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Samaras G, Wen H, Meaud J. Broad nonlinearity in reticular lamina vibrations requires compliant organ of Corti structures. Biophys J 2023; 122:880-891. [PMID: 36709411 PMCID: PMC10027437 DOI: 10.1016/j.bpj.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
In the mammalian cochlea, each longitudinal position of the basilar membrane (BM) has a nonlinear vibratory response in a limited frequency range around the location-dependent frequency of maximum response, known as the best frequency (BF). This nonlinear response arises from the electromechanical feedback from outer hair cells (OHCs). However, recent in vivo measurements have demonstrated that the mechanical response of other organ of Corti (OoC) structures, such as the reticular lamina (RL), and the electrical response of OHCs (measured in the local cochlear microphonic [LCM]) are nonlinear even at frequencies significantly below BF. In this work, a physiologically motivated model of the gerbil cochlea is used to demonstrate that the source of this discrepancy between the frequency range of the BM, RL, and LCM nonlinearities is greater compliance in the structures at the top of the OHCs. The predicted responses of the BM, RL, and LCM to pure tone and two-tone stimuli are shown to be in line with experimental evidence. Simulations then demonstrate that the sub-BF nonlinearity in the RL requires the structures at the top of the OHCs to be significantly more compliant than the BM. This same condition is also necessary for "optimal" gain near BF, i.e., high amplification that is in line with the experiment. This demonstrates that the conditions for OHCs to operate optimally at BF inevitably yield nonlinearity of the RL response over a broad frequency range.
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Affiliation(s)
- George Samaras
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Haiqi Wen
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Julien Meaud
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia; Petit Institute for Biosciences and Bioengineering, Georgia Institute of Technology, Atlanta, Georgia.
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2
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Saremi A, Stenfelt S. The effects of noise-induced hair cell lesions on cochlear electromechanical responses: A computational approach using a biophysical model. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3582. [PMID: 35150464 PMCID: PMC9286811 DOI: 10.1002/cnm.3582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
A biophysically inspired signal processing model of the human cochlea is deployed to simulate the effects of specific noise-induced inner hair cell (IHC) and outer hair cell (OHC) lesions on hearing thresholds, cochlear compression, and the spectral and temporal features of the auditory nerve (AN) coding. The model predictions were evaluated by comparison with corresponding data from animal studies as well as human clinical observations. The hearing thresholds were simulated for specific OHC and IHC damages and the cochlear nonlinearity was assessed at 0.5 and 4 kHz. The tuning curves were estimated at 1 kHz and the contributions of the OHC and IHC pathologies to the tuning curve were distinguished by the model. Furthermore, the phase locking of AN spikes were simulated in quiet and in presence of noise. The model predicts that the phase locking drastically deteriorates in noise indicating the disturbing effect of background noise on the temporal coding in case of hearing impairment. Moreover, the paper presents an example wherein the model is inversely configured for diagnostic purposes using a machine learning optimization technique (Nelder-Mead method). Accordingly, the model finds a specific pattern of OHC lesions that gives the audiometric hearing loss measured in a group of noise-induced hearing impaired humans.
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Affiliation(s)
- Amin Saremi
- Department of Applied Physics and ElectronicsUmeå UniversityUmeåSweden
| | - Stefan Stenfelt
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
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Wen H, Meaud J. Link between stimulus otoacoustic emissions fine structure peaks and standing wave resonances in a cochlear model. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:1875. [PMID: 35364913 PMCID: PMC8934193 DOI: 10.1121/10.0009839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
In response to an external stimulus, the cochlea emits sounds, called stimulus frequency otoacoustic emissions (SFOAEs), at the stimulus frequency. In this article, a three-dimensional computational model of the gerbil cochlea is used to simulate SFOAEs and clarify their generation mechanisms and characteristics. This model includes electromechanical feedback from outer hair cells (OHCs) and cochlear roughness due to spatially random inhomogeneities in the OHC properties. As in the experiments, SFOAE simulations are characterized by a quasiperiodic fine structure and a fast varying phase. Increasing the sound pressure level broadens the peaks and decreases the phase-gradient delay of SFOAEs. A state-space formulation of the model provides a theoretical framework to analyze the link between the fine structure and global modes of the cochlea, which arise as a result of standing wave resonances. The SFOAE fine structure peaks correspond to weakly damped resonant modes because they are observed at the frequencies of nearly unstable modes of the model. Variations of the model parameters that affect the reflection mechanism show that the magnitude and sharpness of the tuning of these peaks are correlated with the modal damping ratio of the nearly unstable modes. The analysis of the model predictions demonstrates that SFOAEs originate from the peak of the traveling wave.
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Affiliation(s)
- Haiqi Wen
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive, Atlanta, Georgia 30332, USA
| | - Julien Meaud
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive, Atlanta, Georgia 30332, USA
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Bowling T, Wen H, Meenderink SWF, Dong W, Meaud J. Intracochlear distortion products are broadly generated by outer hair cells but their contributions to otoacoustic emissions are spatially restricted. Sci Rep 2021; 11:13651. [PMID: 34211051 PMCID: PMC8249639 DOI: 10.1038/s41598-021-93099-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023] Open
Abstract
Detection of low-level sounds by the mammalian cochlea requires electromechanical feedback from outer hair cells (OHCs). This feedback arises due to the electromotile response of OHCs, which is driven by the modulation of their receptor potential caused by the stimulation of mechano-sensitive ion channels. Nonlinearity in these channels distorts impinging sounds, creating distortion-products that are detectable in the ear canal as distortion-product otoacoustic emissions (DPOAEs). Ongoing efforts aim to develop DPOAEs, which reflects the ear's health, into diagnostic tools for sensory hearing loss. These efforts are hampered by limited knowledge on the cochlear extent contributing to DPOAEs. Here, we report on intracochlear distortion products (IDPs) in OHC electrical responses and intracochlear fluid pressures. Experiments and simulations with a physiologically motivated cochlear model show that widely generated electrical IDPs lead to mechanical vibrations in a frequency-dependent manner. The local cochlear impedance restricts the region from which IDPs contribute to DPOAEs at low to moderate intensity, which suggests that DPOAEs may be used clinically to provide location-specific information about cochlear damage.
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Affiliation(s)
- Thomas Bowling
- grid.213917.f0000 0001 2097 4943GWW School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA USA
| | - Haiqi Wen
- grid.213917.f0000 0001 2097 4943GWW School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA USA
| | - Sebastiaan W. F. Meenderink
- grid.422066.40000 0001 2195 7301VA Loma Linda Healthcare System, Loma Linda, CA 92357 USA ,grid.429814.2Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA 92350 USA
| | - Wei Dong
- grid.422066.40000 0001 2195 7301VA Loma Linda Healthcare System, Loma Linda, CA 92357 USA ,grid.429814.2Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA 92350 USA
| | - Julien Meaud
- grid.213917.f0000 0001 2097 4943GWW School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Petit Institute for Biosciences and Bioengineering, Georgia Institute of Technology, Atlanta, GA USA
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Bowling T, Lemons C, Meaud J. Reducing tectorial membrane viscoelasticity enhances spontaneous otoacoustic emissions and compromises the detection of low level sound. Sci Rep 2019; 9:7494. [PMID: 31097743 PMCID: PMC6522542 DOI: 10.1038/s41598-019-43970-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/02/2019] [Indexed: 01/08/2023] Open
Abstract
The mammalian cochlea is able to detect faint sounds due to the presence of an active nonlinear feedback mechanism that boosts cochlear vibrations of low amplitude. Because of this feedback, self-sustained oscillations called spontaneous otoacoustic emissions (SOAEs) can often be measured in the ear canal. Recent experiments in genetically modified mice have demonstrated that mutations of the genes expressed in the tectorial membrane (TM), an extracellular matrix located in the cochlea, can significantly enhance the generation of SOAEs. Multiple untested mechanisms have been proposed to explain these unexpected results. In this work, a physiologically motivated computational model of a mammalian species commonly studied in auditory research, the gerbil, is used to demonstrate that altering the viscoelastic properties of the TM tends to affect the linear stability of the cochlea, SOAE generation and the cochlear response to low amplitude stimuli. These results suggest that changes in TM properties might be the underlying cause for SOAE enhancement in some mutant mice. Furthermore, these theoretical findings imply that the TM contributes to keeping the mammalian cochlea near an oscillatory instability, which promotes high sensitivity and the detection of low level stimuli.
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Affiliation(s)
- Thomas Bowling
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive NW, Atlanta, Georgia, 30332, USA
| | - Charlsie Lemons
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive NW, Atlanta, Georgia, 30332, USA
| | - Julien Meaud
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive NW, Atlanta, Georgia, 30332, USA. .,Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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Probing hair cell's mechano-transduction using two-tone suppression measurements. Sci Rep 2019; 9:4626. [PMID: 30874606 PMCID: PMC6420497 DOI: 10.1038/s41598-019-41112-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/01/2019] [Indexed: 11/27/2022] Open
Abstract
When two sound tones are delivered to the cochlea simultaneously, they interact with each other in a suppressive way, a phenomenon referred to as two-tone suppression (2TS). This nonlinear response is ascribed to the saturation of the outer hair cell’s mechano-transduction. Thus, 2TS can be used as a non-invasive probe to investigate the fundamental properties of cochlear mechano-transduction. We developed a nonlinear cochlear model in the time domain to interpret 2TS data. The multi-scale model incorporates cochlear fluid dynamics, organ of Corti (OoC) mechanics and outer hair cell electrophysiology. The model simulations of 2TS show that the threshold amplitudes and rates of low-side suppression are dependent on mechano-transduction properties. By comparing model responses to existing 2TS measurement data, we estimate intrinsic characteristics of mechano-transduction such as sensitivity and adaptation. For mechano-transduction sensitivity at the basal location (characteristic frequency of 17 kHz) at 0.06 nm−1, the simulation results agree with 2TS measurements of basilar membrane responses. This estimate is an order of magnitude higher than the values observed in experiments on isolated outer hair cells. The model also demonstrates how the outer hair cell’s adaptation alters the temporal pattern of 2TS by modulating mechano-electrical gain and phase.
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Bowling T, Meaud J. Forward and Reverse Waves: Modeling Distortion Products in the Intracochlear Fluid Pressure. Biophys J 2019; 114:747-757. [PMID: 29414719 DOI: 10.1016/j.bpj.2017.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/06/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022] Open
Abstract
Distortion product otoacoustic emissions are sounds that are emitted by the cochlea due to the nonlinearity of the outer hair cells. These emissions play an important role both in clinical settings and research laboratories. However, how distortion products propagate from their generation location to the middle ear remains unclear; whether distortion products propagate as a slow reverse traveling wave, or as a fast compression wave, through the cochlear fluid has been debated. In this article, we evaluate the contributions of the slow reverse wave and fast compression wave to the propagation of intracochlear distortion products using a physiologically based nonlinear model of the gerbil cochlea. This model includes a 3D two-duct model of the intracochlear fluid and a realistic model of outer hair cell biophysics. Simulations of the distortion products in the cochlear fluid pressure in response to a two-tone stimulus are compared with published in vivo experimental results. Whereas experiments have characterized distortion products at a limited number of locations, this model provides a complete description of the fluid pressure at all locations in the cochlear ducts. As in experiments, the spatial variations of the distortion products in the fluid pressure have some similarities with what is observed in response to a pure tone. Analysis of the fluid pressure demonstrates that although a fast wave component is generated, the slow wave component dominates the response. Decomposition of the model simulations into forward and reverse wave components shows that a slow forward propagating wave is generated due to the reflection of the slow reverse wave at the stapes. Wave interference between the reverse and forward components sometimes complicates the analysis of distortion products propagation using measurements at a few locations.
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Affiliation(s)
- Thomas Bowling
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Julien Meaud
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia; Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia.
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Bell A, Wit HP. Cochlear impulse responses resolved into sets of gammatones: the case for beating of closely spaced local resonances. PeerJ 2018; 6:e6016. [PMID: 30515362 PMCID: PMC6266938 DOI: 10.7717/peerj.6016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/27/2018] [Indexed: 02/05/2023] Open
Abstract
Gammatones have had a long history in auditory studies, and recent theoretical work suggests they may play an important role in cochlear mechanics as well. Following this lead, the present paper takes five examples of basilar membrane impulse responses and uses a curve-fitting algorithm to decompose them into a number of discrete gammatones. The limits of this ‘sum of gammatones’ (SOG) method to accurately represent the impulse response waveforms were tested and it was found that at least two and up to six gammatones could be isolated from each example. Their frequencies were stable and largely independent of stimulus parameters. The gammatones typically formed a regular series in which the frequency ratio between successive members was about 1.1. Adding together the first few gammatones in a set produced beating-like waveforms which mimicked waxing and waning, and the instantaneous frequencies of the waveforms were also well reproduced, providing an explanation for frequency glides. Consideration was also given to the impulse response of a pair of elastically coupled masses—the basis of two-degree-of-freedom models comprised of coupled basilar and tectorial membranes—and the resulting waveform was similar to a pair of beating gammatones, perhaps explaining why the SOG method seems to work well in describing cochlear impulse responses. A major limitation of the SOG method is that it cannot distinguish a waveform resulting from an actual physical resonance from one derived from overfitting, but taken together the method points to the presence of a series of closely spaced local resonances in the cochlea.
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Affiliation(s)
- Andrew Bell
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Hero P Wit
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, Groningen, Netherlands
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Wen H, Bowling T, Meaud J. Investigation of the 2f 1-f 2 and 2f 2-f 1 distortion product otoacoustic emissions using a computational model of the gerbil ear. Hear Res 2018; 365:127-140. [PMID: 29801982 DOI: 10.1016/j.heares.2018.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/07/2018] [Accepted: 05/16/2018] [Indexed: 11/25/2022]
Abstract
In this work, a three-dimensional computational model of the gerbil ear is used to investigate the generation of the 2f1-f2 and 2f2-f1 distortion product otoacoustic emissions (DPOAEs). In order to predict both the distortion and reflection sources, cochlear roughness is modeled by introducing random inhomogeneities in the outer hair cell properties. The model was used to simulate the generation of DPOAEs in response to a two-tone stimulus for various primary stimulus levels and frequency ratios. As in published experiments, the 2f1-f2 DPOAEs are mostly dominated by the distortion component while the 2f2-f1 DPOAEs are dominated by the reflection component; furthermore, the influence of the levels and frequency ratio of the primaries are consistent with measurements. Analysis of the intracochlear response shows that the distortion component has the highest magnitude at all longitudinal locations for the 2f1-f2 distortion product (DP) while the distortion component only dominates close to the DP best place in the case of the 2f2-f1 DP. Decomposition of the intracochlear DPs into forward and reverse waves demonstrates that the 2f1-f2 DP generates reverse waves for both the distortion and reflection components; however, a reverse wave is only generated for the reflection component in the case of the 2f2-f1 DP. As in experiments in the gerbil, the group delay of the reflection component of the DPOAE is between 1× and 2× the forward group delay, which is consistent with the propagation of DP towards the stapes as slow reverse waves.
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Affiliation(s)
- Haiqi Wen
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Thomas Bowling
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Julien Meaud
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, USA; Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, USA.
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Lemons C, Meaud J. Middle-ear function in the chinchilla: Circuit models and comparison with other mammalian species. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:2735. [PMID: 27794345 DOI: 10.1121/1.4964707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The middle ear efficiently transmits sound from the ear canal into the inner ear through a broad range of frequencies. Thus, understanding middle-ear transmission characteristics is essential in the study of hearing mechanics. Two models of the chinchilla middle ear are presented. In the first model, the middle ear is modeled as a lumped parameter system with elements that represent the ossicular chain and the middle-ear cavity. Parameters of this model are fit using available experimental data of two-port transmission matrix parameters. In an effort to improve agreement between model simulations and the phase of published experimental measurements for the forward pressure transfer function at high frequencies, a second model in which a lossless transmission line model of the tympanic membrane is appended to the original model is proposed. Two-port transmission matrix parameter results from this second model were compared with results from previously developed models of the guinea pig, cat, and human middle ears. Model results and published experimental data for the two-port transmission matrix parameters are found to be qualitatively similar between species. Quantitative differences in the two-port transmission matrix parameters suggest that the ossicular chains of chinchillas, cats, and guinea pigs are less flexible than in humans.
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Affiliation(s)
- Charlsie Lemons
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive, Atlanta, Georgia 30332, USA
| | - Julien Meaud
- G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, 771 Ferst Drive, Atlanta, Georgia 30332, USA
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The Coda of the Transient Response in a Sensitive Cochlea: A Computational Modeling Study. PLoS Comput Biol 2016; 12:e1005015. [PMID: 27380177 PMCID: PMC4933343 DOI: 10.1371/journal.pcbi.1005015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
In a sensitive cochlea, the basilar membrane response to transient excitation of any kind–normal acoustic or artificial intracochlear excitation–consists of not only a primary impulse but also a coda of delayed secondary responses with varying amplitudes but similar spectral content around the characteristic frequency of the measurement location. The coda, sometimes referred to as echoes or ringing, has been described as a form of local, short term memory which may influence the ability of the auditory system to detect gaps in an acoustic stimulus such as speech. Depending on the individual cochlea, the temporal gap between the primary impulse and the following coda ranges from once to thrice the group delay of the primary impulse (the group delay of the primary impulse is on the order of a few hundred microseconds). The coda is physiologically vulnerable, disappearing when the cochlea is compromised even slightly. The multicomponent sensitive response is not yet completely understood. We use a physiologically-based, mathematical model to investigate (i) the generation of the primary impulse response and the dependence of the group delay on the various stimulation methods, (ii) the effect of spatial perturbations in the properties of mechanically sensitive ion channels on the generation and separation of delayed secondary responses. The model suggests that the presence of the secondary responses depends on the wavenumber content of a perturbation and the activity level of the cochlea. In addition, the model shows that the varying temporal gaps between adjacent coda seen in experiments depend on the individual profiles of perturbations. Implications for non-invasive cochlear diagnosis are also discussed. The fluid-structure-electrical interaction in the cochlea enable the basilar membrane, one of the most important structures in the cochlear partition, to display different dynamic patterns depending on the frequency content of the incoming sound. Interestingly, in a healthy cochlea the motion of the basilar membrane shows echoes upon an impulse acoustic stimulation delivered to the ear canal. The delay, duration, and shape of these echoes vary from one cochlea to another. A hypothesis that irregularities of the properties of the cochlear partition coherently scatter acoustic waves and generate echoes is examined. These irregularities are posited to arise, for example, the damage of the sensory cells or the natural randomness in the morphology of the cochlear partition. Here we build a physiologically-based mathematical model to understand the echoes observed in experiments by introducing irregularity to the properties of the sensory cells. We found that the patterns of the echoes depend on the individual profiles of the irregularities. Our work suggest that the ear canal recording, which is correlated to the dynamics of the basilar membrane, can be used as a non-invasive tool not only to diagnose the intracochlear damage but also to interpret these data given its idiosyncratic origin.
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