Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. I. Intersubject variability and consequences on the DPOAE-gram.

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. The standard procedure consists of recording the 2f1-f2 DPOAE amplitude as a function of the f2 frequency, using a fixed f2/f1 ratio (DPOAE-gram), close to 1.20. DPOAE amplitude, as recorded in the DPOAE-gram, shows a wide range of values in normal-hearing subjects, which can impair the predictive value of the DPOAE-gram for hearing thresholds. This study is aimed at comparing intersubject variability in 2f1-f2 DPOAE amplitude according to three paradigms: a fixed f2/f1 ratio, such as the DPOAE-gram, a variable ratio DPOAE-gram (f2/f1 adapted to frequency) and an "optimum" DPOAE-gram, where the f2/f1 is adapted both to subject and frequency. The 2f1-f2 DPOAE amplitude has been investigated on 18 normally hearing subjects at ten different f2 frequencies (from 0.75 to 6 kHz), using an f2 fixed, f1 sweep paradigm, and allowed to define, for each frequency, the f2/f1 ratio giving the greatest 2f1-f2 DPOAE amplitude (or optimum ratio). Results showed a large intersubject variability of the optimum ratio, especially at frequencies below 1.5 kHz, and a significant decrease of the optimum ratio with frequency. The optimum DPOAE-gram was underestimated by up to 5.8 dB on average (up to 14.9 dB for an individual subject) by the fixed ratio DPOAE-gram, and by up to 3 dB on average (up to 10.6 dB for an individual subject) by the variable ratio DPOAE-gram. Intersubject variability was slightly but significantly reduced in the optimum DPOAE-gram versus the fixed-ratio DPOAE-gram. Lastly, correlations between tone-burst evoked otoacoustic emission (TBOAE) amplitudes and maximum DPOAE amplitudes were significantly greater than correlations between TBOAE amplitudes and fixed-ratio DPOAE amplitudes.