Authors: Angeline Meerkerk-Meijer¹, Stefanie Reijers¹, Jantien Vroegop¹, Marc van der Schroeff¹, Bernd Kremer¹
¹Erasmus Medical Center
Background: Young adults are at risk of noise-induced hearing loss from recreational sound exposure. Early detection of cochlear dysfunction is crucial to reduce long-term effects. Distortion product otoacoustic emissions (DPOAEs) show promise as a non-invasive, low-tech and widely applicable method for detecting high-frequency hearing loss (HFHL), yet are underused in adolescent screenings.
Objective: To assess the relationship between DPOAE signal-to-noise ratios (SNRs) and pure-tone audiometry thresholds in adolescents aged 13 to 18, focusing on the ability of SNR values at age 13 to predict HFHL at age 18, and the diagnostic utility of SNR values at age 18 for detecting HFHL.
Setting and Design: This research is part of Generation R, a long-term birth cohort in Rotterdam, The Netherlands, which tracks children from fetal development onward. Data were collected from April 2016 to September 2019 (age 13) and from October 2020 to May 2024 (age 18).
Methods: Pure-tone audiometry (PTA) thresholds were measured at age 18 and DPOAEs were recorded at age 13 and age 18. Participants had normal middle ear function based on tympanometry. In the data analysis, the receiver operator characteristic (ROC) is used to evaluate how well the SNR can distinguish between HFHL and normal hearing. HFHL is defined as PTA thresholds ≤15 dB at 500 and 1000 Hz, and >15 dB averaged across 3, 4, 6, and 8 kHz. For different DPOAE threshold values the sensitivity and specificity of the model is evaluated.
Results: Analysis of 3,463 ears at age 18 showed that SNR values distinguished HFHL from normal hearing with an area under the curve (AUC) of the ROC of 0.830. At age 13, SNR predicted HFHL at age 18 with an AUC of 0.743.
Conclusions: SNR values from DPOAEs show potential for both current and predictive screening of HFHL in adolescents, supporting early detection and prevention of noise-induced hearing loss.
