Cochlear sources and otoacoustic emissions.

Current understanding suggests that there are two different mechanisms by which otoacoustic emissions (OAEs) are generated in the cochlea. These mechanisms include a nonlinear-distortion mechanism and a coherent-reflection mechanism. Distortion product OAEs (DPOAEs) are believed to include contributions from both mechanisms, while stimulus frequency OAEs (SFOAES), at least at low and moderate levels, are believed to be generated primarily by the coherent-reflection mechanism. In the case of DPOAEs, the interaction of the two mechanisms produces a series of alternating peaks and valleys in the response level when recorded in small frequency increments. This pattern of peaks and valleys typically is referred to as fine structure. There has been much speculation that the interaction of the two mechanisms and the resulting fine structure limits the clinical test performance of DPOAEs. There are few data to address this speculation. Here, we review the literature that describes the cochlear source mechanisms and their potential relationship to clinical applications. We then present results for preliminary data collected in a group of 10 normal-hearing subjects where we explore the influence of common approaches to setting DPOAE stimulus parameters on the resulting fine structure. These preliminary results suggest that, at the moderate stimulus levels used in clinical applications, each of the different stimulus parameters results in a similar amount of fine structure and, therefore, fine structure cannot be eliminated through manipulation of stimulus parameters. We also review the results of some preliminary efforts to identify stimulus parameters that can be used to record SFOAEs (OAEs generated by the reflection mechanism). The potential clinical applications of SFOAEs have received little attention in the literature. By identifying stimulus parameters producing robust responses in normal-hearing ears, it may be possible to more fully evaluate clinical applications of SFOAEs.