Wideband Absorbance and 226-Hz Tympanometry in the Prediction of Optimal Distortion Product Otoacoustic Emission Primary Tone Levels Purpose Distortion product otoacoustic emission (DPOAE) amplitude is sensitive to the primary tone level separation effective within the cochlea. Despite potential for middle ear sound transmission characteristics to affect this separation, no primary tone level optimization formula accounts for its influence. This study was conducted to determine if inclusion of ... Research Article
Newly Published
Research Article  |   October 31, 2018
Wideband Absorbance and 226-Hz Tympanometry in the Prediction of Optimal Distortion Product Otoacoustic Emission Primary Tone Levels
 
Author Affiliations & Notes
  • Steven C. Marcrum
    Department of Otolaryngology, University Hospital Regensburg, Germany
  • Thomas Steffens
    Department of Otolaryngology, University Hospital Regensburg, Germany
  • Florian Zeman
    Center for Clinical Studies, University Hospital Regensburg, Germany
  • Peter Kummer
    Department of Otolaryngology, University Hospital Regensburg, Germany
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Steven C. Marcrum: steven.marcrum@ukr.de
  • Editor-in-Chief: Sumitrajit (Sumit) Dhar
    Editor-in-Chief: Sumitrajit (Sumit) Dhar×
  • Editor: Kathy Vander Werff
    Editor: Kathy Vander Werff×
Article Information
Hearing Disorders / Newly Published / Research Article
Research Article   |   October 31, 2018
Wideband Absorbance and 226-Hz Tympanometry in the Prediction of Optimal Distortion Product Otoacoustic Emission Primary Tone Levels
American Journal of Audiology, Newly Published. doi:10.1044/2018_AJA-18-0069
History: Received April 19, 2018 , Revised June 6, 2018 , Accepted July 10, 2018
 
American Journal of Audiology, Newly Published. doi:10.1044/2018_AJA-18-0069
History: Received April 19, 2018; Revised June 6, 2018; Accepted July 10, 2018

Purpose Distortion product otoacoustic emission (DPOAE) amplitude is sensitive to the primary tone level separation effective within the cochlea. Despite potential for middle ear sound transmission characteristics to affect this separation, no primary tone level optimization formula accounts for its influence. This study was conducted to determine if inclusion of ear- and frequency-specific immittance features improves primary tone level optimization formula performance beyond that achieved using a univariate, L 2-based formula.

Method For 30 adults with normal hearing, DPOAE, wideband absorbance, and 226-Hz tympanometry measures were completed. A mixed linear modeling technique, incorporating both primary tone and acoustic immittance features, was used to generate a multivariable formula for the middle ear–specific recommendation of primary tone level separations for f 2 = 1–6 kHz. The accuracy with which L 1OPT, or the L 1 observed to maximize DPOAE level for each given L 2, could be predicted using the multivariable formula was then compared with that of a traditional, L 2-based univariate formula for each individual ear.

Results Use of the multivariable formula L 1 = 0.47L 2 + 2.40A + f 2param + 38 [dB SPL] resulted in significantly more accurate L 1OPT predictions than did the univariate formula L 1 = 0.49L 2 + 41 [dB SPL]. Although average improvement was small, meaningful improvements were identified within individual ears, especially for f 2 = 1 and 6 kHz.

Conclusion Incorporation of a wideband absorbance measure into a primary tone level optimization formula resulted in a minor average improvement in L 1OPT prediction accuracy when compared with a traditional univariate optimization formula. Further research is needed to identify characteristics of ears that might disproportionately benefit from the additional measure.

Acknowledgments
The authors thank Christoph Kreitmayer for his data collection efforts. An earlier version of this work appeared in the doctoral dissertation of the lead author: Marcrum, S. C. (2017). Optimal primary tone levels in distortion product otoacoustic emissions and the role of middle ear transmission (Doctoral dissertation). Technical University of Munich, Munich.
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