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David J. Arnold, MD; Brenda L. Lonsbury-Martin, PhD; Glen K. Martin, PhD

Arch Otolaryngol Head Neck Surg. 1999;125:215-222.

Objectives  The primary goal of this study was to test the ability of 2f₁-f₂ distortion-product otoacoustic emissions (DPOAEs) to detect reduced cochlear function in the presence of normal behavioral sensitivity.

Design  A prospective study was performed in normal-hearing young adults using simple and complex regression analyses to clarify the relationship between ultrahigh frequency (UHF) hearing and DPOAE levels at lower frequencies, as well as the influence of hearing levels for frequencies within the conventional test range and subject age on this association.

Methods  Average DPOAE levels between 4 to 8 kHz, which were elicited by equilevel primary tones of low to moderate levels, were measured as level-frequency functions, or distortion-product (DP) grams, and related to the mean UHF hearing levels from 11.2 to 20 kHz. The median hearing level for the UHF hearing was used to separate subjects into good and poor UHF hearers. This distinction was then used to compare DPOAE levels from 4 to 8 kHz for the 2 groups to determine if UHF hearing status influenced DPOAE levels at lower frequencies.

Results  Simple regression analysis revealed that the 4- to 8-kHz DPOAE levels were significantly correlated with the pure-tone average (PTA) from 11.2 to 20 kHz. However, the PTA for 4 and 8 kHz was also significantly correlated with the PTA for UHF hearing. Further multiple regression analyses revealed that UHF hearing significantly and uniquely accounted for approximately 14% of the variance in DPOAE levels from 4 to 8 kHz for most of the primary-tone level combinations. In contrast, neither the PTA for the conventional hearing range nor subject age contributed significantly to the DPOAE variance.

Conclusions  The findings suggest that UHF hearing influences DPOAEs at significantly lower frequencies because emissions are sensitive to subtle changes in outer hair cells not yet detected by pure-tone thresholds in this region or because alterations in the basal cochlea affect the generation of lower-frequency DPOAEs originating from more apical cochlear regions.

From the Department of Otolaryngology, University of Miami Ear Institute, Miami, Fla.

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