title: Detecting high-frequency hearing loss with click-evoked otoacoustic emissions.
abstract: In contrast to clinical click-evoked otoacoustic emission (CEOAE) tests that are inaccurate above 4-5 kHz, a research procedure measured CEOAEs up to 16 kHz in 446 ears and predicted the presence/absence of a sensorineural hearing loss. The behavioral threshold test that served as a reference to evaluate CEOAE test accuracy used a yes-no task in a maximum-likelihood adaptive procedure. This test was highly efficient between 0.5 and 12.7 kHz: Thresholds measured in 2 min per frequency had a median standard deviation (SD) of 1.2-1.5 dB across subjects. CEOAE test performance was assessed by the area under the receiver operating characteristic curve (AUC). The mean AUC from 1 to 10 kHz was 0.90 (SD=0.016). AUC decreased to 0.86 at 12.7 kHz and to 0.7 at 0.5 and 16 kHz, possibly due in part to insufficient stimulus levels. Between 1 and 12.7 kHz, the medians of the magnitude difference in CEOAEs and in behavioral thresholds were <4 dB. The improved CEOAE test performance above 4-5 kHz was due to retaining the portion of the CEOAE response with latencies as short as 0.3 ms. Results have potential clinical significance in predicting hearing status from at least 1 to 10 kHz using a single CEOAE response.
authors.affiliation: Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA. Douglas.Keefe@boystown.org
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Keefe
authors.forename: Shawn S
authors.initials: SS
authors.lastname: Goodman
authors.forename: John C
authors.initials: JC
authors.lastname: Ellison
authors.forename: Denis F
authors.initials: DF
authors.lastname: Fitzpatrick
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gorga
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry / Q000379:methods*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D016022:Case-Control Studies; D003051:Cochlea / Q000503:physiopathology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous; D011237:Predictive Value of Tests; D011571:Psychoacoustics; D011930:Reaction Time; D015203:Reproducibility of Results; D013018:Sound Spectrography; D013997:Time Factors; D055815:Young Adult