Objectives: Distortion-product otoacoustic emissions (DPOAEs) collected after sound pressure level (SPL) calibration are susceptible to standing waves that affect measurements at the plane of the probe microphone due to overlap of incident and reflected waves. These standing-wave effects can be as large as 20 dB, and may affect frequencies both above and below 4 kHz. It has been shown that forward pressure level (FPL) calibration minimizes standing-wave effects by isolating the forward-propagating component of the stimulus. Yet, previous work has failed to demonstrate more than a small difference in test performance and behavioral-threshold prediction with DPOAEs after SPL and FPL calibration. One potential limitation in prior studies is that measurements were restricted to octave and interoctave frequencies; as a consequence, data were not necessarily collected at the standing-wave null frequency. In the present study, DPOAE responses were measured with f2 set to each participant's standing-wave frequency in an effort to increase the possibility that differences in test performance and threshold prediction would be observed for SPL and FPL calibration methods.
Design: Data were collected from 42 normal-hearing participants and 93 participants with hearing loss. DPOAEs were measured with f2 set to 4 kHz and at each participant's notch frequency after SPL and FPL calibration. DPOAE input/output functions were obtained from −10 to 80 dB in 5 dB steps for each calibration/stimulus condition. Test performance was evaluated using clinical decision theory. Both area under receiver operating characteristic curves for all stimulus levels and cumulative distributions when L2 = 50 dB (a level at which the best performance was observed regardless of calibration method) were used to evaluate the accuracy with which auditory status was determined. A bootstrap procedure was used to evaluate the significance of the differences in test performance between SPL and FPL calibrations. DPOAE predictions of behavioral threshold were evaluated by correlating actual behavioral thresholds and predicted thresholds using a multiple linear regression model.
Results: First, larger DPOAE levels were measured after SPL calibration than after FPL calibration, which demonstrated the expected impact of standing waves. Second, for both FPL and SPL calibration, test performance was best for moderate stimulus levels. Third, differences in test performance between calibration methods were evident at low- and high-stimulus levels. Fourth, there were small but statistically significant improvements in test performance after FPL calibration for clinically relevant conditions. Fifth, calibration method had no effect on threshold prediction.
Conclusions: Standing waves after SPL calibration have an impact on DPOAE levels. Although the effect of calibration method on test performance was small, test performance was better after FPL calibration than after SPL calibration. There was no effect of calibration method on predictions of behavioral threshold.
Sound pressure level calibrated distortion-product otoacoustic emissions (DPOAEs) are susceptible to standing waves, whereas forward pressure level calibration minimizes standing-wave effects. However, previous research has failed to demonstrate a difference in DPOAE test performance and behavioral-threshold prediction (Burke et al. 2010; Rogers et al. 2010; Kirby et al. 2011). DPOAE data from normal-hearing and hearing-impaired individuals with f2 set to 4 kHz and to each subject’s standing-wave frequency demonstrated slightly better test performance following forward pressure level calibration for clinically relevant conditions. Threshold prediction was not affected by calibration method.
1Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, USA; 2Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA; and 3Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
ACKNOWLEDGMENTS: The authors thank Colleen Gibilisco for her assistance with participant recruitment and Shapelle Freudenberg for her contributions to the experimental design and to data collection.
This work was supported by the National Institutes of Health (National Institute on Deafness and Other Communication Disorders grants T35 DC8757, R01 DC2251, R01 DC8318, P30 DC4662).
Address for correspondence: Michael P. Gorga, Boys Town National Research Hospital, 555 North 30th Street, Omaha, NE 68131, USA. E-mail: firstname.lastname@example.org