Repeatability of medial olivocochlear efferent effects on transient-evoked otoacoustic emissions in normal-hearing adults

The medial olivocochlear reflex (MOCR) is a brainstem-mediated reflex that reduces cochlear amplifier gain when elicited by sound. The MOCR may provide benefits such as protection from acoustic trauma and improved hearing in background noise. Measurement of MOCR effects may also have clinical applications. MOCR effects can be measured using transient-evoked otoacoustic emissions (TEOAEs), as amplitudes of TEOAEs are typically reduced during MOCR activation. The primary purpose of the current study was to quantify the repeatability of MOCR effects on TEOAEs because high repeatability in a healthy population is a necessary (but not sufficient) component of a clinically-useful test. A secondary purpose was to assess the relationship between MOCR strength and speech perception in noise. Twenty-one normal hearing subjects ages 18-30 participated. TEOAEs were elicited using 35 dB SL clicks. The MOCR was elicited using contralateral acoustic stimulation (CAS) consisting of 35 dB SL broadband noise. Sixteen measurements were made across a 5-week period (4 visits × 4 measurements per visit). TEOAEs were bandpass filtered in 1/6-octaves from 1-2 kHz. An individualized time-frequency analysis was used to select the largest TEOAE envelope peak within a restricted time analysis window. Responses were characterized as the complex ratio of TEOAEs obtained with versus without CAS. The statistical significance of effects was assessed. Results revealed generally high levels of stability across time, as assessed by the interquartile ranges of all results and as assessed by Cronbach’s alpha. Four MOCR measurements appeared to be adequate to obtain a reliable baseline measurement. Individualized time-frequency analyses were also important for obtaining reliable measurements. However, several subjects showed stable baseline measurements but unusual patterns of variability at subsequent sessions. These changes did not appear to be the result of changes in auditory status, methodological issues, or equipment issues. No