Detection of age-related hearing losses (ARHL) via transient-evoked otoacoustic emissions.

Purpose: The objective of the study was to identify subjects presenting hearing deficits,
specifically age-related hearing losses (ARHL), via objective assessment methodologies.
Materials and Methods: Initially, 259 subjects (165 men, 94 women) were enrolled in the
study. After the application of inclusion criteria, the final number was reduced to 88 subjects
(49.8 ± 19.1 ys) subdivided into 64 normal and 83 ARHL cases. The subjects were assessed
with traditional audiometry tests and with transiently evoked otoacoustic emissions
(TEOAEs). Since each ear has its own acoustic signature, the TEOAE analyses were
conducted in terms of ears and not subjects. The TEOAE data were processed by traditional
and recurrence quantification analyses, leading to the estimation of the WWR (whole waveform
reproducibility) and the new RAD2D (2-dimensional radius) parameters. A plot of
WWR vs RAD2D was used to optimize the classification of the cases presenting ARHL.
Results: By using a WWR value of 70% as a classifier, the sensitivity of TEOAEs was
estimated as 75.9% and the specificity as 89.1%. By using the RAD2D parameter (with a cutoff
value of 1.78), a sensitivity value of 80.7% and a specificity value of 71.9% were
obtained. When both parameters were used, a sensitivity value of 85.5% and a specificity
value of 92.2% were estimated. In the latter classification paradigm, the number of false
negatives decreased from 20 to 12 out of 83 ears (14%).
Conclusion: In adult hearing screening assessments, the proposed method optimizes the identification
of subjects with a hearing impairment correlated to the presence of age-related hearing loss.