Estimation of outer hair cells function in chronic bilateral tinnitus patients with normal hearing using distortion product otoacoustic emissions

Background and Aim: It is not clear if the measurement of distortion product otoacoustic emissions (DPOAE) at frequencies above 8 kHz adds any value in determining the differences in the cochlear function between patients with and without tinnitus. This study aimed to compare DPOAE in the frequency range of 0.5-10 kHz in patients with normal hearing with and without tinnitus. Methods: This comparative cross-sectional study was conducted on 20 individuals with tinnitus and normal hearing as a study group (SG) and a control group (CG) of 20 normal-hearing individuals without tinnitus. The DPOAE was measured with F-1/F-2 = 1.22 and intensities of F-1 = 65 dB SPL and F-2 =55 dB SPL in the frequency range of 0.5-10 kHz, moreover in the frequency of tinnitus in SG and corresponding frequency in CG. Results: DPOAE level at 10 kHz did not differ significantly between SG and CG (p = 0.491). However, the mean of overall DPOAE level, DPOAE level at the frequency of tinnitus, and F-2 values of 2.5, 5, and 6.298 kHz were significantly lower in SG than CG (p < 0.05). Conclusion: Measurement of DPOAE at 10 kHz did not seem to add any value in determining the differences in the cochlear function between patients with and without tinnitus. However, decreased DPOAE levels at 2.5, 5, and 6.298 kHz which were observed among patients who have tinnitus and normal hearing, indicates some outer hair cells damage that was not detectable by conventional audiometry.