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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(01): e046-e057
DOI: 10.1055/s-0040-1722248
Original Research

Distortion Product Otoacoustic Emissions (DPOAEs) In Tinnitus Patients

Hend F. Alshabory
1   Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
,
Takwa A. Gabr 
1   Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
,
Mona A. Kotait
2   Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Abstract

Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage.

Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints.

Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions.

Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases.

Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

Keywords

tinnitus - otoacoustic emissions - cochlear outer hair cells


Publication History

Received: 17 July 2020

Accepted: 08 November 2020

Article published online:
29 March 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Crummer RW, Hassan GA. Diagnostic approach to tinnitus. Am Fam Physician 2004; 69 (01) 120-126
    PubMedGoogle Scholar
  • 2 Nondahl DM, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study. J Am Acad Audiol 2002; 13 (06) 323-331
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. Am J Med 2010; 123 (08) 711-718
    CrossrefPubMedGoogle Scholar
  • 4 Park KH, Lee SH, Koo JW. et al. Prevalence and associated factors of tinnitus: data from the Korean National Health and Nutrition Examination Survey 2009-2011. J Epidemiol 2014; 24 (05) 417-426
    CrossrefPubMedGoogle Scholar
  • 5 Roberts LE. Neural synchrony and neural plasticity in tinnitus. In: Møller AR, Langguth B, DeRidder D, Kleinjung T. editors. Textbook of Tinnitus. New York: Springer; 2011: 103-112
    CrossrefGoogle Scholar
  • 6 Hazell J. Incidence, classification, and models of tinnitus. In: Ludman H, Wright T. editors. Diseases of the Ear. London: Arnold; 1998: 185-195
    Google Scholar
  • 7 Rodriguez-Casero MV, Mandelstam S, Kornberg AJ, Berkowitz RG. Acute tinnitus and hearing loss as the initial symptom of multiple sclerosis in a child. Int J Pediatr Otorhinolaryngol 2005; 69 (01) 123-126
    CrossrefPubMedGoogle Scholar
  • 8 Henry JA, Roberts LE, Caspary DM, Theodoroff SM, Salvi RJ. Underlying mechanisms of tinnitus: review and clinical implications. J Am Acad Audiol 2014; 25 (01) 5-22 , quiz 126
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Claussen CF, Franz B. Contemporary and practical neurootology. Germany: 2006 18. 298-299
    Google Scholar
  • 10 Weisz N, Müller S, Schlee W, Dohrmann K, Hartmann T, Elbert T. The neural code of auditory phantom perception. J Neurosci 2007; 27 (06) 1479-1484
    CrossrefPubMedGoogle Scholar
  • 11 Shiomi Y, Tsuji J, Naito Y, Fujiki N, Yamamoto N. Characteristics of DPOAE audiogram in tinnitus patients. Hear Res 1997; 108 (1-2): 83-88
    CrossrefPubMedGoogle Scholar
  • 12 Bartnik G, Hawley ML, Rogowski M. et al. Distortion product otoacoustic emission levels and Input/Output-Growth functions in normal-hearing individuals with tinnitus and/or hyperacusis. Semin Hear 2007; 28: 303-318
    Article in Thieme ConnectGoogle Scholar
  • 13 Newman CW, Jacobson GP, Spitzer JB. Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg 1996; 122 (02) 143-148
    CrossrefPubMedGoogle Scholar
  • 14 Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res 1990; 8 (04) 221-254
    CrossrefPubMedGoogle Scholar
  • 15 Meikle M, Taylor-Walsh E. Characteristics of tinnitus and related observations in over 1800 tinnitus clinic patients. J Laryngol Otol Suppl 1984; 9: 17-21
    CrossrefPubMedGoogle Scholar
  • 16 Davis A, Rafaie EA. Epidemiology of tinnitus. In: Tyler R. editor. Tinnitus Handbook. New York: Thomson Learning; 2000: 1-23
    Google Scholar
  • 17 Kannan PM, Lipscomb DM. Letter: Bilateral hearing asymmetry in a large population. J Acoust Soc Am 1974; 55 (05) 1092-1094
    CrossrefPubMedGoogle Scholar
  • 18 Schmidt CM, Knief A, Lagosch AK, Deuster D, am Zehnhoff-Dinnesen A. Left-right asymmetry in hearing loss following cisplatin therapy in children--the left ear is slightly but significantly more affected. Ear Hear 2008; 29 (06) 830-837
    CrossrefPubMedGoogle Scholar
  • 19 Kujawa SG, Liberman MC. Adding insult to injury: cochlear nerve degeneration after “temporary” noise-induced hearing loss. J Neurosci 2009; 29 (45) 14077-14085
    CrossrefPubMedGoogle Scholar
  • 20 Xiong B, Liu Z, Liu Q. et al. Missed hearing loss in tinnitus patients with normal audiograms. Hear Res 2019; 384: 107826
    CrossrefPubMedGoogle Scholar
  • 21 Ishak WS, Zhao F, Rajenderkumar D, Arif M. Measurement of subtle auditory deficit in tinnitus patients with normal audiometric thresholds using evoked otoacoustic emissions and threshold equalizing noise tests. Int Tinnitus J 2013; 18 (01) 35-44
    CrossrefPubMedGoogle Scholar
  • 22 Blinowska KJ, Fernandez BR. The application of wavelet transform and matching pursuit to the time-varying EEG signals. Intelligent Engineering Systems through Artificial Neural Networks. ASME Press. 1994; 4: 535-540
    Google Scholar
  • 23 Ami M, Abdullah A, Awang MA, Liyab B, Saim L. Relation of distortion product otoacoustic emission with tinnitus. Laryngoscope 2008; 118 (04) 712-717
    CrossrefPubMedGoogle Scholar
  • 24 Arnold DJ, Lonsbury-Martin BL, Martin GK. High-frequency hearing influences lower-frequency distortion-product otoacoustic emissions. Arch Otolaryngol Head Neck Surg 1999; 125 (02) 215-222
    CrossrefPubMedGoogle Scholar
  • 25 Dreisbach LE, Torre III P, Kramer SJ, Kopke R, Jackson R, Balough B. Influence of ultrahigh-frequency hearing thresholds on distortion-product otoacoustic emission levels at conventional frequencies. J Am Acad Audiol 2008; 19 (04) 325-336
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Clark WW, Kim DO, Zurek PM, Bohne BA. Spontaneous otoacoustic emissions in chinchilla ear canals: correlation with histopathology and suppression by external tones. Hear Res 1984; 16 (03) 299-314
    CrossrefPubMedGoogle Scholar
  • 27 Fabijańska A, Smurzyński J, Hatzopoulos S. et al. The relationship between distortion product otoacoustic emissions and extended high-frequency audiometry in tinnitus patients. Part 1: normally hearing patients with unilateral tinnitus. Med Sci Monit 2012; 18 (12) CR765-CR770
    CrossrefPubMedGoogle Scholar
  • 28 Kiang NY-S, Moxon EC. Tails of tuning curves of auditory-nerve fibers. J Acoust Soc Am 1974; 55 (03) 620-630
    CrossrefPubMedGoogle Scholar
  • 29 Gorga MP, Neely ST, Dierking DM. et al. Low-frequency and high-frequency cochlear nonlinearity in humans. J Acoust Soc Am 2007; 122 (03) 1671
    CrossrefPubMedGoogle Scholar
  • 30 Hesse G, Schaaf H, Laubert A. Specific findings in distortion product otoacoustic emissions and growth functions with chronic tinnitus. Int Tinnitus J 2005; 11 (01) 6-13
    PubMedGoogle Scholar
  • 31 Munro KJ, Blount J. Adaptive plasticity in brainstem of adult listeners following earplug-induced deprivation. J Acoust Soc Am 2009; 126 (02) 568-571
    CrossrefPubMedGoogle Scholar
  • 32 Schaette R, McAlpine D. Tinnitus with a normal audiogram: physiological evidence for hidden hearing loss and computational model. J Neurosci 2011; 31 (38) 13452-13457
    CrossrefPubMedGoogle Scholar