Volterra Slice otoacoustic emissions recorded using maximum length sequences from patients with sensorineural hearing loss

When normally hearing ears are stimulated with maximum length sequences (MLS) of clicks, a family of non-linear temporal interaction components of otoacoustic emissions (OAEs) can be derived, which have been named Volterra Slice OAEs (VS OAEs). This study investigates the sensitivity of VS OAEs to sensorineural hearing impairment in adults, compared to that of the widely used derived non-linear click evoked OAE (DNL CEOAE). VS OAEs and DNL CEOAEs were obtained from 24 normally hearing and 24 hearing impaired ears using a custom-built MLS system and a Otodynamics 'ILO88' OAE Analyzer, respectively. The results show that, based on waveform reproducibility, VS OAEs are as successful as DNL CEOAEs at separating normal from impaired ears at the audiometric frequencies of 1 and 2 kHz, where a strong correlation is found between the amplitudes of the two OAE types. At 4 kHz however, VS OAEs are a significantly better indicator of hearing loss than DNL CEOAEs. This difference at 4 kHz appears to be due to the lack of stimulus artefact contamination of VS OAEs in the early, high frequency portion of the response. The findings suggest that VS OAEs may provide a better diagnostic and monitoring tool for hearing loss at high frequencies than the conventional DNL CEOAE.