Copyright © American Speech-Language-Hearing Association From: Clinical Applications of Otoacoustic Emissions J Speech Hear Res. 1991;34(5):964-981. doi:10.1044/jshr.3405.964 Legend: An example of the Influence of middle-ear pathology on the expression of evoked emissions for a 56-year-old man. At the top left, the tympanogram patterns (admittance In mmhos as a function of air pressure in daPa) are consistent with a long-standing history of a normally functioning middle ear on the right side, along with the presence of a monomeric tympanic membrane on the left side. The clinical audiograms (top center) also reflect the patient’s history of bilateral noise exposure during previous military service, in combination with a positive pathologic history for the left middle ear, which experienced a number of episodes of otitis media while the patient was a child and several eardrum perforations when he was a teenager. The corresponding evoked-OAE data show the capacity of these responses to efficiently track the abrupt mid- to high-frequency noise-induced loss evidenced by the right ear (open squares). However, the middle-ear dysfunction prevented the successful performance of emissions testing in the left ear, which exhibited only a mild hearing impairment over the low- to mid-frequency range. Although not tested during this session, previous bone-conduction testing revealed an air/bone gap of about 10 dB in the left ear. Date of download: 12/27/2017 Copyright © American Speech-Language-Hearing Association