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Otoacoustic Emissions. Low-level sounds produced by the cochlea and recordable in the external ear canal. Spontaneous Click-evoked Distortion Product Stimulus Frequency. History. First described by Kemp (1977 & 1978), But predicted by Gold (1948!)
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Otoacoustic Emissions • Low-level sounds produced by the cochlea and recordable in the external ear canal. • Spontaneous • Click-evoked • Distortion Product • Stimulus Frequency
History • First described by Kemp (1977 & 1978), • But predicted by Gold (1948!) • Supported by almost simultaneous discovery of OHC motility • Movement into Clinical Use: • Screening for hearing loss • Role in Audiologic Battery
Anatomy and Physiology • Generators = Outer Hair Cells • “Pre-neural” • Low-level event//High level stimuli produce their own distortions • Reduction/Loss of emission in NITTS • SOAEs correlated to number of rows of OHCs
Energy Path: • “Reverse Traveling Wave” is debated • Through Middle Ear: Filtering and attenuation • Into ear canal Note: requirement of healthy middle ear and clear outer ear.
Clinical Utility -- Neonatal Hearing Screening • Transient and Distortion-Product OAEs • Rationale: quick, relatively inexpensive, possibly catching losses in a broader frequency range than ABR • NIH (1994) recommended two-stage protocol combining OAEs and ABR
Clinical Utility-- in the Audiologic Battery • Assessment of cochlear health in site-of lesion testing • Objective info on peripheral auditory functioning • Correlation to audiogram • Assessment of Auditory Efferents through Contralateral Suppression
Spectrum of Sound in Ear Canal Stimulus Tones Emission Frequency Background Noise
Caveats--Remember: • there is more to “Hearing” than a healthy cochlea • what lies between your equipment and the source? • high level stimuli evoke response from inanimate cavities (e.g. in cadavers)