The Effect of Stimuli Level on Distortion Product Otoacoustic Emission in Normal Hearing Adults.

The goal of this study is to compare three of the most commonly used primary-level relation paradigms (i.e., Scissors, Boys Town 'Optimal', and Equal-Level) in generation of distortion product otoacoustic emissions (DPOAEs) in normal hearing adults. The generator and reflection components were extracted from DPOAEs in each paradigm. The generator and reflection component levels and input/output (I/O) functions were compared across paradigms and primary-tone levels. The results showed a different I/O function growth behavior across frequency and levels among paradigms. The Optimal paradigm showed a systematic change in the generator and reflection component levels and I/O slopes across primary levels among subjects. Moreover, the levels and slopes in the Optimal paradigm were more distinct across levels with less variations across frequency leading to a systematic change in the DPOAE fine structure across levels. The I/O functions were found to be more sensitive to the selected paradigm; especially the I/O function for the reflection component. The I/O functions of the reflection components showed large variability across frequencies due to different frequency shifts in their microstructure depending on the paradigm. The findings of this study suggested the Optimal paradigm as the proper primary-level relation to study cochlear amplification/compression. The findings of this study shows that care needs to be taken in comparing the findings of different studies that generated DPOAEs with a different level-relation paradigm.