Evaluating noise induced hearing loss with distortion product otoacoustic emissions

This study assessed the clinical efficacy of screening for noise induced hearing loss (NIHL) with distortion product otoacoustic emissions (DPOAE). DPOAEs were recorded from 76 military personnel (137 ears) aged between 17 and 41 years in response to equilevel 70 dB SPL primary stimulating tones. The 2f1-f2 DPOAE levels were correlated with audiometric thresholds at frequencies close to f2. Ears with normal audiograms, but with a history of military noise exposure, had DPOAEs that were significantly decreased in amplitude as compared to the ears of normal hearing non-exposed to noise subjects. These ears also had an increased absence of DPOAEs as compared with the ears of the normal hearing non-exposed to noise subjects. Although, in general, the DPOAE amplitudes and spectral frequency ranges reflected the audiometric NIHL configurations, in a number of cases DPOAEs were present for hearing losses up to 75 dB HL. As a consequence, DPOAEs correlated moderately and negatively with the audiometric thresholds. Applying test criteria designed to logically reflect NIHL, DPOAE sensitivity and specificity levels ranged between 0.51-0.90 and 0.63-0.25, respectively. These findings indicate that DPOAEs, recorded and analysed as described, are not sufficiently sensitive to serve as a single test to identify NIHL.