Otoacoustic Emissions as a Promising Diagnostic Tool for the Early Detection of Mild Hearing Impairment - Technical Advances in Acquisition, Analysis and Modeling

Otoacoustic emissions are a by-product of the active nonlinear amplification mechanism located in the cochlear outer hair cells, which provides high sensitivity and frequency resolution to human hearing. Being intrinsically sensitive to hearing loss at a cochlear level, they represent a promising non-invasive, fast, and objective diagnostic tool. On the other hand, the complexity of their linear and nonlinear generation mechanisms and other confounding physical phenomena (e.g., interference between different otoacoustic components, acoustical resonances in the ear canal, transmission of the middle ear) introduce a large inter-subject variability in their measured levels, which makes it difficult using them as a direct measure of the hearing threshold using commercially available devices. Nonlinear cochlear modeling has been successfully used to understand the complexity of the otoacoustic generation mechanisms, and to design new acquisition and analysis techniques that help disentangling the different components of the otoacoustic response, therefore improving the correlation between measured otoacoustic levels and audiometric thresholds. In particular, nonlinear cochlear modeling was able to effectively describe the complex (amplitude and phase) response of the basilar membrane, and the generation of otoacoustic emissions by two mechanisms, nonlinear distortion and linear reflection by cochlear roughness. Different phase-frequency relations are predicted for the otoacoustic components generated by the two mechanisms, so they can be effectively separated according to their different phase-gradient delay, using an innovative time-frequency domain filtering technique based on the wavelet transform. A brief introduction to these topics and some new theoretical and experimental results are presented and discussed in this study.