Characteristics of click-evoked otoacoustic emissions in ears with normal hearing and with noise-induced hearing loss

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Abstract
The clinical application of click-evoked otoacoustic emissions (EOAE) in the assessment of noise-induced hearing loss (NIHL) was examined in a group of 72 cars with N1HL and 61 ears with normal hearing (NH). The characteristics of the EOAE in cars with NIHL significantly differed from the NH, according to all EOAE parameters tested in the present study. The mean overall EOAE level was lower and the mean EOAE nonlinearity threshold was worse in the NIHL group. In 95% of the NH ears the EOAE spectrum range was wide, while in 91.5% of the NIHL ears the range was narrow. Moreover, in 94% of the ears with NIHL, the frequency at which the hearing loss began (BHL) was at or above the frequency of the last peak in the EOAE spectrum (FLP). Furthermore, combination of EOAE spectral measures correctly discriminate on average 93.5% of ears with NH from NIHL (sensitivity) and 92% of ears with NIHL from NH (specificity). In contrast, the nonlinearity threshold and the overall level of EOAE yielded lower specificity of less than 33%. It was therefore concluded that EOAE spectrum may serve as a useful and objective tool in screening adults with suspected noise-induced high frequency hearing loss.