Towards the preferred stimulus parameters for distortion product otoacoustic emissions in adults: A preliminary study.
Lucretia Petersen, Wayne J Wilson, Harsha Kathard
PMID 30035604WHAT IT FOUND
In normal-hearing adults, DPOAE levels were higher with 65/55 or 65/65 dB SPL stimulus levels and with frequency ratios of 1.18 to 1.22.
No settings clearly gave more repeatable results, and 8003 Hz was less repeatable.
Key findings
01DPOAE levels were higher with L1/L2 settings of 65/55 and 65/65 dB SPL, and with f2/f1 ratios of 1.18, 1.20 and 1.22.
02When level and ratio were considered together, 65/65 with 1.20 and 65/55 with 1.18, 1.20 or 1.22 regularly produced higher DPOAE levels.
03No stimulus combination clearly produced more repeatable DPOAEs, and combinations at f2=8003 Hz were more likely to be unreliable.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 20 young normal-hearing adults were tested, so the results may not apply to patients with hearing loss or older adults. The study measured DPOAE level and repeatability only; it did not test signal-to-noise ratio, sensitivity or specificity for cochlear dysfunction. The stimulus range excluded higher L1/L2 levels because of possible artefacts, so the tested settings were not exhaustive. Repeatability did not clearly favour any stimulus combination, so the larger DPOAE levels did not come with a clear reliability advantage. At f2=8003 Hz, more stimulus combinations were less repeatable, and the authors caution that probe microphone placement may affect calibration at high frequencies.
The easy way to misread this
Do not read this as proof that 65/55 or 65/65 dB SPL is the best clinical DPOAE setting for detecting cochlear damage. It was a preliminary study in 20 normal-hearing adults, and it did not test diagnostic sensitivity or specificity.