The reported research introduces a noninvasive approach to estimate round-trip outer-middle ear pressure gain using distortion product otoacoustic emissions (DPOAEs). Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. The role of the outer and middle ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the effect of the outer and middle ear on sound transmission. DPOAEs were obtained in two conditions: (i) two-tone and (ii) three-tone. In the two-tone condition, DPOAEs were generated by presenting two primary tones in the ear canal. In the three-tone condition, DPOAEs at the same frequencies (as in the two-tone condition) were generated by the interaction of the lower frequency primary tone in the two-tone condition with a distortion product generated by the interaction of two other external tones. Considering how the primary tones and DPOAEs of the aforementioned conditions were affected by the forward and reverse outer-middle ear transmission, an estimate of the round-trip outer-middle ear pressure gain was obtained. The round-trip outer-middle ear gain estimates ranged from -39 to -17 dB between 1 and 3.3 kHz.
Keywords: distortion product otoacoustic emissions; forward transmission; middle ear; outer-middle ear gain; reverse transmission.