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An otoacoustic emission (OAE) is a sound which is generated from within the inner ear. Having been predicted by Thomas Gold in 1948, their existence was first demonstrated experimentally by David Kemp in 1978 and they have since been shown to arise by a number of different cellular mechanisms within the inner ear. Numerous studies have shown that OAEs disappear after the inner ear has been damaged, so OAEs are often used in the laboratory and the clinic as a measure of inner ear health. Broadly speaking, there are two types of otoacoustic emissions: Spontaneous Otoacoustic Emissions (SOAEs) and Evoked Otoacoustic Emissions (EOAEs). As their names suggest, SOAEs arise spontaneously and EOAEs require an evoking stimulus.
OAE's are considered to be related to the amplification function of the cochlea. In a the absence of external stimulation, the activity of the cochlear amplifier increases, leading to the production of sound. Several lines of evidence suggest that, in mammals, outer hair cells are the elements that enhance cochlear sensitivity and frequency selectivity and hence act as the energy sources for amplification. The outer hair cells make only token projections via afferent fibers to the central nervous system. However, they receive extensive efferent innervation, whose activation decreases cochlear sensitivity and frequency discrimination.
OAEs are currently evoked using two different methodologies. Transient OAEs (TOAE or TrOAE) are evoked using a click (broad frequency range) stimulus. The evoked response from this type of stimulus covers the frequency range up to around 4 kHz. Distortion Product OAEs (DPOAE) are evoked using a pair of tones with particular intensity (usually either 65 - 55 dB or 65 for both) and ratio (F2/F1). The evoked response from these stimuli occurs at a third frequency; the distortion product frequency is calculated based on the original F1 and F2.
Clinical Importance of OAE's
Otoacoustic emissions are clinically important because they are the basis of a simple, non-invasive, test for hearing defects in newborn babies and in children who are too young to cooperate in conventional hearing tests. Many western countries now have national programmes for the universal hearing screening of newborn babies. The primary screening tool is a test for the presence of a click-evoked OAE.
- Kemp DT. Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am. 1978;64:1386–1391
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