Tympanic pressure gradients and otoacoustic emissions

OBJECTIVE: The purpose of this study was to investigate the immediate effects of tympanic over- and under-pressure, induced by variations in ambient pressure on click-evoked otoacoustic emissions (CEOAEs) in healthy individuals. It was of particular interest to elucidate whether changes in the CEOAE response in both spectral and time domains could be attributed not only to tympanic, but also to cochlear influence. DESIGN: Nine healthy subjects with normal hearing and middle ear pressure were exposed to ambient pressure changes in a pressure chamber. The pressure was progressively changed in 100 daPa steps to accomplish an increase and a decrease in tympanic pressure. Pressure equilibration of the middle ear was avoided. The relative tympanic over- and under-pressure (+/- 320daPa) was monitored by tympanometry and the CEOAEs recorded at every step of tympanic pressure change. RESULTS: There was a statistically significant reduction of the otoacoustic emission (OAE) response levels and reproducibility already at 100 daPa of ambient pressure change. The OAE response was progressively reduced by increased pressure gradients. The CEOAEs recorded during progressive tympanic over- and under-pressure also had increasingly shorter latencies. These changes of the OAE response characteristics were most pronounced in the 750 to 3000 Hz frequency bands. CONCLUSIONS: The progressive attenuation of the OAE response and the concomitant shortening of the OAE response latencies were observed during a combination of altered middle and inner ear pressure. Although the middle and inner ear influence cannot be separated we suggest, based on our findings, that the shortening of latencies may partly be caused by inner ear pressure changes and stiffening of the labyrinthine membranes. Further studies are needed to more specifically clarify the relative contribution of the tympanic and labyrinthine influence, respectively, for the various aspects of pressure influence on the OAE response.