Quantitative assessment of human cochlear function by evoked otoacoustic emissions.

The amplitudes of evoked otoacoustic emissions (EOE) and their detection threshold were measured in 44 normal young adults and 118 patients with two categories of cochlear dysfunction, acoustic trauma and presbycusis. A different method was used for each category: detection of click EOE or of stimulus frequency emissions. A partial correlation and multivariate analysis was performed for both groups of results to investigate the relations between EOE threshold one pure tone audiometric thresholds (250 to 8000 Hz). Only one significant correlation was found, linearly relating EOE threshold and hearing threshold at 2 kHz (P less than 0.001), independently of the origin of cochlear dysfunction. It suggests that EOE threshold is not frequency-specific since the frequency of EOE at threshold was nearly always close to 1 kHz. A simple model is proposed, based on the assumption that EOE amplitudes and threshold are proportional to the total number of residual active sites in the organ of Corti, i.e. to the total length of active basilar membrane. It is shown that this model accounts for the results disclosed by the statistical analysis and fits the experimental data. It can be used for quantitatively predicting the residual cochlear activity of a patient. However, the EOE threshold is only sensitive to already important cochlear alterations and this parameter does not seem to allow a follow-up of early stages of cochlear dysfunction.