[Otoacoustic emissions in clinical and surgical practice].
OBJECTIVE
Otoacoustic emissions (OAEs), discovered in 1978, have a well-established cochlear origin. They strongly depend on the outer hair cells and are widely used in experimental research as a means for testing cochlear function. However, outside screening, OAEs are only rarely used in clinical practice. The objective of this paper was to show their vast clinical utility.


METHODS
First, a review of the biophysical and physiological knowledge on OAEs is provided, concerning transient OAEs as well as distortion-product OAEs, recalling the origin and the meanings of these acoustic signals. Several clinical situations are then presented, and the corresponding OAE alterations are explained, such as hearing screening in neonates, diagnosis of hearing impairment with particularities related to the age of the patient, situations critical to the cochlea such as ototoxic treatments, and surgical procedures to the cerebellopontine angle.


RESULTS
OAEs appear to be a powerful tool in clinical practice, particularly in hearing screening and diagnosis of deafness. They can also be used to monitor hearing function during cerebellopontine angle tumor resection.


CONCLUSIONS
OAEs are still rarely used as a diagnostic tool by clinicians despite their clinical value, which should make them a primary choice.
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Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Gabriel-Montpied, Université Clermont-Ferrand-I, 63000 Clermont-Ferrand, France. tmom@chu-clermontferrand.fr
D002530:Cerebellopontine Angle / Q000601:surgery; D002648:Child; D015834:Cochlear Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D003638:Deafness / Q000175:diagnosis* / Q000453:epidemiology*; D004429:Ear Ossicles / Q000503:physiopathology; D018072:Hair Cells, Auditory, Outer / Q000473:pathology; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D019586:Intracranial Hypertension / Q000453:epidemiology; D008403:Mass Screening; D019635:Neurosurgical Procedures; D009925:Organ of Corti / Q000473:pathology / Q000502:physiology*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D011300:Preoperative Care