TEOAE and DPAOE, whereas auditory evoked potentials were missing. TEOAE and DPOAE recordings in these cases indicate substantially preserved outer hair-cell function independent of profound pre-sensineural hearing loss. Since the incidence of children with preserved otoacoustic emissions together with impairment of synaptic or postsynaptic function of the first neuron is not known, the unconditioned use of TEOAE nor DPOAE as a screening instrument must be seriously questioned. Secondly, in conjunction with subjective audiometry and brain-stem-evoked potentials, emission recordings is an indispensable measurement prior to cochlear implantation and use of high-power hearing aids.     

Transient changes in cochlear potentials and DPOAEs after low-frequency tones: the 'two-minute bounce' revisited

After exposure to a loud, non-traumatic low-frequency tone, auditory thresholds are elevated. Thresholds recover to normal in a non-monotonic manner, decreasing rapidly at first before increasing again, until they finally decrease monotonically towards normal. Although the transient elevation of thresholds after the initial improvement was originally called a 'bounce' by Hirsh and Ward (1952), Kemp (1986) suggests that the initial rapid recovery is the oddity: under some conditions a low-frequency tone can produce hypersensitivity in otoacoustic emissions, psychophysical thresholds, and perceived loudness (Kemp's 'bounce') without a later elevation of threshold (Hirsh and Ward's 'bounce'). Kemp also suggested that the transient hypersensitivity was caused by changes in the sensitivity of the active process within the cochlea. We have investigated the origin of this transient hypersensitivity (Kemp's bounce) in guinea pigs, recording cochlear potentials (CM, CAP, SP and EP) and otoacoustic emissions (DPOAEs at f2-f1, 2f1-f2, 2f2-2f1 and 3f1-2f2). Our results indicate that the bounce does not require neural activity, but is probably produced by non-neural cochlear mechanisms, possibly a transient decrease in the permeability of the organ of Corti which produces a small but significant change in standing current through outer hair cells. At least part of these changes, which are reduced as the stimulation frequency increases, and absent above 2 kHz, seem due to a small and transient movement of the cochlear partition towards scala tympani, probably due to a transient osmotic imbalance.     

Otoacoustic emissions in full-term newborns at risk for hearing loss

Distortion product otoacoustic emissions (DPOEs) and click-evoked otoacoustic emissions (CEOEs) characteristics of the normal newborn population have been previously reported in the literature. There is little information about DPOE evaluations in the newborn population at risk for hearing loss. The authors now report the DPOE and/or CEOE data from six full-term subjects at risk for hearing loss or with highly suspected hearing loss. These subjects were less than 1 year of age and at risk for hearing loss secondary to a history of hereditary hearing loss, meningitis, hyperbilirubinemia, and ototoxic drug exposure. Audiometric evaluation included auditory brainstem responses (ABR), behavioral observation audiometry, and tympanometry. The CEOEs and DPOEs were found to be decreased or absent in the subjects with suspected hearing loss secondary to cochlear pathology; they were found to be normal in a subject with a suspected central hearing loss. This study's data suggest that otoacoustic emissions when combined with ABR can provide a frequency-specific evaluation of cochlear function and help determine the anatomic site of a pathologic lesion.