The development of cochlear frequency resolution in the human auditory system

Spectral Resolution Development in Children With Normal Hearing and With Cochlear Implants: A Review of Behavioral Studies

PURPOSE

This review article provides a theoretical overview of the development of spectral resolution in children with normal hearing (cNH) and in those who use cochlear implants (CIs), with an emphasis on methodological considerations. The aim was to identify key directions for future research on spectral resolution development in children with CIs.

METHOD

A comprehensive literature review was conducted to summarize and synthesize previously published behavioral research on spectral resolution development in normal and impaired auditory systems.

CONCLUSIONS

In cNH, performance on spectral resolution tasks continues to improve through the teenage years and is likely driven by gradual maturation of across-channel intensity resolution. A small but growing body of evidence from children with CIs suggests a more complex relationship between spectral resolution development, patient demographics, and the quality of the CI electrode-neuron interface. Future research should aim to distinguish between the effects of patient-specific variables and the underlying physiology on spectral resolution abilities in children of all ages who are hard of hearing and use auditory prostheses.

Longitudinal Development of Distortion Product Otoacoustic Emissions in Infants With Normal Hearing

OBJECTIVES

The purpose of this study was to describe normal characteristics of distortion product otoacoustic emission (DPOAE) signal and noise level in a group of newborns and infants with normal hearing followed longitudinally from birth to 15 months of age.

DESIGN

This is a prospective, longitudinal study of 231 infants who passed newborn hearing screening and were verified to have normal hearing. Infants were enrolled from a well-baby nursery and two neonatal intensive care units (NICUs) in Cincinnati, OH. Normal hearing was confirmed with threshold auditory brainstem response and visual reinforcement audiometry. DPOAEs were measured in up to four study visits over the first year after birth. Stimulus frequencies f1 and f2 were used with f2/f1 = 1.22, and the DPOAE was recorded at frequency 2f1-f2. A longitudinal repeated-measure linear mixed model design was used to study changes in DPOAE level and noise level as related to age, middle ear transfer, race, and NICU history.

RESULTS

Significant changes in the DPOAE and noise levels occurred from birth to 12 months of age. DPOAE levels were the highest at 1 month of age. The largest decrease in DPOAE level occurred between 1 and 5 months of age in the mid to high frequencies (2 to 8 kHz) with minimal changes occurring between 6, 9, and 12 months of age. The decrease in DPOAE level was significantly related to a decrease in wideband absorbance at the same f2 frequencies. DPOAE noise level increased only slightly with age over the first year with the highest noise levels in the 12-month-old age range. Minor, nonsystematic effects for NICU history, race, and gestational age at birth were found, thus these results were generalizable to commonly seen clinical populations.

CONCLUSIONS

DPOAE levels were related to wideband middle ear absorbance changes in this large sample of infants confirmed to have normal hearing at auditory brainstem response and visual reinforcement audiometry testing. This normative database can be used to evaluate clinical results from birth to 1 year of age. The distributions of DPOAE level and signal to noise ratio data reported herein across frequency and age in normal-hearing infants who were healthy or had NICU histories may be helpful to detect the presence of hearing loss in infants.

Effect of age on click-evoked otoacoustic emission: A systematic review

OBJECTIVE:

The aims of this study were to investigate the changes of the total intensity of transient evoked otoacoustic emission (TEOAE) and signal-to-noise ratio in various frequency bands as a function of aging, and to explore the role of age-related decline of cochlear outer hair cells.

DATA SOURCES:

The literature was searched using the PubMed database using ‘transient-evoked otoacoustic emissions’ as a keyword. Articles were limited as follows: Species was ‘Humans’; languages were ‘English and Chinese’; publication date between 1990-01-01 and 2010-12-31. The references of the found were also searched to obtain additional articles.

DATA SELECTION:

Inclusion criteria: (1) Articles should involve the total TEOAE level or signal-to-noise ratio. (2) The measurement and analysis system used was Otodynamics ILO analysis system (ILO88, ILO92, ILO96 or ILO292). (3) Studies involved groups of greater than 10 subjects and TEOAE results were from normally hearing ears. (4) If more papers from the same author or laboratory analyzed the same subjects, only one was used.

MAIN OUTCOME MEASURES:

The correlations of the age scale with the total level and signal-to-noise ratio of TEOAE was determined, respectively.

RESULTS:

(1) TEOAE total level gradually increased until 2 months of age, and then decreased with increasing age. Significant negative correlations between total TEOAE level and age were found (r = –0.885, P = 0.000). (2) The most rapid decrease of TEOAE amplitude occurred at 1 year old. The total TEOAE level decreased about 4.25 dB SPL between 2 months to 1 year old, then about 0.26–0.52 dB SPL from 1 year to 10 years old, about 0.23 dB SPL from 11 years to 25 years old, and about 0.14 dB SPL from 26 years to 60 years old. (3) The signal-to-noise ratio in the frequency bands centered at 1.5, 2, 3 and 4 kHz decreased with increasing age after 2 months of age. Significant negative correlations between the signal-to-noise ratio and age were found for frequency bands ranging from 1.5 kHz to 4 kHz, with the highest correlations at 4 kHz (r = –0.890, P < 0.01), then at 3 kHz (r = –0.889, P < 0.01), at 2 kHz (r = –0.850, P < 0.01) and at 1.5 kHz (r = –0.705, P < 0.05). Conversely, a positive correlation between the signal-to-noise ratio centered at 1 kHz and age was found, but was not statistically significant (r = 0.298, P = 0.374).

CONCLUSION:

The total TEOAE response level decreased with increasing age after the first 2 months of age. The signal-to-noise ratio also decreased with increasing age in frequency bands above 1.5 kHz. The signal-to-noise ratio in higher frequencies decreased faster than in lower frequencies, leading to the maximum signal-to-noise ratio shift form 3.2–4.0 kHz in neonates to 1.5 kHz in adults, and further decreasing the total TEOAE response level. The age-related TEOAE spectrum peak shift is most likely because the outer hair cells functioning in higher frequencies are more prone to damage than those for lower frequencies.

Maturation of auditory function related to hearing threshold estimations using the auditory brainstem response during infancy

OBJECTIVE

The objective of this study was to quantify the maturation of the Auditory Brainstem Response (ABR) at discrete periods during infancy and to provide a means to appropriately estimate hearing thresholds when the ABR is immature.

METHODS

A longitudinal study was designed to measure the in situ ABR thresholds of infants using air-conduction tone bursts of 500, 2000 and 4000Hz. Thresholds were measured using an eardrum-level microphone to eliminate the bias related to coupler-referenced scales such as the dB nHL scale used for adult assessments.

RESULTS

The study found that the in situ thresholds of a sample of normally developing infants decreased significantly during the first 6 months of life. A comparison of these in situ thresholds with those of normal-hearing adults revealed that the ABR response reached maturity in these infants between 4 and 6 months of age for the frequencies 500 and 2000Hz but remained immature, or elevated, at 6 months of age for 4000Hz.

CONCLUSIONS

The maturation of the ABR should be considered during the estimation of an infant's audiogram and subsequent diagnosis.

Maturation of visual and auditory temporal processing in school-aged children

PURPOSE

To examine development of sensitivity to auditory and visual temporal processes in children and the association with standardized measures of auditory processing and communication. Methods Normative data on tests of visual and auditory processing were collected on 18 adults and 98 children aged 6-10 years of age. Auditory processes included detection of pitch from temporal cues using iterated rippled noise and frequency modulation detection at 2 Hz, 40 Hz, and 240 Hz. Visual processes were coherent form and coherent motion detection. Test-retest data were gathered on 21 children.

RESULTS

Performance on perceptual tasks improved with age, except for fine temporal processing (iterated rippled noise) and coherent form perception, both of which were relatively stable over the age range. Within-subject variability (as assessed by track width) did not account for age-related change. There was no evidence for a common temporal processing factor, and there were no significant associations between perceptual task performance and communication level (Children's Communication Checklist, 2nd ed.; D. V. M. Bishop, 2003) or speech-based auditory processing (SCAN-C; R. W. Keith, 2000).

CONCLUSIONS

The auditory tasks had different developmental trajectories despite a common procedure, indicating that age-related change was not solely due to responsiveness to task demands. The 2-Hz frequency modulation detection task, previously used in dyslexia research, and the visual tasks had low reliability compared to other measures.

Neonatal frequency discrimination in 250–4000-Hz range: Electrophysiological evidence

OBJECTIVE

The precision of sound frequency discrimination in newborn infants in the 250-4000-Hz frequency range was determined using the neonatal electrophysiological mismatch response (MMR), the infant equivalent of adult mismatch negativity (MMN).

METHODS

The electroencephalogram (EEG) was recorded in 11 full-term sleeping newborn infants mostly in active sleep (67% of the time). Pure tones were presented through loudspeakers in an oddball paradigm with a 800-ms stimulus onset asynchrony (SOA). Each stimulus block contained a standard (p=0.76) of 250, 1000, or 4000Hz in frequency (in separate blocks) and deviants with a frequency change of either 5% or 20% of the standard (p=0.12 of each).

RESULTS

A positive ERP deflection was found at 200-300ms from stimulus onset in response to the 20% deviation from the 250, 1000, and 4000Hz standard frequencies. The amplitude of the response in the 200-300ms time window was significantly larger for the 20% than 5% deviation.

CONCLUSIONS

We observed in newborn infants automatic frequency discrimination as reflected by a positive MMR. The newborns were able to discriminate frequency change of 20% in the 250-4000-Hz frequency range, whereas the discrimination of the 5% frequency change was not statistically confirmed.

SIGNIFICANCE

The present data hence suggest that the neonatal frequency discrimination has lower resolution than that in adult and older children data.

Development of f2/f1 ratio functions in humans

Otoacoustic emissions (OAEs) presumably represent active processes within the cochlea fundamental to frequency-selectivity in peripheral auditory function. Maturation of the cochlear amplifier, vis-a-vis frequency encoding or selectivity, has yet to be fully characterized in humans. The purpose of this study was to further investigate the maturation of features of the f2/f1 frequency ratio (Distortion Product OAE amplitude X f2/f1 ratio) presumed to reflect cochlear frequency selectivity. A cross-sectional, multivariate study was completed comparing three age groups: pre-term infants, term infants and young adult subjects. Frequency ratio functions were analyzed at three f2 frequencies--2000, 4000 and 6000 Hz. An analysis included an estimation of the optimal ratio (OR) and a bandwidth-like measure (Q3). Analysis revealed significant interactions of age x frequency x gender for optimal ratio and a significant interaction of age x frequency for Q3. Consistent and statistically significant differences for both OR and Q3 were found in female subjects and when f2 = 2 or 6 kHz. This supports research by others [Abdala, J. Acoust. Soc. Am. 114, 3239-3250 (2003)] suggesting that the development of cochlear active mechanisms may still be somewhat in flux at least through term birth. Furthermore, OAEs appear to demonstrate gender differences in the course of such maturational changes.

Suppression and enhancement of distortion-product otoacoustic emissions by interference tones above f(2). II. Findings in humans

Distortion-product otoacoustic emission (DPOAE) suppression tuning curves (STCs) can be obtained in a variety of laboratory animals and humans by sweeping the frequencies and levels of a third tone (f(3)) around a set of f(1) and f(2) primaries. In small laboratory animals, it was previously observed that, when the suppressor tone (f(3)) is above f(2), substantial suppression and or enhancement (suppression/enhancement) could be obtained. In the present study, it was of interest to determine if similar suppression/enhancement phenomena could be observed in humans and to what extent this might influence the interpretation of STC results reported in the literature. To this end, STCs were measured for DPOAEs at 2f(1)-f(2) and 2f(2)-f(1) in human subjects at geometric-mean frequencies (GM) of 1, 2, 3, and 4 kHz, and primary-tone equilevels of 80/80 and 75/75 dB SPL and unequal levels of 65/55 dB SPL. Overall, STC parameters were found to be comparable to those reported in the literature. For the 2f(1)-f(2) DPOAE, STC tip frequencies tuned to the region of the primaries, and tip frequencies were slightly influenced by primary-tone level. STC tip thresholds were typically within 10 dB of the level of L(2), and Q(10dB) values ranged from 1.0 to 2.5, which was consistent with the higher-level primaries employed. The 2f(1)-f(2) DPOAE showed consistent regions of suppression that were approximately an octave above the GM for the 1-kHz, 65/55-dB SPL condition. The 2f(2)-f(1) DPOAE tuned to its characteristic place above f(2) and showed reliable enhancement above the STC tip region for the 1-kHz, 75/75-dB SPL primaries. Overall, the results clearly revealed that human ears also display suppression/enhancement phenomena when f(3) reaches frequencies considerably above f(2). If suppression/enhancement phenomena reflect secondary DPOAE sources, then these sources are present in the ear-canal signal from humans as well as small laboratory animals.

Maturation of the human cochlear amplifier: distortion product otoacoustic emission suppression tuning curves recorded at low and high primary tone levels

The cochlear amplifier shows level-dependent function and works optimally at low levels. For this reason, manipulation of stimulus level is a route through which the human cochlear amplifier can be investigated in a noninvasive manner. Distortion product otoacoustic emissions (DPOAEs) evoked as a function of stimulus level provide a tool for exploration of human cochlear amplifier function and, when applied to neonates, for investigation of cochlear maturation. The current experiment generated 2f1-f2 DPOAE ipsilateral suppression tuning curves (STCs) at three primary tone levels and five f2 frequencies in a large group of premature and term neonates and adults. The differences between tuning generated with low- and high-level primary tones was measured to provide a gross estimate of the "tuning enhancement effect" attributed to the cochlear amplifier. Other features of the DPOAE suppression tuning curves were measured as well. Consistent with previous reports, at 1500 and 6000 Hz, STCs were narrower, with a steeper slope on the low-frequency flank of the tuning curve in premature neonates versus adults. Additionally, only DPOAE STCs from adults and term neonates became markedly broader and more shallow when recorded with high-level primary tones. It has been hypothesized that the excessive narrowness of suppression tuning and the absence of a level effect on DPOAE STCs recorded in premature neonates reflects a subtle immaturity in cochlear amplifier function just prior to term birth.

Identification of neonatal hearing impairment: distortion product otoacoustic emissions during the perinatal period

OBJECTIVES

1) To describe distortion product otoacoustic emission (DPOAE) levels, noise levels and signal to noise ratios (SNRs) for a wide range of frequencies and two stimulus levels in neonates and infants. 2) To describe the relations between these DPOAE measurements and age, test environment, baby state, and test time.

DESIGN

DPOAEs were measured in 2348 well babies without risk indicators, 353 well babies with at least one risk indicator, and 4478 graduates of neonatal intensive care units (NICUs). DPOAE and noise levels were measured at f2 frequencies of 1.0, 1.5, 2.0, 3.0, and 4.0 kHz, and for primary levels (L1/L2) of 65/50 dB SPL and 75/75 dB SPL. Measurement-based stopping rules were used such that a test did not terminate unless the response was at least 3 dB above the mean noise floor + 2 SDs (SNR) for at least four of five test frequencies. The test would terminate, however, if these criteria were not met after 360 sec. Baby state, test environment, and other test factors were captured at the time of each test.

RESULTS

DPOAE levels, noise levels and SNRs were similar for well babies without risk indicators, well babies with risk indicators, and NICU graduates. There was a tendency for larger responses at f2 frequencies of 1.5 and 2.0 Hz, compared with 3.0 and 4.0 kHz; however, the noise levels systematically decreased as frequency increased, resulting in the most favorable SNRs at 3.0 and 4.0 kHz. Response levels were least and noise levels highest for an f2 frequency of 1.0 kHz. In addition, test time to achieve automatic stopping criteria was greatest for 1.0 kHz. With the exception of "active/alert" and "crying" babies, baby state had little influence on DPOAE measurements. Additionally, test environment had little impact on these measurements, at least for the environments in which babies were tested in this study. However, the lowest SNRs were observed for infants who were tested in functioning isolettes. Finally, there were some subtle age affects on DPOAE levels, with the infants born most prematurely producing the smallest responses, regardless of age at the time of test.

CONCLUSIONS

DPOAE measurements in neonates and infants result in robust responses in the vast majority of ears for f2 frequencies of at least 2.0, 3.0 and 4.0 kHz. SNRs decrease as frequency decreases, making the measurements less reliable at 1.0 kHz. When considered along with test time, there may be little justification for including an f2 frequency at 1.0 kHz in newborn screening programs. It would appear that DPOAEs result in reliable measurements when tests are conducted in the environments in which babies typically are found. Finally, these data suggest that babies can be tested in those states of arousal that are most commonly encountered in the perinatal period.

Frequency responses of two- and three-tone distortion product otoacoustic emissions in Mongolian gerbils

The frequency responses of distortion product otoacoustic emission (DPOAEs) were investigated in adult Mongolian gerbils. The main goal was to investigate in this species the extent to which DPOAE measurements might be useful in estimating cochlear frequency-tuning characteristics. Specifically, this study investigated the parameter space for generation of DPOAEs to determine those regions, if any, where the emission responses gave "simple" frequency responses, i.e., responses similar in form to typical neural responses. At the same time, it was desired to determine in this species the existence, extent, and nature of the more complex three-tone emission frequency responses as observed in some other species [e.g., Martin et al., Hearing Res. 136, 105-123 (1999)]. In the present work, two-tone frequency response curves (f2/f1 ratio functions) were obtained by varying the lower frequency, f1, while holding the f2 frequency and both amplitudes (L1, L2) constant. Only for frequencies, f2, near 8 kHz did the response at the emission frequency, 2 f1-f2, form a simple, relatively broad peak. At all lower frequencies, the two-tone frequency response curve was typically complex and composed of multiple peaks. In comparison, three-tone frequency responses were constructed by fixing the primary stimulus pair (f1, f2) and varying a third tone widely in frequency (f3) and intensity (L3). Points in f3 and L3 which caused a criterion reduction in primary emission amplitude (at 2 f1-f2) were used to construct emission suppression tuning curves (STCs). Only for primary frequencies, f2, at 8 kHz and above were the emission STCs found to be simple, with shapes similar to neural frequency-tuning curves. At lower primary frequencies, particularly for relatively low primary frequency ratios (low f2/f1), three-tone responses were very complex. This complex response usually included a region of anomalous suppression in which very low suppression levels (L3) could result in significant decreases in the primary emission amplitude, often exceeding 12 dB. Regions of such anomalous suppression were typically observed under the following conditions: (1) for all f2 frequencies from 0.5 to 4 kHz; (2) for f3 frequencies between 1.4 and 8 kHz; (3) i.e., for f3 frequencies 1-3 octaves above the primary frequency, f2; (4) at L3 levels often 10 dB lower or more than the usual "best frequency" threshold, i.e., even lower than the relative minimum threshold found near the primary stimulus frequencies; (5) exhibiting sharp amplitude decreases often accompanied by emission phase shifts of about 180 deg; (6) present in both cubic emissions (2 f1-f2 and 2 f2-f1); (7) to be less extreme at larger primary stimulus frequency ratios (larger f2/f1); and (8) less extreme at larger intensity ratios (larger L1/L2). Because of the anomalous behavior at f2 frequencies below 8 kHz, "simple" emission STCs were typically only obtainable, if at all, near the extreme boundaries of the parameter space giving measurable emission amplitudes.

Maturation of human central auditory system activity: evidence from multi-channel evoked potentials

OBJECTIVE

The purpose of this study was to evaluate central auditory system maturation based on detailed data from multi-electrode recordings of long-latency auditory evoked potentials (AEPs).

METHODS

AEPs were measured at 30 scalp-electrode locations from 118 subjects between 5 and 20 years of age. Analyses focused on age-related latency and amplitude changes in the P1, N1b, P2, and N2 peaks of the AEPs generated by a brief train of clicks presented to the left ear.

RESULTS

Substantial and unexpected changes that extend well into adolescence were found for both the amplitude and latency of the AEP components. While the maturational changes in latency followed a pattern of gradual change, amplitude changes tended to be more abrupt and step-like. Age-related latency decreases were largest for the P1 and N1b peaks. In contrast, P2 latency did not change significantly and the N2 peak increased in latency as a function of age. Abrupt changes in P1, P1-N1b, and N2 peak amplitude (also RMS amplitude) were observed around age 10 at the lateral electrode locations C3 and C4, but not at the midline electrodes Cz and Fz. These changes in amplitude coincided with a sharp increase and plateau in AEP peak and RMS amplitude variability from 9 to 11 years of age.

CONCLUSIONS

These analyses demonstrated that the observed pattern of AEP maturation depends on the scalp location at which the responses are recorded. The distinct maturational time courses observed for individual AEP peaks support a model of AEP generation in which activity originates from two or more at least partly independent central nervous system pathways. A striking parallel was observed between previously reported maturational changes in auditory cortex synaptic density and, in particular, the age-related changes in P1 amplitude. The results indicate that some areas of the brain activated by sound stimulation have a maturational time course that extends into adolescence. Maturation of certain auditory processing skills such as speech recognition in noise also has a prolonged time course. This raises the possibility that the emergence of adult-like auditory processing skills may be governed by the same maturing neural processes that affect AEP latency and amplitude.

Suppression and enhancement of distortion-product otoacoustic emissions by interference tones above f(2). I. Basic findings in rabbits

The present study measured interference-response areas (IRAs) for distortion-product otoacoustic emissions (DPOAEs) at 2f(1)-f(2), 3f(1)-2f(2), and 2f(2)-f(1). The IRAs were obtained in either awake or anesthetized rabbits, or in anesthetized guinea pigs and mice, by sweeping the frequencies and levels of an interference tone (IT) around a set of f(1) and f(2) primary tones, at several fixed frequencies and levels, while plotting the effects of the IT on DPOAE level. An unexpected outcome was the occurrence of regions of suppression and/or enhancement of DPOAE level when the IT was at a frequency slightly less than to more than an octave above f(2). The IRA of the 2f(1)-f(2) DPOAE typically displayed a high-frequency (HF) lobe of suppression, while the 2f(2)-f(1) emission often exhibited considerable amounts of enhancement. Moreover, for the 2f(2)-f(1) DPOAE, when enhancement was absent, its IRA usually tuned to a region above f(2). Whether or not suppression/enhancement was observed depended upon primary-tone level and frequency separation, as well as on the relative levels of the two primaries. Various physiological manipulations involving anesthesia, eighth-nerve section, diuretic administration, or pure-tone overstimulation showed that these phenomena were of cochlear origin, and were not dependent upon the acoustic reflex or cochlear-efferent activity. The aftereffects of applying diuretics or over-exposures revealed that suppression/enhancement required the presence of sensitive, low-level DPOAE-generator sources. Additionally, suppression/enhancement were general effects in that, in addition to rabbits, they were also observed in mice and guinea pigs. Further, corresponding plots of DPOAE phase often revealed areas of differing phase change in the vicinity of the primary tones as compared to regions above f(2). These findings, along with the effects of tonal exposures designed to fatigue regions above f(2), and instances in which DPOAE level was dependent upon the amount of suppression/enhancement, suggested that the interactions of two DPOAE-generator sources contributed, in some manner, to these phenomena.

The case for early identification of hearing loss in children. Auditory system development, experimental auditory deprivation, and development of speech perception and hearing

Human infants spend the first year of life learning about their environment through experience. Although it is not visible to observers, infants with hearing are learning to process speech and understand language and are quite linguistically sophisticated by 1 year of age. At this same time, the neurons in the auditory brain stem are maturing, and billions of major neural connections are being formed. During this time, the auditory brain stem and thalamus are just beginning to connect to the auditory cortex. When sensory input to the auditory nervous system is interrupted, especially during early development, the morphology and functional properties of neurons in the central auditory system can break down. In some instances, these deleterious effects of lack of sound input can be ameliorated by reintroduction of stimulation, but critical periods may exist for intervention. Hearing loss in newborn infants can go undetected until as late as 2 years of age without specialized testing. When hearing loss is detected in the newborn period, infants can benefit from amplification (hearing aids) and intervention to facilitate speech and language development. All evidence regarding neural development supports such early intervention for maximum development of communication ability and hearing in infants.

Effects of loop diuretics on the suppression tuning of distortion-product otoacoustic emissions in rabbits

The suppression tuning of distortion-product otoacoustic emissions (DPOAEs) is commonly assumed to measure frequency selectivity, because the dominant features of suppression-tuning curves (STCs) are similar to the principal properties of the neural-tuning curves (NTCs) of single auditory-nerve fibers. In the present study, several common loop diuretics were used to affect the DPOAE-generation process to determine if reversible ototoxicity could adversely modify the characteristics of STCs, in a manner similar to that shown previously for NTCs. Contour plots of DPOAE level in the presence of a series of variable-level suppressor tones were obtained before and after administering diuretic drugs that reversibly reduced or eliminated DPOAEs. Primary-tone pairs were centered at 2.8 or 4 kHz, with L1 = L2, or L2 < L1. From the resulting plots, STC parameters including tip frequency, threshold at the tip frequency, and Q10 dB measures of tuning were extracted for four suppression criteria of 3, 6, 9, and 12 dB. In the pre-drug nonototoxic state, suppression tuning depended on both primary-tone level (L1, L2), and the relative levels of the primaries (L1-L2), with tuning being sharper for lower- than for higher-level equilevel primaries, and sharpest for offset-level primary tones. Following drug injection, the expected decrease in sharpness of tuning evidenced by changes in Q10 dB as well as the dramatically elevated tip thresholds normally seen for NTCs under similar conditions, were not observed. Overall, Q10 dB increased or decreased more or less randomly, with a slight tendency for STCs to become sharper than prior to drug dosing, for the two highest suppression criteria. The STC-tip frequencies demonstrated significant decreases following diuretic administration that were weakly correlated with the associated decreases in DPOAE amplitude. The most consistent changes in response to the drug-induced reduction in DPOAE level were increases in the STC-tip thresholds. However, these changes were relatively small and rarely exceeded 10 dB. In the absence of notable changes in overall STC shape, a major finding was a change in the effectiveness of suppression following ototoxic insult. However, when the amount of suppression was expressed as a percentage of the DPOAE remaining, the effects of diuretic dosing were often almost completely obscured. Overall, the results demonstrated that when the generation of DPOAEs was interfered with by the introduction of a suppressor tone to produce STCs that resemble NTCs, STCs behaved quite differently following reversible cochlear insult than their previously documented neural counterparts. These findings imply that STCs do not assess the frequency-selective aspects of the cochlear amplification process in a manner similar to NTCs.

Identification of noise sources that influence distortion product otoacoustic emission measurements in human neonates

OBJECTIVE

The objective of this study was to identify individual sources of noise and their contribution to the overall noise that influences valid measurement of otoacoustic emissions in neonates. The hypothesis was that careful selection of eliciting signals and signal processing parameters, unique analysis of measured results, and control of certain subject characteristics would allow isolation of these individual noise sources and determine their relative influence.

DESIGN

Eliciting signal parameters were optimized and held constant to minimize equipment noise. Analysis of noise floors in relation to signal level was used to identify equipment-related noise associated with changes in signal parameters. Analysis of noise floor distributions was used to determine whether environmental noise entered the measurements via inadequate coupling of the probe to the ear. The acoustic characteristics of the middle ear were varied via subject selection to determine the influence of middle-ear characteristics on noise floor levels.

RESULTS

The two sources of noise associated with the measurement equipment need not contribute to the noise floor for biologically relevant otoacoustic emissions measurements (eliciting signal levels between 30 and 75 dB SPL). Of the two pathways identified for environmental noise, the pathway resulting from an inadequate seal between the probe and the ear canal can be eliminated. One of the two sources of noise related to the subject, noise resulting from biologic activity unrelated to the ear can be minimized. However, the remaining factor, the status of the middle ear, has been shown to contribute as much as 6 dB to the overall noise floor.

CONCLUSIONS

Careful selection of signal parameters and additional data analyses and procedural variables can isolate or control several sources of noise that influence distortion product otoacoustic emission measurements in neonates. Tight coupling between the probe unit and the external ear canal should be maintained for all measurements. Middle ear abnormalities can increase noise floors up to 6 dB.

A developmental study of distortion product otoacoustic emission (2f1-f2) suppression in humans

Suppression of the 2f1-f2 distortion product otoacoustic emission (DPOAE) provides an effective paradigm for the study of functional cochlear maturation in humans. DPOAE iso-suppression tuning curves (STCs) represent some aspect of peripheral filtering, probably related to the boundaries of distortion generation. Studies conducted thus far suggest that the cochlear tuning assessed by this technique is adult-like in humans by term birth (Abdala et al., Hear. Res. 98 (1996) 38-53; Abdala and Sininger, Ear Hear. 17 (1996) 374-385). However, there have been no studies of cochlear tuning in premature human neonates. DPOAE STCs and suppression growth functions were measured from 14 normal-hearing adults, 33 term and 85 premature neonates to investigate the developmental time course of cochlear frequency resolution and non-linearity. Premature neonates showed non-adult-like DPOAE suppression at f2 of 1500 and 6000 Hz: (1) STCs were narrower in width (Q10) and steeper in slope on the low-frequency flank of the tuning curve; (2) suppressor tones lower in frequency than f2 produced atypically shallow growth of DPOAE suppression. The influence of immature conductive pathways cannot be entirely ruled out as a factor contributing to these results. However, findings may indicate that an immaturity exists in cochlear frequency resolution and non-linearity just prior to term birth. The bases of this immaturity are hypothesized to be outer hair cell in origin.