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Relationship between DPOAEs and the audiogram (Bramhall et al., 2021)

journal contribution
posted on 19.01.2021, 22:48 by Naomi F. Bramhall, Garnett P. McMillan, Amy N. Mashburn
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 f2 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 S1. Detailed description of the statistical models.

Supplemental Material S2. Relationship between pure tone thresholds and DPOAE levels across frequency.

Bramhall, N. F., McMillan, G. P., & Mashburn, A. N. (2021). Subclinical auditory dysfunction: Relationship between distortion product otoacoustic emissions and the audiogram. American Journal of Audiology. Advance online publication. https://doi.org/10.1044/2020_AJA-20-00056

Publisher Note: This article is part of the Special Issue: Select Papers from the National Center for Rehabilitative Auditory Research Conference.


The research described here was supported by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service Awards C1484-M (to N. F. B.), C2104-W (to N. F. B.), and C9230-C (to the National Center for Rehabilitative Auditory Research) and the Veterans Health Administration Office of Academic Affiliations (to A. N. M.). Research audiologist support was also provided by the Department of Defense Hearing Center of Excellence and zCore Business Solutions, Inc.