Wideband Transient Otoacoustic Emissions in Ears with Normal Hearing and Sensorineural Hearing Loss

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Otoacoustic emissions (OAEs) are generated in the cochlea in response to sound and are used clinically to separate ears with normal hearing from sensorineural hearing loss (SNHL). OAEs were elicited at ambient pressure by clicks (CEOAE) and wideband chirps (TEOAE) sweeping from low-to-high frequency with a sweep rate of either 187.6 Hz/ms (short chirps) or 58.2 Hz/ms (long chirps) and a bandwidth extending to 8 kHz. Chirps were presented at the same sound exposure level (SEL) as clicks, or + 6 dB relative to clicks. A total of 288 OAE waveforms were averaged for short chirps in ~1 minute compared to 120 waveforms for long chirps. Compared to clicks, the chirp has a lower crest factor, which allows it to be presented at an overall higher SEL without distortion. OAEs were elicited in 79 adults with normal hearing and 51 adults with mild-to-moderate SNHL. One-sixth octave OAE signal-to-noise ratios from 0.7 to 8.0 kHz were compared across stimulus types and conditions. The area under the receiver operating curve (AUC) was used to assess the accuracy of detecting SNHL. Average AUCs across 1/6th octave frequencies ranged from 0.90 to 0.89 for TEOAEs and were 0.87 for the CEOAE suggesting excellent test performance.