Subclinical Dysfunction of Cochlea and Cochlear Efferents in Migraine: An Otoacoustic Emission Study

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 309-317 ◽  
Author(s):  
H Bolay ◽  
YA Bayazit ◽  
B Gündüz ◽  
AK Ugur ◽  
D Akçali ◽  
...  

Otoacoustic emission (OAE) testing enables us to identify the cochlear component of a hearing disorder and to monitor objectively minute changes in cochlear status undetectable by other audiological methods. Contralateral sound-induced suppression is mediated by medial superior olivary complex efferents which induce hyperpolarization counteracting the amplifying effects of outer hair cell (OHC) activity. The aim of this study was to assess functions of cochlea and its efferents in migraine using OAE testing and contralateral suppression of transiently evoked OAEs (TEOAE). Fifty-three migraineurs (106 ears) and 41 healthy subjects (82 ears) were included and pure tone audiometry (PTA), speech discrimination scores (SDS), distortion product OAE (DPOAE), TEOAE and contralateral suppression of TEOAEs were tested. PTA and SDS of migraineurs and controls were not different ( P > 0.05). DPOAEs were tested between 1 and 6 kHz and a significant difference was detected only at 5 kHz frequency, where DPOAE amplitudes in migraine with aura (MA) were lower than in controls ( P < 0.03). The mean amplitudes of TEOAEs were statistically insignificant between controls and migraine groups. Contralateral sound stimulus induced significant decrease in amplitudes of TEOAE ( P = 0.005) in controls. In patients with migraine without aura and MA, mean amplitudes of TEOAEs were not suppressed by contralateral sound stimulus ( P > 0.05). As PTA, SDS and DPOAE tests demonstrate normal functioning of inner ear between 1 and 4 kHz, absence of suppression of the TEOAEs by contralateral sound stimulation indicates the presence of dysfunction either in the medial olivocochlear complex in the brainstem or at the synaptic transmission between olivocochlear efferents and OHCs in the cochlea. Disruption in the contralateral suppression may be one of the mechanisms predisposing to the phonophobia symptom associated with migraine headache.

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Pretty Omar Afifi ◽  
Tayseer Taha Tayseer Abdel Rahman ◽  
Ahmed Gamal Khafagy

Abstract Background To assess whether call center operators are subject to or suffer from any auditory fatigue when compared to normal subjects. A prospective case-control study where twenty-eight call center operators (10 females and 18 males) with an age range from 25 to 46 years and twenty controls (12 females and 8 males) with an age range from 23 to 44 years were included. All call center operators use a headset for up to 8 h daily for a minimum of two consecutive years. Audiological assessments were done to all participants that included pure tone audiometry (PTA), speech audiometry, tympanometry, and acoustic reflexes. Moreover, transient-evoked otoacoustic emission (TEOAE) absolute threshold and distortion product otoacoustic emission (DPOAE) signal to noise thresholds as well as contralateral suppression of TEOAEs and DPOAEs were recorded for both groups. Results There was no significant variation in auditory performances detected with either PTA or OAE (TEOAEs and DPOAEs) test. Besides, there was no statistically significant difference in OAEs (TEOAEs and DPOAEs) with contralateral suppression for both the call center operators and control groups. However, call center operators expressed a feeling of tiredness. Conclusions There was no detectable central or peripheral auditory fatigue experienced by the call center operators when using headsets. However, their sensation of auditory fatigue could be due to cognitive fatigue rather than noise-induced fatigue.


2015 ◽  
Vol 129 (12) ◽  
pp. 1174-1181 ◽  
Author(s):  
N Wooles ◽  
M Mulheran ◽  
P Bray ◽  
M Brewster ◽  
A R Banerjee

AbstractObjective:To examine whether distortion product otoacoustic emissions can serve as a replacement for pure tone audiometry in longitudinal screening for occupational noise exposure related auditory deficit.Methods:A retrospective review was conducted of pure tone audiometry and distortion product otoacoustic emission data obtained sequentially during mandatory screening of brickyard workers (n = 16). Individual pure tone audiometry thresholds were compared with distortion product otoacoustic emission amplitudes, and a correlation of these measurements was conducted.Results:Pure tone audiometry threshold elevation was identified in 13 out of 16 workers. When distortion product otoacoustic emission amplitudes were compared with pure tone audiometry thresholds at matched frequencies, no evidence of a robust relationship was apparent. Seven out of 16 workers had substantial distortion product otoacoustic emissions with elevated pure tone audiometry thresholds.Conclusion:No clinically relevant predictive relationship between distortion product otoacoustic emission amplitude and pure tone audiometry threshold was apparent. These results do not support the replacement of pure tone audiometry with distortion product otoacoustic emissions in screening. Distortion product otoacoustic emissions at frequencies associated with elevated pure tone audiometry thresholds are evidence of intact outer hair cell function, suggesting that sites distinct from these contribute to auditory deficit following ototrauma.


2005 ◽  
Vol 16 (02) ◽  
pp. 069-078 ◽  
Author(s):  
Bob Davis ◽  
Wei Qiu ◽  
Roger P. Hamernik

The present study investigates the effect of small amounts of outer hair cell (OHC) loss on distortion product otoacoustic emission (DPOAE) levels and evoked potential permanent threshold shifts (PTS) in a population of 12 noise-exposed chinchillas. The group mean DPOAE level, which decreased by up to ~15 dB in the presence of less than 8 dB PTS and 15% OHC loss, indicates that DPOAEs can detect an underlying cochlear pathology (i.e., OHC damage/loss) despite the presence of normal to near normal thresholds. The sensitivity of DPOAEs in detecting OHC loss makes this test measure suited for diagnosing sensorineural hearing impairment, particularly when abnormal auditory symptoms (i.e., speech discrimination problems) are associated with a normal audiogram in the clinical setting and as part of a hearing conservation program.


2008 ◽  
Vol 122 (10) ◽  
pp. 1047-1051 ◽  
Author(s):  
B Gunduz ◽  
Y A Bayazit ◽  
F Celenk ◽  
C Sarıdoğan ◽  
A G Guclu ◽  
...  

AbstractObjective:To assess contralateral suppression of transiently evoked otoacoustic emissions in patients with fibromyalgia syndrome and normal hearing.Methods:Twenty-four female patients with fibromyalgia syndrome and 24 healthy female controls with normal hearing were assessed using pure tone audiometry and transiently evoked otoacoustic emissions.Results:All patients with fibromyalgia syndrome and all controls had normal hearing on pure tone audiometry. In the patients with fibromyalgia syndrome, the mean transiently evoked otoacoustic emission amplitude was 15.5 ± 4.8 dB. The mean transiently evoked otoacoustic emission amplitudes after contralateral suppression was 15.5 ± 4.9 dB. There was no statistically significant difference between the transiently evoked otoacoustic emission amplitudes measured before and after contralateral suppression (p > 0.05). In the controls, the mean transiently evoked otoacoustic emission amplitude was 12 ± 5 dB. The mean transiently evoked otoacoustic emission amplitudes after contralateral suppression was 11 ± 4.7 dB. There was a statistically significant decrease in transiently evoked otoacoustic emission amplitudes after contralateral suppression (p < 0.01).Conclusion:The mechanisms related to contralateral suppression of transiently evoked otoacoustic emissions seem dysfunctional in fibromyalgia syndrome. This dysfunction may be at the brain stem level, where the medial superior olivary complex is located, or at the synapses of medial superior olivary complex fibres with the outer hair cells in the cochlea. Demonstration of lack of contralateral suppression of transiently evoked otoacoustic emissions can be used as a diagnostic tool in patients with fibromyalgia syndrome.


CoDAS ◽  
2015 ◽  
Vol 27 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Tanit Ganz Sanchez ◽  
Juliana Casseb Oliveira ◽  
Márcia Akemi Kii ◽  
Katya Freire ◽  
Jaci Cota ◽  
...  

INTRODUCTION: Although tinnitus is an increasingly common symptom, few studies have assessed its prevalence or incidence among adolescents. PURPOSE: To assess whether the presence of tinnitus in adolescents is associated with minimal hearing damage, evaluated through high-frequency audiometry (HFA), otoacoustic emission (OAE), and loudness discomfort level (LDL). METHODS: The sample comprised 168 adolescents of a private school (61.3% boys; mean age 14.1 years old; standard deviation=2). All of them completed a questionnaire about tinnitus and hypersensitivity to sounds (sound intolerance), and then underwent otoscopy, pure-tone audiometry, HFA, LDL, transient and distortion product otoacoustic emissions (TOAE and DPOAE), and tinnitus pitch/loudness matching (the latter only in those with tinnitus). Participants were later divided into three groups: with no tinnitus (n=73, 43.4%), with sporadic tinnitus (n=47, 28%), and with constant tinnitus (n=48, 28.6%). RESULTS: No significant difference was observed between the groups regarding audiometry thresholds in frequencies from 0.25 to 16 kHz, or TOAE and DPOAE. However, the LDL in adolescents with constant tinnitus was significantly lower than that in other groups, suggesting hypersensitivity to sounds. CONCLUSION: There was no evidence of minimal hearing damage in the audiometry and OAE. Nonetheless, the decreased LDL in adolescents with constant tinnitus suggests that their auditory system is more sensitive. Therefore, this may be the first sign of vulnerability to sounds. Future medium- to long-term monitoring of these students may show whether they will begin a process of functional impairment, altering hearing thresholds, and OAE.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Doaa Elmoazen ◽  
Hesham Kozou ◽  
Basma Elabassiery

Abstract Background The general consensus on the role of hearing loss in generating tinnitus is not relevant in tinnitus patients with normal hearing thresholds. One source of tinnitus may be related to damage to outer hair cells (OHC) of the cochlea. If the OHC of the human cochlea are to be involved in the generation of tinnitus, testing of Otoacoustic emissions (OAE) could provide a reliable means of recording OHC dysfunction. We investigated the role of OHC and cochlear efferent system in tinnitus development in normal hearing ears through studying of Distortion Product Otoacoustic Emissions (DPOAE) and Transient Evoked Otoacoustic Emissions (TEOAE) amplitudes, contralateral suppression amplitudes and suppression value in 15 normal hearing tinnitus patients and 15 control subjects. Results Mean f2 DPOAE amplitudes and contralateral suppression were significantly lower in tinnitus group compared to controls for all frequencies from 1001 to 6348 Hz. Suppression values of DPOAEs revealed lower but not significant difference between tinnitus and control groups for all frequencies except 1587 and 6348 Hz. TEOAE amplitudes and contralateral suppression were significantly lower in tinnitus groups for all frequencies from 1000 to 4000 Hz compared to the control group. Suppression value of TEOAEs revealed no significant difference between the two groups for all frequencies except 3000 and 4000 Hz were significantly lower in the tinnitus group compared to the control group. Conclusions Normal hearing manifested by pure tone audiometry in non-vascular tinnitus sufferers does not exclude OHC and/or cochlear efferent pathology.


2013 ◽  
Vol 127 (10) ◽  
pp. 952-956 ◽  
Author(s):  
A Goyal ◽  
P P Singh ◽  
A Vashishth

AbstractObjectives:This study aimed to: understand the effect that high intensity noise associated with drilling (during otological surgery) has on hearing in the contralateral ear; determine the nature of hearing loss, if any, by establishing whether it is temporary or persistent; and examine the association between hearing loss and various drill parameters.Methods:A prospective clinical study was carried out at a tertiary centre. Thirty patients with unilateral cholesteatoma and normal contralateral hearing were included. Patients were evaluated pre-operatively and for five days following surgery using high frequency pure tone audiometry, and low and high frequency transient evoked and distortion product otoacoustic emission testing.Results:The findings revealed statistically significant changes in distortion product otoacoustic emissions at high frequencies (p = 0.016), and in transient evoked otoacoustic emissions at both low and high frequencies (p = 0.035 and 0.021, respectively). There was a higher statistical association between otoacoustic emission changes and cutting burrs compared with diamond burrs.Conclusion:Drilling during mastoid surgery poses a threat to hearing in the contralateral ear due to noise and vibration conducted transcranially.


2005 ◽  
Vol 133 (4) ◽  
pp. 619-624 ◽  
Author(s):  
Jin Sook Kim ◽  
Eui-Cheol Nam ◽  
Sung Il Park

OBJECTIVE: We investigated and compared the usefulness of the electrocochleography and distortion product otoacoustic emission tests for detecting the earliest noise-induced damage by analyzing the sensitivity and specificity of the 2 tests. STUDY DESIGN: A prospective study. METHODS: After listening to music at 90.3 ± 4.2 dB in the same night-club for 2 hours continuously, 23 healthy normal ears experienced a temporary threshold shift exceeding 5 dB. Pure-tone audiometry, the distortion product otoacoustic emission test, and electrocochleography were performed before, immediately after, and 24 hours after the exposure. RESULTS: Before exposure, the measured distortion product/noise floor was 9.8 ± 10.4, 23.5 ± 6.4, 18.7 ± 6.4, and 19.1 ± 5.6 dB sound pressure level (SPL) at frequencies of 1, 2, 3, and 4 kHz, respectively. Immediately after exposure, it decreased significantly at 2, 3, and 4 kHz to 16.6 ± 7.6, 12.5 ± 6.8, and 14.8 ± 7.7 dB SPL, respectively. Marked increases in the amplitude of the summating potential and summating potential/action potential ratio were recorded from 0.15 ± 0.06 to 0.32 ± 0.11 and 0.23 ± 0.06 to 0.44 ± 0.08, respectively. The respective sensitivity and specificity of electrocochleography were 76.7% to 88.5% and 91.0% to 100%. Those of the distortion product otoacoustic emission test were 54.8% to 62.2% and 75.5% to 87.0%, respectively. CONCLUSION: Electrocochleography appears to provide more sensitive and specific information than the distortion product otoacoustic emission test for detecting a noise-induced temporary threshold shift.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Nur Baizura Salahuddin ◽  
Sarah Rahmat

Introduction: Schroeder-phase masking has been proven to be more sensitive than pure tone audiometry in detecting changes in cochlear function. Schroeder harmonic complexes with different phases have been observed to excite basilar membranes differently and give different masking abilities (‘phase effect’) when used as maskers. Previous theory suggested that phase effect was contributed by cochlear non-linearity of outer hair cells (OHC); however the theory was derived from behavioral observation alone. Therefore, this study aims to further investigate the cochlear non-linearity involvement in phase effect mechanism by measuring the Schroeder phase effect together with another electrophysiological test that measures the cochlear non-linearity function, i.e. Distortion Product Otoacoustic Emission (DPOAE). Methods: Twelve normal hearing and four sensorineural hearing loss subjects were recruited. Schroeder phase masking test was conducted and phase effect (using 75 dB A masker) at 1kHz and 2 kHz was measured. DPOAE was recorded at multiple intensities (45-75 dB SPL) for 1 kHz and 2 kHz, and slope of DPOAE input output function was measured. Correlation analysis was performed to find correlation between phase effect and slope of DPOAE input output function. Results: Result showed no significant correlation (p > 0.05) between phase effect and slope of DPOAE input output function. Conclusions: This findings suggest that Schroeder-phase effect may not be/ may not only be contributed by OHC’s cochlear non-linearity. This finding opens the possibility of other auditory functions’ involvement in phase effect mechanism, and contribute to better understanding towards auditory perceptions.


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