What Are Otoacoustic Emissions and How Are They Used?

UPDATED June 1, 2023

Discover the fascinating world of otoacoustic emissions and their applications in audiology.

written by

Mark Ross

If someone has ever placed a small device in your ear to check your hearing, it’s possible that the device was used to measure otoacoustic emissions (OAEs). These tiny sounds, created by the inner ear, play an important role in the hearing process and can be used to identify hearing loss, among other things.

Understanding Otoacoustic Emissions

Otoacoustic emissions (OAEs) are sounds produced by the inner ear in response to a sound stimulus. They are generated by the outer hair cells in the cochlea, a snail-shaped structure in the inner ear responsible for converting sound waves into electrical signals that can be sent to the brain.

Definition of Otoacoustic Emissions

Otoacoustic emissions are sounds that are produced by the inner ear in response to a sound stimulus. They are typically measured using a small probe that is placed in the ear and can help healthcare practitioners to identify hearing loss, especially in newborns and young children.

When sound enters the ear, it causes the eardrum to vibrate. These vibrations are then transmitted to the cochlea, where they are picked up by the hair cells. The outer hair cells in the cochlea amplify the sound signal and produce otoacoustic emissions, which can be detected using specialized equipment.

Types of Otoacoustic Emissions

There are two main types of otoacoustic emissions:

  • Spontaneous otoacoustic emissions (SOAEs) occur without any external stimulus and can be detected with a sensitive microphone placed within the ear canal. These sounds are usually low in frequency and very faint, and their significance is still not fully understood.
  • Evoked otoacoustic emissions (EOAEs) are sounds produced in response to an external stimulus such as a click or tone. They can be measured using an otoacoustic emission test and used to assess hearing ability.

EOAEs can be further divided into two categories: transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs). TEOAEs are evoked by a brief click or tone, while DPOAEs are evoked by two tones that are presented simultaneously.

The Science Behind Otoacoustic Emissions

Otoacoustic emissions are thought to be the result of a mechanical process known as cochlear amplification. This process involves the outer hair cells in the cochlea working together to amplify and enhance the sound signal. This amplification process is essential for normal hearing and allows us to hear very soft sounds.

The outer hair cells in the cochlea are able to amplify sound signals because they are able to change shape in response to electrical signals. When a sound signal is detected by the hair cells, it causes them to change shape and release energy. This energy is then used to amplify the sound signal, making it easier for the inner ear to pick up and transmit to the brain.

Understanding otoacoustic emissions is important for diagnosing hearing loss, especially in newborns and young children who may not be able to communicate their hearing difficulties. By measuring otoacoustic emissions, healthcare practitioners can identify potential hearing problems and provide appropriate treatment.

The Role of Otoacoustic Emissions in Hearing

Now that we know what otoacoustic emissions are and how they are produced, let’s explore their role in the hearing process.

Otoacoustic emissions (OAEs) are a sound that is produced by the inner ear in response to an external sound. These emissions are generated by the movement of the outer hair cells in the cochlea, which amplify the sound waves and send them to the brain.

The Healthy Ear and Otoacoustic Emissions

In a healthy ear, otoacoustic emissions will be present and consistent. This means that the outer hair cells are functioning properly and are able to produce the necessary sounds. If these emissions are absent or reduced, this can be a sign of hearing loss. This is because hearing loss can cause damage to the outer hair cells in the cochlea, which are responsible for producing these emissions.

It is important to note that not all types of hearing loss will result in a reduction or absence of otoacoustic emissions. For example, conductive hearing loss, which is caused by a blockage or damage to the outer or middle ear, will not affect the functioning of the outer hair cells and therefore will not impact the production of otoacoustic emissions.

Detecting Hearing Loss with Otoacoustic Emissions

Otoacoustic emission testing can help to detect hearing loss, especially in newborns and young children who may not be able to communicate or cooperate during traditional hearing tests. By measuring evoked otoacoustic emissions, healthcare practitioners can assess the functioning of the outer hair cells and determine whether an individual has a hearing impairment.

There are two types of otoacoustic emissions: spontaneous and evoked. Spontaneous otoacoustic emissions are sounds that are produced by the inner ear without any external stimulation. Evoked otoacoustic emissions, on the other hand, are produced in response to an external sound, such as a click or a tone. Evoked otoacoustic emissions are more commonly used in hearing tests as they provide more specific information about an individual’s hearing ability.

Otoacoustic Emissions and Tinnitus

Tinnitus is a common condition that affects millions of people around the world. It causes a ringing or buzzing sensation in the ears and can be very distressing. Otoacoustic emissions can be used to investigate the underlying causes of tinnitus and may provide insight into new treatments for this condition.

Research has shown that individuals with tinnitus often have reduced or absent otoacoustic emissions, particularly in the frequency range that corresponds to the pitch of the tinnitus. This suggests that damage to the outer hair cells may be a contributing factor to the development of tinnitus.

By using otoacoustic emissions to investigate the underlying causes of tinnitus, researchers may be able to develop new treatments that target the specific mechanisms involved in the condition. For example, if damage to the outer hair cells is found to be a major contributor to tinnitus, treatments that aim to protect or repair these cells may be effective in reducing the severity of the condition.

Otoacoustic Emission Testing

If you or someone you know is concerned about their hearing, an otoacoustic emission test may be recommended. This test measures the evoked otoacoustic emissions produced by the outer hair cells in response to a sound stimulus.

Otoacoustic emissions were first discovered in the 1970s and have since become an important tool in assessing hearing ability. They are sounds that are produced by the inner ear in response to external sounds. These sounds are very faint and can only be detected using sensitive equipment.

The Otoacoustic Emission Test Procedure

An otoacoustic emission test is a quick and painless procedure that can be performed in a doctor’s office or audiology clinic. A small probe is placed in the ear, and a series of clicks or tones are played through headphones. The probe measures the otoacoustic emissions produced by the outer hair cells in response to the sounds.

The test is non-invasive and does not require any special preparation. It is suitable for individuals of all ages, including infants and young children.

Interpreting Otoacoustic Emission Test Results

If otoacoustic emissions are present and consistent, this indicates that the outer hair cells are functioning normally and the individual has normal hearing. Absent or reduced emissions may indicate hearing loss, and further testing may be required to determine the extent and type of hearing loss.

It is important to note that otoacoustic emission testing is just one part of a comprehensive hearing evaluation. Other tests, such as pure-tone audiometry and speech audiometry, may also be conducted to provide a complete picture of an individual’s hearing ability.

Limitations and Considerations of Otoacoustic Emission Testing

While otoacoustic emission testing can be a useful tool in assessing hearing ability, it has some limitations. For example, it may not be able to detect certain types of hearing loss, especially those that affect the inner ear or auditory nerve. Furthermore, it may not be suitable for individuals with certain medical conditions or ear abnormalities.

It is important to discuss any concerns or questions you may have about otoacoustic emission testing with your healthcare provider. They can provide you with more information about the procedure and help you determine if it is the right test for you.

Applications of Otoacoustic Emissions in Medicine and Research

The use of otoacoustic emissions extends beyond hearing assessment and testing. Let’s explore some of the additional applications of this technology.

Newborn Hearing Screening

Otoacoustic emission testing is commonly used to screen newborns for hearing loss. This is because hearing loss can significantly affect a child’s language and social development, and early intervention is critical to ensure the best possible outcomes.

During the screening process, a tiny earphone and microphone are placed in the baby’s ear. The earphone plays a series of clicking sounds while the microphone records the otoacoustic emissions that are produced by the inner ear in response to the sounds. If the emissions are not detected, it may indicate that the baby has hearing loss and further testing is required.

It is important to note that otoacoustic emissions testing is not a definitive diagnosis of hearing loss, but rather a screening tool. If a baby does not pass the screening, further testing will be needed to determine if there is hearing loss present and the extent of the loss.

Monitoring Ototoxicity in Patients

Some medications and treatments can cause hearing loss as a side effect. Otoacoustic emission testing can be used to monitor individuals who are receiving these treatments, and detect any hearing loss that may occur as a result.

This is particularly important for patients undergoing chemotherapy, as certain drugs used in chemotherapy can cause damage to the hair cells in the inner ear, leading to hearing loss. By regularly monitoring otoacoustic emissions, doctors can detect any changes in hearing and adjust the treatment plan accordingly.

Investigating the Function of the Cochlea

Researchers are using otoacoustic emissions to investigate the function of the cochlea in more detail. By analyzing these emissions, scientists can gain a better understanding of how the cochlea amplifies sound and how this process may be disrupted in individuals with hearing loss.

One area of research is focused on the role of the outer hair cells in the cochlea. These cells are responsible for amplifying sound waves, allowing us to hear soft sounds. By studying otoacoustic emissions, researchers can gain insights into how these cells function and how they may be affected by different types of hearing loss.

Overall, otoacoustic emissions are a valuable tool in the field of audiology and beyond. From screening newborns for hearing loss to investigating the inner workings of the cochlea, this technology has the potential to improve our understanding of hearing and lead to better outcomes for patients.

Conclusion

Otoacoustic emissions are an important aspect of the hearing process. They are generated by the outer hair cells in the cochlea and can be used to assess hearing ability, detect hearing loss, and investigate the function of the inner ear. Otoacoustic emission testing is a valuable tool, especially for newborn screening and monitoring ototoxicity in patients. Although there are some limitations to this technology, ongoing research is helping to refine and improve its use in a variety of clinical and research settings.

Experts behind this article

written by

Mark Ross

Dr. Mark Ross is a Principal Investigator of the RERC on Hearing Enhancement, Professor Emeritus of Audiology, University of Connecticut and has served as Vice President of the SHHH Board of Trustees.

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