Reduced àudiogram ripple' in normally-hearing subjects with weak otoacoustic emissions.

Correspondence between spectral patterns in otoacoustic emissions (OAE) and the fine structure of the pure-tone audiogram has often been noted, but the link is by no means clearly understood nor complete in all subjects. This paper presents part of a broader study focusing on individuals with normal hearing but anomalously weak OAEs, the primary purpose of which was to determine the reasons for the weak OAEs. Subjects were selected from an exhaustive search of some 400 ears of highly co-operative adults, and comprised a test group of subjects with normal hearing thresholds but weak OAEs, and a control group of normals from the same sample. Reported here are data on audiogram fine structure measured in the two groups of subjects. The basic finding is that the subjects with weak OAEs also exhibited significantly less audiogram fine structure than the controls, as evaluated by analysing the periodicity in the respective threshold curves as well as by identifying and quantifying individual peaks in the curves. These findings first provide further evidence of an underlying link between the fine structure of the audiogram and OAEs, as proposed by Kemp in his original work. Second, assuming that the degree of fine structure would be largely unaffected by minor middle ear alterations, our findings suggest that predominantly cochlear rather than middle ear factors are responsible for the low levels of OAEs in the normal subjects of our test group. Finally, the results presented suggest that, like OAEs, audiogram fine structure measurements provide information on the auditory system that is not available in the conventional pure-tone audiogram.