Comparison of the Transient Evoked Otoacoustic Emissions (TEOAEs) and Distortion Products Otoacoustic Emissions (DPOAEs) in Normal Hearing Subjects With and Without Tinnitus

Emadi, Maryam; Rezaei, Mohammad; Najafi, Sirvan; Faramarzi, Ali; Farahani, Farhad

doi:10.1007/s12070-015-0824-9

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…24 Cochlear affection is supported by the significant elevation of hearing threshold at all frequencies including the extended high frequencies, and the significant reduction of TEOAE amplitude in tinnitus patients, as evidenced in the current study and in literature. 8,16,25 Otoacoustic emissions originate from properly functioning outer hair cells. Thus, the presence of cochlear dysfunction will cause reduction or even absence of the otoacoustic emissions.…”

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confidence: 99%

Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in Subjects with Normal Hearing Sensitivity

Ibraheem

Hassaan

2016

Int Arch Otorhinolaryngol

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Introduction Cochlear or neural mechanisms of tinnitus generation may affect auditory temporal resolution in tinnitus patients even with normal audiometry. Thus, studying the correlation between tinnitus characteristics and auditory temporal resolution in subjects with tinnitus may help in proper modification of tinnitus management strategy. Objective This study aims to examine the relationship between the psychoacoustic measures of tinnitus and the auditory temporal resolution in subjects with normal audiometry. Methods Two normal hearing groups with ages ranging from 20 to 45 years were involved: control group of 15 adults (30 ears) without tinnitus and study group of 15 adults (24 ears) with tinnitus. Subjective scaling of annoyance and sleep disturbance caused by tinnitus, basic audiological evaluation, tinnitus psychoacoustic measures and Gaps in Noise test were performed. Data from both groups were compared using independent sample t-test. Psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group were correlated with Pearson's correlation coefficient. Results Significantly higher hearing threshold, higher approximate threshold and lower correct Gaps in Noise scores were observed in tinnitus ears. There was no significant correlation between psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group. Conclusion Auditory temporal resolution impairment was found in tinnitus patients, which could be attributed to cochlear impairment or altered neural firing within the auditory pathway. It is recommended to include temporal resolution testing in the tinnitus evaluation battery to provide a proper management planning.

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confidence: 99%

Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in Subjects with Normal Hearing Sensitivity

Ibraheem

Hassaan

2016

Int Arch Otorhinolaryngol

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“…In addition, due to the evaluation of the larger frequency spectrum, it is possible to examine the cochlear function from the basal (high frequencies) to the apical (low frequencies) [10]. There are several studies on DPOAE in people with tinnitus and normal hearing that have been performed in different ways such as pass/refer rates [11], normal/abnormal rates [12], DPOAE alteration [13,14], the slope of input/output function [15] and DPOAE amplitude in the frequency range of 1−8 kHz [16,17]. Past studies have reported significant differences in DPOAE parameters between patients with and without tinnitus when adjusted for their hearing thresholds up to 8 kHz [3,5,10].…”

Section: Introductionmentioning

confidence: 99%

Estimation of outer hair cells function in chronic bilateral tinnitus patients with normal hearing using distortion product otoacoustic emissions

Karimiani

Rouhbakhsh

Abdollahi

et al. 2021

AVR

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Background and Aim: It is not clear if the measurement of distortion product otoacoustic emissions (DPOAE) at frequencies above 8 kHz adds any value in determining the differences in the cochlear function between patients with and without tinnitus. This study aimed to compare DPOAE in the frequency range of 0.5−10 kHz in patients with normal hearing with and without tinnitus. Methods: This comparative cross-sectional study was conducted on 20 individuals with tinnitus and normal hearing as a study group (SG) and a control group (CG) of 20 normal-hearing individuals without tinnitus. The DPOAE was measured with F1/F2 = 1.22 and intensities of F1 = 65 dB SPL and F2 =55 dB SPL in the frequency range of 0.5−10 kHz, moreover in the frequency of tinnitus in SG and corresponding frequency in CG. Results: DPOAE level at 10 kHz did not differ significantly between SG and CG (p = 0.491). However, the mean of overall DPOAE level, DPOAE level at the frequency of tinnitus, and F2 values of 2.5, 5, and 6.298 kHz were significantly lower in SG than CG (p < 0.05). Conclusion: Measurement of DPOAE at 10 kHz did not seem to add any value in determining the differences in the cochlear function between patients with and without tinnitus. However, decreased DPOAE levels at 2.5, 5, and 6.298 kHz which were observed among patients who have tinnitus and normal hearing, indicates some outer hair cells damage that was not detectable by conventional audiometry. Keywords: Tinnitus; normal hearing; outer hair cell; distortion product otoacoustic emission

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“…There are many studies that have tried to correlate the sound levels of distortion products with tinnitus characteristics. The results are very inhomogeneous and describe almost every possible scenario like no difference at all 83,84 , lower DP amplitudes in tinnitus patients 85,86,84,87 , hinting towards OHC dysfunction as a possible cause for tinnitus 88,89 or higher DP amplitudes in tinnitus patients theorized to be because of higher motility of the OHC´s 90,91 . In alignment with most studies describing "normal-hearing" the distinction was made using clinical audiometry without including frequencies above 8 kHz thus suffering the same inaccuracies as described in chapter 4.2., and thereby explaining the inhomogeneous results.…”

Section: Links Between Synaptopathy and Tinnitusmentioning

confidence: 90%

Tinnitus bei Normalgehör : Untersuchung von Hörschwellenfeinstruktur, otoakustischen Emissionen und Hörnervenpotenzialen

Kirchfeld

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Tinnitus is a symptom experienced by most people at least once in their lifetime. In most documented cases, a new onset of chronic tinnitus can be chronologically correlated with hearing loss. However, tinnitus can also occur in people with (apparently) normal hearing and remains without a traceable preceding cause. Despite the frequency of occurrence of tinnitus, the pathophysiological mechanisms are still not fully understood. A currently proposed hypothesis focuses on a "hidden" hearing loss called synaptopathy as a pathomechanism of tinnitus in normal hearing subjects. In the present study, the objective was to test whether finestructure audiometry or measurement of otoacoustic emissions can reveal possibly overlooked hearing impairment in presumed normalhearing individuals with chronic tinnitus. Thus, a hearing loss not audiologically detectable by the usual methods would supplement or replace the presumed synaptopathic pathomechanism. Another objective was to attempt to replicate the existing findings of another research group on synaptopathy as cause for tinnitus in normal hearing people. Schaette and McAlpine (2011) were able to demonstrate a significant difference in wave I amplitudes between groups of normal hearing subjects with and without chronic tinnitus by deriving clickevoked auditory brainstem potentials, thus supporting the hypothesis of synaptopathy18. For the present study, a cohort of normal-hearing subjects consisting of a group of tinnitus subjects (N = 15) and a control group (N = 14) was tested. Manual puretone audiometry with 11 test frequencies was conducted to determine hearing performance. Inclusion criteria were defined as air conducted hearing thresholds of 10 dB HL or lower. A deviation at a test frequency of 15 dB HL or less was tolerated. Data of tinnitus characteristics, such as pitch and intensity, were collected by presentation and matching of comparative tones, quality and subjective disturbance by questionnaire. Furthermore, data was obtained from both test groups by Békésy gliding frequency audiometry (794 test frequencies), as well as DPOAE measurement (36 test frequencies) and auditory brainstem response (ABR) audiometry (derivation of early auditory evoked potentials). The results showed a correlation of the determined tinnitus comparison pitch with the frequency location of the largest deviation (impairment) from the normal hearing curve in the Békésy gliding frequency audiometry (p = 0.032). All further analyses of the finestructure hearing curve (steepness of hearing loss, slope, number of hearing loss dips) showed no statistically significant relationship between the morphology of the fine-structure hearing curve and tinnitus characteristics. Finestructure measurement revealed areas of hearing loss that were not mapped in manual puretone audiometry. These "undetected" hearing losses would have led to the exclusion of 12 of 29 subjects (41.4 %) if the finestructure hearing curve had been used as an inclusion criterion. A direct comparison of the mean finestructure hearing curves of both test groups showed a statistically significant better mean hearing performance of the tinnitus group (p < 0.05) in 3 different test frequency ranges (1.5 kHz, 3 kHz, 7 kHz) with a maximum of 4 dB HL. Analy-sis of the mean amplitudes of wave I of the ABRs showed, contrary to expectation, a weak trend toward higher amplitudes in the tinnitus group (p = 0.06). According to Schaette and McAlpine (2011), synaptopathy pathogenesis should have resulted in an opposite trend, i.e., a decrease in wave I amplitude in the tinnitus group. As a secondary finding, a weak trend between wave I amplitude and subjectively perceived disturbance of tinnitus was demonstrated (p = 0.06). Statistical analysis of the parameters determined from the DPOAE measurements did not reveal any significant differences between the tinnitus group and control group. Direct comparison of the DPOAE and finestructure hearing curves, revealed a significant difference in the differences of the frequencyspecific measurements around 2.4 kHz (p = 0.007). The results of the study suggest that in previous studies with supposedly normal hearing tinnitus subjects there were unrecognized hearing losses that either went unrecognized by the screening by manual puretone audiometry, or subjects with previously aboveaverage hearing experienced a subtle spontaneous decrease in their hearing as tinnitus pathogenesis. This assumption is also supported by the fact that there is a significant correlation between the frequency range of the greatest hearing loss in the finestructure hearing curves and the tinnitus frequency. The suspected pathomechanism of synaptopathy in "normal hearing" subjects with tinnitus could not be confirmed. The correlation between wave I amplitudes and subjectively perceived disturbance by tinnitus, indicated by the data of this study, should be investigated in more detail in future studies. Further research with more accurate measurement methods and larger subject groups is needed to clarify the hypothesis "Genesis of chronic subjective tinnitus without hearing loss".

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Comparison of the Transient Evoked Otoacoustic Emissions (TEOAEs) and Distortion Products Otoacoustic Emissions (DPOAEs) in Normal Hearing Subjects With and Without Tinnitus

Cited by 6 publications

References 21 publications

Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in Subjects with Normal Hearing Sensitivity

Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in Subjects with Normal Hearing Sensitivity

Estimation of outer hair cells function in chronic bilateral tinnitus patients with normal hearing using distortion product otoacoustic emissions

Tinnitus bei Normalgehör : Untersuchung von Hörschwellenfeinstruktur, otoakustischen Emissionen und Hörnervenpotenzialen

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