Distortion product otoacoustic emission fine structure is responsible for variability of distortion product otoacoustic emission contralateral suppression.

Alteration of the distortion product otoacoustic emission (DPOAE) level by a contralateral sound, which is known as DPOAE contralateral suppression, has been attributed to the feedback mechanism of the medial olivocochlear efferents. However, the limited dynamic range and large intra- and intersubject variabilities in the outcome of the measurement restrict its application in assessing the efferent function. In this study, the 2f(1)-f(2) DPgram was measured with a high frequency resolution in six human ears, which exhibits a fine structure with the quasiperiodic appearance of peaks and dips. In the presence of contralateral noise, the DPOAE level increased, decreased, or remained unchanged depending on the frequency. At the peaks, DPOAEs were mostly suppressed with a larger change, while those at the dips had greater variance, with increased occurrence of enhancement or no change. The difference between the peak and dip frequencies in the DPOAE-level change was significant. A switch from suppression to enhancement of the DPOAE level or vice versa with a small change in frequency was noted. These results imply that the DPOAE fine structure is a main source of the variability in DPOAE contralateral suppression measurement. The study suggests that the DPOAE contralateral suppression test would be improved if it is conducted for frequencies at major peaks of the DPOAE fine structure.