Rethinking the clinical utility of distortion-product otoacoustic emission (DPOAE) signal-to-noise ratio.
Nicholas Portugal, Gayla L Poling, Laura Dreisbach
PMID 37267054WHAT IT FOUND
DPOAE SNR values stayed similar across four trials, but they varied more than DPOAE levels did.
For monitoring cochlear change, DPOAE levels are less variable.
Key findings
01SNR values did not differ significantly across trials, but they varied more between trials than DPOAE levels did.
02For the cystic fibrosis group, average absolute SNR differences between trials at frequencies above 8 kHz were 6.09 dB, compared with 1.96 dB for DPOAE levels.
03Noise floor levels varied the most between trials, and DPOAE levels varied the least, across all groups.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The data came from three earlier studies with different participants, frequency ranges, stimulus levels, and calibration methods, so the groups are not directly comparable as one uniform sample. The young adult group used traditional calibration, while the child and cystic fibrosis groups used depth-compensated calibration, so calibration differences may have affected the variability. The cystic fibrosis group was tested only above 8 kHz, so conventional-frequency SNR variability was not reported for that group. Participants were selected for normal middle-ear function and present DPOAEs, so the results may not apply to ears with poor middle-ear function or absent DPOAEs. The time between trials varied, and the study did not test whether SNR or DPOAE level changes detected real cochlear damage during ototoxic exposure.
Declared interests
No conflict-of-interest or funding statement is included in the supplied text. The journal metadata lists NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that SNR is a good standalone measure of cochlear change. SNR varied more between tests than DPOAE levels, and noise-floor levels varied the most between trials.