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OBJECTIVES About 15% of U.S. adults report speech perception difficulties despite showing normal audiograms. Recent research suggests that genetic factors might influence the phenotypic spectrum of speech perception difficulties. The primary objective of the present study was to describe a conceptual framework of a deep phenotyping method, referred to as AudioChipping, for deconstructing and quantifying complex audiometric phenotypes. DESIGN In a sample of 70 females 18 to 35 years of age with normal audiograms (from 250 to 8000 Hz), the study measured behavioral hearing thresholds (250 to 16,000 Hz), distortion product otoacoustic emissions (1000 to 16,000 Hz), click-evoked auditory brainstem responses (ABR), complex ABR (cABR), QuickSIN, dichotic digit test score, loudness discomfort level, and noise exposure background. The speech perception difficulties were evaluated using the Speech, Spatial, and Quality of Hearing Scale-12-item version (SSQ). A multiple linear regression model was used to determine the relationship between SSQ scores and audiometric measures. Participants were categorized into three groups (i.e., high, mid, and low) using the SSQ scores before performing the clustering analysis. Audiometric measures were normalized and standardized before performing unsupervised k-means clustering to generate AudioChip. RESULTS The results showed that SSQ and noise exposure background exhibited a significant negative correlation. ABR wave I amplitude, cABR offset latency, cABR response morphology, and loudness discomfort level were significant predictors for SSQ scores. These predictors explained about 18% of the variance in the SSQ score. The k-means clustering was used to split the participants into three major groups; one of these clusters revealed 53% of participants with low SSQ. CONCLUSIONS Our study highlighted the relationship between SSQ and auditory coding precision in the auditory brainstem in normal-hearing young females. AudioChip was useful in delineating and quantifying internal homogeneity and heterogeneity in audiometric measures among individuals with a range of SSQ scores. AudioChip could help identify the genotype-phenotype relationship, document longitudinal changes in auditory phenotypes, and pair individuals in case-control groups for the genetic association analysis.

Objective The prolonged exposure to electromagnetic fields of mobile phones can damage the cochlear hair cells, which can be detected by otoacoustic emission (OAE). To know the effect of mobile phones on hearing, the young volunteers were subjected to prolonged mobile phone usage and changes in OAE were recorded. Materials and Methods Twenty-eight volunteers with normal hearing were made to talk one full hour continuously on the mobile phone. Distortion product otoacoustic emission (DPOAE) was measured prior to the usage of mobile phones and immediately after the use (post-exposure 1) and 24 hours after the use (post-exposure 2). The values were compared. Results Out of the 28 volunteers, 20 were females and 8 were males. Twenty-one volunteers preferred the right ear while using mobile phones, 7 preferred the left ear. There was no statistically significant difference between the baseline DPOAE values and values of post-exposure 1 and 2 when only the preferred ear was taken into consideration. When the preferred ear was compared with nonpreferred ear, a statistically significant difference was found only in the low frequencies between the pre-exposure and post-exposure 1 values. Conclusion This study shows there was no significant correlation between OAE and prolonged mobile phone exposure when the preferred ear was not considered.

OBJECTIVES Humans can hear up to 20 kHz. Emerging evidence suggests that hearing in the extended high frequencies (EHFs; >8 kHz) contributes to speech perception in noise. The objective of the present study was to describe the features of EHF hearing impairment in young adults with normal standard audiograms (0.25-8 kHz). Specifically, the study goals were to: (1) characterize the EHF hearing impairment and identify potential risk factors; (2) elucidate the age-related changes in EHF hearing; (3) determine the effect of EHF hearing impairment on speech-in-noise recognition; and (4) examine the extent to which EHF hearing impairment influences cochlear functioning in the standard frequencies. DESIGN Hearing thresholds at standard frequencies and EHFs (10, 12.5, 14, and 16 kHz), and speech recognition thresholds (SRTs) using digit triplets in multi-talker babble were measured in both ears from 222 participants (19-38 years; n = 444 ears) with normal audiograms (≤20 dB HL at standard frequencies). Test-retest measurement of hearing thresholds was obtained in a subset of 50 participants (100 ears), and clinical distortion product otoacoustic emissions (f2 frequency = 2, 3, 4, and 5 kHz) were recorded in 49 participants (98 ears). RESULTS Forty-two of 222 participants had EHF hearing impairment (>20 dB HL for at least one EHF in either ear). Only seven individuals with EHF impairment had significant case history and/or listening-in-noise complaints. A breakpoint in the threshold-age function was observed for the EHFs for males but not for females. Linear mixed models revealed a significant effect of age, pure-tone averages for speech frequencies (0.5, 1, 2, and 4 kHz), and EHFs and group (NH versus EHF hearing impairment) independent of each other on the SRTs. Individuals with EHF hearing impairment had less measurable emissions and when present, had a lower magnitude of otoacoustic emissions relative to NH controls. There was no difference in hearing thresholds, SRTs, or otoacoustic emissions between earphone users and nonusers. CONCLUSIONS The hearing thresholds for the EHFs exhibit signs of early auditory aging. Age-related deterioration in auditory function can be observed in the third decade of human life. A breakpoint in the threshold-age function suggests that rapid aging processes are operational at a relatively younger age (21 years) for males. The audibility of EHFs contributes to speech-in-noise recognition. EHF hearing impairment independent of age and speech frequencies can affect speech-in-noise recognition. Reduced distortion product otoacoustic emissions in the standard frequencies may suggest preclinical cochlear degeneration in individuals with EHF hearing impairment.

Purpose Distortion product otoacoustic emissions (DPOAEs) and audiometric thresholds have been used to account for the impacts of subclinical outer hair cell (OHC) dysfunction on auditory perception and measures of auditory physiology. However, the relationship between DPOAEs and the audiogram is unclear. This study investigated this relationship by determining how well DPOAE levels can predict the audiogram among individuals with clinically normal hearing. Additionally, the impacts of age, noise exposure, and the perception of tinnitus on the ability of DPOAE levels to predict the audiogram were evaluated. Method Suprathreshold DPOAE levels from 1 to 10 kHz and pure-tone thresholds from 0.25 to 16 kHz were measured in 366 ears from 194 young adults (19–35 years old) with clinically normal audiograms and middle ear function. The measured DPOAE levels at all frequencies were used to predict pure-tone thresholds at each frequency. Participants were grouped by age, self-reported noise exposure/Veteran status, and self-report of tinnitus. Results Including DPOAE levels in the pure-tone threshold prediction model improved threshold predictions at all frequencies from 0.25 to 16 kHz compared with a model based only on sample mean pure-tone thresholds, but these improvements were modest. DPOAE levels for f 2 frequencies of 4 and 5 kHz were particularly influential in predicting pure-tone thresholds above 4 kHz. However, prediction accuracy varied based on participant characteristics. On average, predicted pure-tone thresholds were better than measured thresholds among Veterans, individuals with tinnitus, and the oldest age group. Conclusions These results indicate a complex relationship between DPOAE levels and the audiogram. Underestimation of pure-tone thresholds for some groups suggests that additional factors other than OHC damage may impact thresholds among individuals within these categories. These findings suggest that DPOAE levels and pure-tone thresholds may differ in terms of how well they reflect subclinical OHC dysfunction. Supplemental Material https://doi.org/10.23641/asha.13564745

Hearing is one of the five sensory organs that allows us to interact with society and our environment. However, one in eight Americans suffers from sensorineural hearing loss that is great enough to adversely impact their daily life. There is an urgent need to identify what part/degree of the auditory pathway (sensory or neural) is compromised so that appropriate treatment/intervention can be implemented. Single- or two-tone evoked potentials, the electrocochleography (eCochG), were measured along the auditory pathway, i.e., at the round window and remotely at the vertex, with simultaneous recordings of ear canal distortion product otoacoustic emissions. Sensory (cochlear) and neural components in the (remote-) eCochG responses showed distinct level- and frequency-dependent features allowing to be differentiated from each other. Specifically, the distortion products in the (remote-)eCochGs can precisely localize the sensory damage showing that they are effective to determine the sensory or neural damage along the auditory pathway.

Introduction Aminoglycosides are widely known for their ototoxic side effects. Nevertheless, they are potent antibiotics used in the treatment of life-threatening conditions because of the current concern for antibiotic resistance. We hypothesized that creatine supplements which are believed to improve mitochondrial antioxidant defense system and maintain optimal energy homeostasis may improve the ototoxic side effects. Objective This study aimed to investigate the protective effects of creatine monohydrate against ototoxicity induced by amikacin in rats in an experimental animal model, using distortion product otoacoustic emissions and auditory brainstem response. Methods Twenty healthy rats were assigned to four groups (5 rats in each): the control group, the creatine monohydrate group, the amikacin group and the amikacin + creatine monohydrate group. The creatine monohydrate group received creatine at a dose of 2 g/kg once daily via gastric gavage for 21 days. The amikacin group received amikacin at a dose of 600 mg/kg by intramuscular injections once daily for 21 days. The amikacin + creatine monohydrate group received intramuscular injections of amikacin (600 mg/kg) once daily for 21 days and creatine monohydrate (2 g/kg) once daily via gastric gavage for 21 days. The control group received nothing. The distortion product otoacoustic emissions and auditory brainstem response measurements were performed on all rats on days 0, 7, 21. Results Regarding auditory brainstem response values, a significant increase in the auditory threshold was observed in the amikacin group on day 21 (p < 0.001). The amikacin+creatine monohydrate group showed significantly lower levels of auditory brainstem response auditory thresholds on day 21 in comparison to the amikacin group (p < 0.001). Additionally, the control group and the amikacin+creatine monohydrate group did not differ significantly with respect to auditory brainstem response thresholds on treatment day 21 (p > 0.05). When we compare distortion product otoacoustic emissions values, there was no significant difference between the amikacin and amikacin+creatine monohydrate groups on day 7 (p > 0.05), However significantly greater distortion product otoacoustic emissions values were observed in the amikacin+creatine monohydrate group on day 21 compared to the amikacin group (p < 0.001). Conclusion Our findings demonstrate that creatine treatment protects against amikacin ototoxicity when given at a sufficient dose and for an adequate time period.

Diabetes mellitus (DM) is a chronic and potentially life-threatening condition, incidence of which is increasing rapidly in the present era. Various studies showed conflicting relationship between DM and Hearing Loss (HL). The current study was carried out to find the effect of Type 1 and Type 2 DM on hearing. The study group consisted of 90 adults in the age range of 20 to 40 years from various hospitals in and around Calicut, Kerala. These participants were divided into three groups: Group1 (Experimental group 1), included 30 individuals with Type 1 DM; Group 2 (Experimental group 2), included 30 individuals with Type 2 DM and Group 3 (Control group) included 30 age-matched non-diabetic individuals with normal hearing sensitivity. Results of the study revealed that there was significant difference in the DPOAE amplitude between Type 1 and Type 2 DM with control group and there was no significant difference in the DPOAE amplitude between Type 1 and Type 2 DM group. From the results it can be concluded that DPOAE amplitude were reduced in both Type 1 and Type 2 DM when compared to control group. This could be attributed to damage of the cochlear Outer Hair Cells (OHCs). Further, it could be assumed that damage to the OHCs due to DM in both Type 1 and Type 2 groups are relatively equal.

Age-related hearing loss (ARHL) is a devastating public health issue. To successfully address ARHL using existing and future treatments, it is imperative to detect the earliest signs of age-related auditory decline and understand the mechanisms driving it. Here, we explore early signs of age-related auditory decline by characterizing cochlear function in 199 ears aged 10–65 years, all of which had clinically defined normal hearing (i.e., behavioral thresholds ≤ 25 dB HL from .25 to 8 kHz bilaterally) and no history of noise exposure. We characterized cochlear function by measuring behavioral thresholds in two paradigms (traditional audiometric thresholds from .25 to 8 kHz and Békésy tracking thresholds from .125 to 20 kHz) and distortion product otoacoustic emission (DPOAE) growth functions at f(2) = 2, 4, and 8 kHz. Behavioral thresholds through a standard clinical frequency range (up to 8 kHz) showed statistically, but not clinically, significant declines across increasing decades of life. In contrast, DPOAE growth measured in the same frequency range showed clear declines as early 30 years of age, particularly across moderate stimulus levels (L(2) = 25–45 dB SPL). These substantial declines in DPOAE growth were not fully explained by differences in behavioral thresholds measured in the same frequency region. Additionally, high-frequency Békésy tracking thresholds above ~11.2 kHz showed frank declines with increasing age. Collectively, these results suggest that early age-related cochlear decline (1) begins as early as the third or fourth decade of life, (2) is greatest in the cochlear base but apparent through the length of the cochlear partition, (3) cannot be detected fully by traditional clinical measures, and (4) is likely due to a complex mix of etiologies.

Introduction Distortion product otoacoustic emissions (DPOAE) and their suppression may be considered useful in monitoring cochlear function and the efferent auditory pathway inhibitory effect. Nonetheless, the establishment of reliable parameters of response variations is of great importance. Objectives To verify the replicability of test and retest in the research of the inhibitory effect of the efferent pathway using contralateral suppressing stimulus during DPOAE recording for clinical applicability. Methods Cross-sectional study with 48 volunteers, aged 18 to 30 years, with normal audiometric thresholds. The procedures included were audiometric and immittance measures to overrule any conductive or sensorineural conditions and DPOAE recordings without and with contralateral suppression with a 60 dBHL white noise. Distortion product otoacoustic emissions amplitudes were analyzed and compared in both conditions with Wilcoxon test, and the Spearman correlation test was used to assess test-retest reliability. Results The comparative analysis showed differences between amplitudes in test and retest conditions only in 1,500 Hz for DPOAE measures with all other tested frequencies showing no differences, and no difference was observed in all recorded frequencies in the test and retest comparison for DPOAE suppression. The degree of correlation between test and retest of DPOAE amplitude was good at 6,000 Hz and strong (r > 0.880) at the other frequencies. For DPOAE with suppression, all frequencies presented strong correlation between test and retest: 1,500 Hz (r = 0.880), 2,000 Hz (r = 0.882), 3,000 Hz (r = 0.940), and 6,000 Hz (r = 0.957). Conclusions The study found good replicability in contralateral suppression of DPOAE with potential clinical applicability, and we recommend conducting the test from 2000Hz to higher frequencies for more reliable results.

Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

Upon calibration of a specific commercially available immittance device, an artifact was consistently measured in a calibration cavity when in ipsilateral acoustic reflex mode. These results were replicated in a controlled fashion, raising concerns about how clinical results might potentially be misinterpreted.Responses were measured from an Interacoustics Titan and Grason-Stadler Tympstar Pro immittance device coupled to a 0.2 cc and, separately, to a 1.0 cc calibration cavity when in ipsilateral acoustic reflex mode. The procedure was repeated with the same outcomes.Clinically significant responses ordinarily associated with presence of an ipsilateral acoustic reflex were obtained in a 0.2 cc and 1 cc coupler with stimuli presented at 0.5 kHz, 1 kHz, and 2 kHz with one of the Interacoustics Titan, but were not obtained in the same conditions with the Grason-Stadler Tympstar Pro.A commercially available immittance device yielded clinically-significant responses to ipsilateral acoustic reflex stimuli within calibration cavities of various sizes. Results suggest that false-positive responses may be obtained when certain immittance devices are used clinically, producing possible misleading or incorrect clinical impressions and assessment.

Sampling distortion product otoacoustic emissions (DPOAEs) at multiple fA map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study.The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure.After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations.Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive.

Cubic distortion product otoacoustic emission input-output functions in humans show a complex pattern of growth. To further investigate the growth of the [Formula: see text] otoacoustic emission, magnitude and phase input-output functions were obtained from human subjects using a range of stimulus levels, frequencies, and frequency ratios. Three factors related to cochlear nonlinearity may produce non-monotonic input-output functions: a two-component interaction, an operating point shift, and two-tone suppression. To complement data interpretation, a local model of distortion product otoacoustic emission generation was fit to the magnitude spectrum of the averaged ear canal sound pressure recording to quantify operating point shift. Results obtained are consistent with non-monotonic growth occurring primarily as a result of two-tone suppression and/or a two-component interaction. These two mechanisms are expected to operate at different stimulus levels, with different signature magnitude and phase patterns, and are unlikely to overlap in producing non-monotonic growth. An operating point shift was suggested in three cases. These results support multiple factors contributing to the complexity of growth of the [Formula: see text] otoacoustic emission in humans and highlight the importance of looking at phase in addition to magnitude when interpreting distortion product otoacoustic emission growth.

Distortion product otoacoustic emission (DPOAE) levels plotted as a function of stimulus frequency ratio demonstrate a bandpass shape. This bandpass shape is narrower at higher frequencies compared to lower frequencies and thus has been thought to be related to cochlear mechanical tuning. However, the frequency- and level-dependence of these functions above 8 kHz is largely unknown. Furthermore, how tuning estimates from these functions are related to behavioral tuning is not fully understood. From experiment 1, we report DPOAE level ratio functions (LRF) from seven normal-hearing, young-adults for f(2) = 0.75-16 kHz and two stimulus levels of 62/52 and 52/37 dB FPL. We found that LRFs became narrower as a function of increasing frequency and decreasing level. Tuning estimates from these functions increased as expected from 1-8 kHz. In experiment 2, we compared tuning estimates from DPOAE LRF to behavioral tuning in 24 normal-hearing, young adults for 1 and 4 kHz and found that behavioral tuning generally predicted DPOAE LRF estimated tuning. Our findings suggest that DPOAE LRFs generally reflect the tuning profile consistent with basilar membrane, neural, and behavioral tuning. However, further investigations are warranted to fully determine the use of DPOAE LRF as a clinical measure of cochlear tuning.

Introduction Caffeine is consumed everyday in a variety of ways by a large population around the world, including coffee, tea, and soft drinks. Therefore, there is a significant need to explore the effects of caffeine on human auditory system. The present study aimed to investigate the effect of caffeine on cochlea using distortion product otoacoustic emission (DPOAE). Materials and Methods Thirty-three young adults were recruited for the study. The effect of caffeine on cochlea was assessed using DPOAE at frequencies between 1 to 10 kHz before and after caffeine consumption. Results The signal to noise ratio of DPOAE was compared before and after coffee intake, which revealed no significant differences. Conclusion The current study results suggest that caffeine has no effect on cochlear functioning.

espanolSe determino la relacion entre la participacion en actividades recreativas con exposicion sonora y el mecanismo coclear de proteccion auditiva regulado por el Sistema Eferente Medial. Se evaluaron 72 jovenes entre 18 y 25 anos, mediante cuestionario sobre Exposicion sonora en actividades recreativas y Supresion Contralateral (SC) de Otoemisiones Productos de Distorsion (OEAPD). De acuerdo a la exposicion se clasificaron categorias de Exposicion General a Musica (EGM). A nivel auditivo se clasificaron los oidos en Grupo 1 (OEAPD presentes normales) y Grupo 2 (OEAPD presentes anormales). Luego se aplico la SC de OEAPD. No se encontro una tendencia clara que relacione directamente EGM y nivel auditivo. Esta situacion podria indicar que ambos actuan independientemente. Sin embargo, la mayoria de los jovenes del Grupo 2 pertenecian a las categorias media y alta, pudiendo inferir que el mecanismo de proteccion podria encontrarse vulnerable si la exposicion se mantuviera o incrementara a futuro. EnglishThe relationship between participation in recreational activities with sound exposure and the cochlear mechanism of hearing protection regulated by the medial efferent system was determined. 72 young people between 18 and 25 years old were evaluated by means of a questionnaire on Sound exposure in recreational activities and Contralateral Suppression (CS) by Distortion Product Otoacoustic Emissions (DPOAE). Young people were classified in categories of General Exposure to Music (GEM). At the hearing level, the ears were classified into Group 1 (DPOAES present normal) and Group 2 (DPOAES present abnormal). Then the DPOAES CS was applied. No clear trend was found that directly related GEM and hearing level. This situation could indicate that both act independently. However, most of the young people in Group 2 belonged to the middle and upper categories, this suggest that the protection mechanism could be vulnerable if the exposure were maintained or increased in the future.

ObjectiveThe purpose of this study is to describe hearing and auditory functional changes in patients receiving platinum-based treatments and to estimate the capacity of DPOAE and pure tone audiometry in evaluating ototoxicity as well as evaluating the risk factors of ototoxicity.DesignStandard pure tone audiometry at frequencies of 250–8000 Hz, and also at 12000 Hz and DPOAE recording were tested prior to starting chemotherapy and once again at the end of our program.Study sample56 patients receiving cisplatin and carboplatin were tested.ResultsAt the conventional frequencies, ototoxicity occurred in 6 (33%) of 18 patients who received cisplatin and in 12 (32%) of 38 carboplatin patients. Ototoxic hearing loss only at 12000 Hz occurred in 5 (28%) patients who received cisplatin and in 2 (5%) carboplatin patients. DPOAEs declined in 9 (75%) of 12 patients who received cisplatin and in 7 (44%) of 16 carboplatin patients. Increased dosage of platinum brought about hearing loss. Our study also investigated the initial hearing threshold as a risk factor for ototoxicity development.ConclusionOtotoxicity monitoring ought to be an important and valuable option in patients being treated with chemotherapy.

Background The general consensus on the role of hearing loss in generating tinnitus is not relevant in tinnitus patients with normal hearing thresholds. One source of tinnitus may be related to damage to outer hair cells (OHC) of the cochlea. If the OHC of the human cochlea are to be involved in the generation of tinnitus, testing of Otoacoustic emissions (OAE) could provide a reliable means of recording OHC dysfunction. We investigated the role of OHC and cochlear efferent system in tinnitus development in normal hearing ears through studying of Distortion Product Otoacoustic Emissions (DPOAE) and Transient Evoked Otoacoustic Emissions (TEOAE) amplitudes, contralateral suppression amplitudes and suppression value in 15 normal hearing tinnitus patients and 15 control subjects. Results Mean f2 DPOAE amplitudes and contralateral suppression were significantly lower in tinnitus group compared to controls for all frequencies from 1001 to 6348 Hz. Suppression values of DPOAEs revealed lower but not significant difference between tinnitus and control groups for all frequencies except 1587 and 6348 Hz. TEOAE amplitudes and contralateral suppression were significantly lower in tinnitus groups for all frequencies from 1000 to 4000 Hz compared to the control group. Suppression value of TEOAEs revealed no significant difference between the two groups for all frequencies except 3000 and 4000 Hz were significantly lower in the tinnitus group compared to the control group. Conclusions Normal hearing manifested by pure tone audiometry in non-vascular tinnitus sufferers does not exclude OHC and/or cochlear efferent pathology.

OBJECTIVES: The purpose of this study was to determine the factors predicting the success or failure of intratympanic dexamethasone (ITD) injection in the treatment of acute subjective tinnitus (AST). MATERIALS AND METHODS: We enrolled patients who were treated with ITD within 3 months of the onset of tinnitus, between 2013 and 2017. We compared the clinical characteristics and audiological data of the patients in the cured group (n=38, 45.6±13.3 years old) and the nonresponder group (n=40, 48.9±18.6 years old). RESULTS: The cured group was predominantly female (p=0.002). The mean duration of tinnitus before ITD was shorter in the cured group than the nonresponder group (p=0.002). The pure-tone averages in both sides were lower in the cured group than in the nonresponder group (p=0.018). The time of tinnitus awareness was shorter in the cured group than in the nonresponder group (p=0.014). Multivariable analysis showed that the duration of tinnitus (odds ratio [OR]=1.045), a history of exposure to noise just before tinnitus development (OR=7.766), and distortion product otoacoustic emissions results (OR=4.580) predicted the outcome of ITD treatment in AST. CONCLUSION: A short duration of tinnitus, no history of immediate noise exposure, and normal distortion product otoacoustic emissions could be favorable prognostic factors for AST treated with ITD injection.

To evaluate two real-time methods for reducing distortion product otoacoustic emission (DPOAE) fine structure in terms of DPOAE amplitude and fine structure depth.A prospective, repeated-measures design was used to assess DPOAE characteristics in response to a conventional stimulation method (Conv.), as well as for methods implementing either a generic suppressor tone (Supp.) or frequency modulation of the fEighty-three young adults (58 females) between the ages of 20 and 34 years with normal hearing completed testing for this study.Use of the Conv. and FM methods resulted in consistently higher DPOAE levels relative to the Supp. method, with average advantages of 6 and 5 dB, respectively. For all methods, increased fine structure depth was observed for stimulation with lower level (25-45 dB SPL) and lower frequency (1000-3000 Hz) primary tones. Finally, use of the Supp. and FM methods resulted in significantly decreased fine structure depth relative to the Conv. method.Through frequency modulation of the f

Introduction Distortion product otoacoustic emissions (DPOAEs) can be helpful in estimating the hearing thresholds by extrapolating the DPOAE input/output function with the help of scissor paradigm, and thus the following study aims at assessing its reliability by comparing DPOAE thresholds with those obtained by behavioral responses at pure tones on various frequencies. Materials and Methods Fifty participants having normal hearing sensitivity were included in the study. Pure tone (PT) audiometry was carried out on all participants to determine PT thresholds in both ears. DPOAE threshold test was administered and thresholds at 1, 2, 4, and 8 kHz were compared accordingly. Results The result indicated significant difference between the two methods of threshold estimation where the mean difference was found to be 3 decibel (dB) and 4 dB for left and right ears, respectively. Shapiro-Wilk test revealed normal distribution (p > 0.05) of the data. Hence, parametric paired t-test was performed, which revealed significant difference between PT and distortion product thresholds. Conclusion Study concludes as having good clinical applicability in assessing neonates and infants.

DPOAEs are acoustic energy within the external auditory canal (EAC) arising from the non-linear interaction within the cochlea; of 2 pure tones presented simultaneously; of primary frequencies f1 a...

OBJECTIVES: This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiD), as reported by caregivers using the Evaluation of Children’s Listening and Processing Skills (ECLiPS) validated questionnaire, compared to children with typically developed (TD) listening abilities. DESIGN: Children with LiD aged 6–14 y.o. (n = 60, mean age = 9.9 yr.) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional area. Both groups completed standard and extended high frequency pure tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. RESULTS: There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that extended high frequency hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product and transient evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with extended high frequency hearing loss, secondary to PE tube history. CONCLUSIONS: Overall, the results of this study in a sample of children with validated LiD compared to a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.

PurposeNo study has investigated the effects of contralateral noise (CN) on speech-in-noise perception (SINP) in listeners with tinnitus. The mechanisms underlying the involvement of medial olivocochlear (MOC) reflex with SINP remain to be elucidated. This study aimed to investigate the MOC function in patients with bilateral tinnitus by measuring distortion product otoacoustic emission and SINP.MethodEighteen patients with bilateral tinnitus (one male and 17 females; age:M±SD= 45.61 ± 10.18 years) and 19 listeners without tinnitus (six males and 13 females; age:M±SD= 34.11 ± 8.35 years) were recruited for the study. Each subject underwent distortion product otoacoustic emission measurement and the SINP test for both ears. The effects of CN on these two measurements were compared between tinnitus ears (TEs) and no-tinnitus ears (NTEs).ResultsThe presence of CN significantly reduced distortion product (DP) amplitudes and improved SINP for TEs, and the amounts of DP suppression and SINP improvement were similar to those in NTEs. Improvement of SINP was positively correlated with DP suppression at 6185 Hz for NTEs and at 1640 Hz for TEs.ConclusionsThe results of this study suggest that the amounts of DP suppression and SINP improvement were similar between listeners with and without tinnitus. For both ear groups, the MOC reflex was involved with SINP at specific frequencies. Any clinical test outcomes with regard to the MOC bundle in patients with tinnitus should be interpreted with caution until further studies are conducted.

Acoustic Diagnostics is an Italian Space Agency (ASI) biomedical experiment exploiting the diagnostic potential of otoacoustic emissions (OAEs) to monitor the astronauts’ hearing health on board the International Space Station (ISS). It is being performed (July 2019–April 2020) on the ISS, in the framework of the BEYOND mission, sponsored by European Space Agency (ESA). A dedicated instrument for measuring distortion product OAE (DPOAE) in a noisy environment was designed by University of Rome Tor Vergata and INAIL. Aerospace Logistics Technology Engineering Company (ALTEC) took care of the payload development, mechanical, thermal and electromagnetic tests, verification, and acceptance. Two astronauts were subjected, before leaving for their mission on the ISS, to the DPOAE test, along with a full set of audiological tests (Baseline Data Collection, BDC), especially designed at University of Roma La Sapienza and Campus Bio-Medico. An identical DPOAE apparatus was used five times on board the ISS to test the two astronauts. Finally, a post-flight BDC was performed, few days after return to Earth. Preliminary analysis demonstrated that the payload was able to record DPOAEs on board the ISS with very low instrumental noise level, despite the high noise level of the ISS environment. ASI, in the frame of its national mission of promoting and fostering the culture of space across the Country, provides access to the ISS as a laboratory in space. The utilization support services are provided, thanks to a contract, awarded by ASI, to ARGOTEC/Telespazio (UTISS Team).

Akbulut, Ahmet Alperen/0000-0002-3273-6632; KARA, Eyyup/0000-0002-4015-4560; Kara, Halide Cetin/0000-0002-6747-7212; Karakol, Sare Nur/0000-0002-3481-5342; Aydin, Kubra/0000-0003-2746-1555 WOS:000531858400018 PubMed ID: 32209515 OBJECTIVES: To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. MATERIALS and METHODS: Nine individuals (ages: 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages: 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. RESULTS:In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase In the summating potential/action potential (SP/AP) ratio in both ears. CONCLUSION: Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus.

Purpose The purpose of this study was to examine marijuana or other substance use on pure-tone thresholds and distortion product otoacoustic emissions (DPOAEs) in young adults. Method Young adults ( n = 243; 182 women, 61 men; M age = 20.9 years, SD = 2.7 years) participated in this study. Survey data included personal music system use, marijuana use, and misuse of prescription medications. Otoscopy, tympanometry, pure-tone audiometry, and DPOAEs were obtained. Pure tones from octave frequencies of 0.25 through 8 kHz were obtained, and DPOAEs were recorded between f 2 frequencies of 1 and 6 kHz using two continuously presented stimulus tones swept in frequency. Results Those who reported marijuana or stimulant use had similar pure-tone averages (0.5, 1, 2, and 4 kHz) compared to those who reported never using marijuana or stimulants. Women who reported marijuana use in the past 30 days > two times had statistically significant higher mean DPOAEs compared to women who reported ≤ two times or no marijuana use in the past 30 days. Men, however, who reported marijuana use in the past 30 days > two times had lower, but not statistically significant, mean DPOAEs compared to men who reported ≤ two times or no marijuana use in the past 30 days. Women who reported ever using stimulants had statistically significant higher mean DPOAEs compared to women who reported never using stimulants; for men, mean DPOAEs were similar between those who reported ever using stimulants and those who never used stimulants. Conclusions The results of this study demonstrate different and contradictory associations between marijuana use, stimulant use, and hearing outcomes as a function of sex. Future research is needed to explore these associations utilizing larger sample sizes while accounting for additional harmful exposures to other noise exposures.

Topicality: Objective research methods of the auditory analyzer are of great importance in diagnosis sensorineural disorders of auditory function, treatment of such diseases and solving a number of expert questions. While diagnosis the damage of auditory system, especially the receptor part of the auditory analyzer the method of the caused OAE on the frequency distortion product (DPOAE) plays a significant role. Quite often at sensorineural hearing loss of different genesis is observed an affection of cochlea structures of the inner ear. Diabetes mellitus (DM) is one of the most acute medical and social problems. According to the latest data, there are 463 million adults with diabetes mellitus in the world; accounting for 9.3% of the world's total population, meaning that 1 among 11 people suffers from diabetes (IDF Diabetes Atlas 9th edition, 2019). Among patients with diabetes, according to various authors, there are disorders in the auditory analyzer. Purpose: to determine changes in the condition of the receptor part of auditory analyzer according to the OAE registration of the frequency of distortion products among patients with diabetes mellitus type II with impaired auditory function. Materials and methods: 17 patients with diabetes mellitus type II were examined, who, according to subjective audiometry, revealed impairments of auditory function of the I-II degree. The control group consisted of 15 healthy normal-hearing persons who did not report hearing impairment, had no elevated blood sugar levels. 32 persons were examined in total. The registration of the caused OAE at frequency of distortion product (DPOAE) was conducted on the analyzing system "Eclipse" "Interacoustics" (Denmark) at frequencies 1-6 kHz. Statistical processing of the obtained results was carried out according to the conventional methods of mathematical variation statistics using the STATISTICA software package. The average value of indicators was calculated - magnitude (M) and its error (+- m). The probability of changes and differences between the comparative values was estimated by the criterion for the reliability of the difference (t) according to the Student's table. Results and discussion: We have selected for the analysis patients with diabetes mellitus type II, who according to subjective audiometry revealed impaired auditory function. Patients also reported otologic complaints of hearing loss, periodic or persistent subjective ear noise. As a result of the OAE researches at frequency distortion products, the following data were obtained. A full adequate response of the otoacoustic emission across all frequency spectrums was reported in only 3 patients (9.4% of cases) on the one hand. The majority of the observed patients in whom the OAE was registered received a partially positive test (68.7%). In 7 patients (21.8%) the OAE response was not registered. The absence of OAE response or a partially positive registration in 90.6% of the observed patients indicated violation function of the cochlea in such patients. The DPOAE (response intensity) emission amplitude at all tested frequencies (1-6 kHz) in patients with diabetes mellitus type II was significantly (P

Hypothesis The phenotype of DFNA11 consists of specific features at diverse developmental and age stages. Background Only eight mutations have been identified for autosomal dominant non-syndromic hearing loss related to MYO7A (DFNA11), and the onset and progression of DFNA11 are poorly understood. Methods After linkage analysis and following Sanger sequencing in a family suspected to have autosomal dominant hereditary hearing loss, we analyzed the audiometric and vestibular functions and their long-term changes in the subjects carrying the variant. Results A reported variant of uncertain significance, NP_000251.3:p.Arg853His, in MYO7A was detected and cosegregation data of this large family provided evidence that the variant was likely pathogenic for DFNA11. Family members with the variant had no other symptoms associated with hearing loss and were confirmed to have autosomal dominant non-syndromic sensorineural hearing loss. Audiograms tended to show gently sloping configuration in childhood and flat configuration after the age of 30 years. Hearing loss at high frequencies progressed slowly, while hearing at low frequencies started to deteriorate later but progressed more rapidly. Some subjects showed partly abnormal results in the distortion products of otoacoustic emissions before the elevation of hearing thresholds. Vestibular function was within the normal range in all the subjects tested. Conclusion We revealed that hearing loss at high frequencies was mainly noted in early developmental stages and that thresholds increased more rapidly in the low frequency range, resulting in changes in audiometric configuration. Deterioration of distortion product otoacoustic emissions (DPOAE) before the elevation of hearing thresholds was considered as a clinical feature of DFNA11.

Objective: To evaluate the ototoxic effect of the exposure to different organic solvents and noise using distortion product otoacoustic emissions (DPOAEs).Design: The exposure to different solvents...

Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

To compare the condition of auditory function during the first year of life according to the registration of distortion product otoacoustic emission (DPOAE) and short-latency evoked potentials (SLEP) in premature infants who received ototoxic antibiotics to those ones, who did not.Auditory function was examined in 145 premature infants. Auditory assessment was carried out by registration of DPOAEs, SLEPs and tympanometry. Statistical processing was performed using the program Statgraphics Centurion XV.In this study, according to DPOAE, the average response values of the cochlea in premature infants who had a history of ototoxic therapy, undergo final changes after children reach the age of 6 months. The study of latent periods and threshold values of the V peak of SLEP showed a delay in the maturation process of the perceiving and conducting auditory structures during the first year of life in children who received ototoxic antibiotics in the first month of life.We evaluated the timing of the completion of response changes in children of the control group using the DPOAE and SLEP registration data. In children of the study group, we evaluated the effect of the administered ototoxic antibiotics. Timing of audiological control of the hearing organ condition are demonstrated for premature children after ototoxicosis, required methods of its examination are established.Сравнить состояние слуховой функции в течение первого года жизни по данным регистрации вызванной отоакустической эмиссии на частоте продукта искажения (ПИОАЭ) и коротколатентных слуховых вызванных потенциалов (КСВП) у недоношенных детей, получавших и не получавших ототоксические антибиотики.Слуховая функция была исследована у 145 недоношенных детей. Оценка слуха проводилась методами регистрации ПИОАЭ, КСВП, тимпанометрии. Статистическая обработка проводилась с использованием программы Statgraphics Centurion XV.В ходе исследования по данным ПИОАЭ усредненные значения ответа улитки у недоношенных детей, получавших в анамнезе терапию ототоксическими препаратами, претерпевают окончательные изменения после достижения детьми возраста 6 мес. Изучение латентных периодов и пороговых значений V пика КСВП указывает на задержку процесса созревания воспринимающих и проводящих слуховых структур в течение первого года жизни у детей, получавших в первый месяц жизни ототоксические антибиотики.На основании регистрации ПИОАЭ и КСВП у детей группы контроля были оценены сроки окончания изменений ответа. У детей опытной группы оценена степень влияния введенных ототоксических антибиотиков. Показаны сроки аудиологического контроля за состоянием органа слуха у недоношенных детей после ототоксикоза, определены необходимые методы его оценки.