Detection of Hearing Loss Using 2f2-f1 and 2f1-f2 Distortion-Product Otoacoustic Emissions Although many distortion-product otoacoustic emissions (DPOAEs) may be measured in the ear canal in response to 2 pure tone stimuli, the majority of clinical studies have focused exclusively on the DPOAE at the frequency 2f1-f2. This study investigated another DPOAE, 2f2-f1, in an attempt to determine the following: (a) the ... Research Article
Research Article  |   October 01, 2005
Detection of Hearing Loss Using 2f2-f1 and 2f1-f2 Distortion-Product Otoacoustic Emissions
 
Author Affiliations & Notes
  • Tracy S. Fitzgerald
    Syracuse University, Syracuse, NY
  • Beth A. Prieve
    Syracuse University, Syracuse, NY
Article Information
Hearing Disorders / Hearing / Research Articles
Research Article   |   October 01, 2005
Detection of Hearing Loss Using 2f2-f1 and 2f1-f2 Distortion-Product Otoacoustic Emissions
Journal of Speech, Language, and Hearing Research, October 2005, Vol. 48, 1165-1186. doi:10.1044/1092-4388(2005/082)
History: Received March 22, 2004 , Revised September 20, 2004 , Accepted February 15, 2005
 
Journal of Speech, Language, and Hearing Research, October 2005, Vol. 48, 1165-1186. doi:10.1044/1092-4388(2005/082)
History: Received March 22, 2004; Revised September 20, 2004; Accepted February 15, 2005
Web of Science® Times Cited: 8

Although many distortion-product otoacoustic emissions (DPOAEs) may be measured in the ear canal in response to 2 pure tone stimuli, the majority of clinical studies have focused exclusively on the DPOAE at the frequency 2f1-f2. This study investigated another DPOAE, 2f2-f1, in an attempt to determine the following: (a) the optimal stimulus parameters for its clinical measurement and (b) its utility in differentiating between normal-hearing and hearing-impaired ears at low-to-mid frequencies (≤2000 Hz) when measured either alone or in conjunction with the 2f1-f2 DPOAE. Two experiments were conducted. In Experiment 1, the effects of primary level, level separation, and frequency separation (f2/f1) on 2f2-f1 DPOAE level were evaluated in normal-hearing ears for low-to-mid f2 frequencies (700–2000 Hz). Moderately high-level primaries (60–70 dB SPL) presented at equal levels or with f2 slightly higher than f1 produced the highest 2f2-f1 DPOAE levels. When the f2/f1 ratio that produced the highest 2f2-f1 DPOAE levels was examined across participants, the mean optimal f2/f1 ratio across f2 frequencies and primary level separations was 1.08. In Experiment 2, the accuracy with which DPOAE level or signal-to-noise ratio identified hearing status at the f2 frequency as normal or impaired was evaluated using clinical decision analysis. The 2f2-f1 and 2f1-f2 DPOAEs were measured from both normal-hearing and hearing-impaired ears using 2 sets of stimulus parameters: (a) the traditional parameters for measuring the 2f1-f2 DPOAE (f2/f1 = 1.22; L1, L2 = 65, 55 dB SPL) and (b) the new parameters that were deemed optimal for the 2f2-f1 DPOAE in Experiment 1 (f2/f1 = 1.073, L1 and L2 = 65 dB SPL). Identification of hearing status using 2f2-f1 DPOAE level and signal-to-noise ratio was more accurate when the new stimulus parameters were used compared with the results achieved when the 2f2-f1 DPOAE was recorded using the traditional parameters. However, identification of hearing status was less accurate for the 2f2-f1 DPOAE measured using the new parameters than for the 2f1-f2 DPOAE measured using the traditional parameters. No statistically significant improvements in test performance were achieved when the information from the 2 DPOAEs was combined, either by summing the DPOAE levels or by using logistic regression analysis.

Acknowledgments
This article is based on the first author’s doctoral dissertation, submitted to Syracuse University. This project was supported by the 1999 Student Research Grant in Audiology from the American Speech-Language-Hearing Foundation and by National Institutes of Health Grant DC00380. Portions of this study were presented at the 24th and 25th Midwinter Meetings of the Association for Research in Otolaryngology. We gratefully acknowledge Karen Doherty, Evan Relkin, Jill Kanaley, and Lori Ploutz-Snyder for their helpful comments on earlier versions of this article. Additional thanks are extended to Cynthia Hogan and the Department of Audiology at Strong Memorial Hospital in Rochester, NY, for their assistance in participant recruitment; to Patricia Dorn and Paige Muellerleile for their assistance with statistical analyses; and to Charles Metz for the use of the ROCKIT software. We extend special thanks to the participants for their commitment to the project.
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