The clinical application of acoustic distortion products.

Otoacoustic emissions provide an objective measure of hair-cell function that is independent of retrocochlear activity. Because of their frequency specificity, distortion-product emissions have great potential for clinical use. The present report describes the results of initial studies in patients with known cochlear or retrocochlear disease, diagnosed with standard otologic and audiologic tests. The cochlear group consisted of those diagnosed with noise-induced hearing loss, Meniere's disease, or hereditary hearing loss, whereas patients with acoustic neuroma comprised a retrocochlear group. A final group consisted of patients with sudden sensorineural hearing loss of unknown origin. Detailed distortion-product emission testing included the computer-controlled acquisition of "audiograms" and response/growth functions. The outcomes of these studies demonstrated that distortion-product emissions provide a noninvasive, frequency-specific test of sensory-cell function that objectively depicts the boundary between normal and abnormal hearing. These emissions were also able to effectively track dynamic changes in progressive disease processes. Finally, as a screening tool, acoustic distortion products provide an objective means of assessing cochlear status in infants and young children and in adults at risk for hearing loss. Because acoustic distortion products accurately measure the sensory component of a sensorineural hearing loss, distortion-product testing may play an important role in the diagnosis and treatment of cochlear dysfunction.