More details
Hide details
ENT Clinic, Attikon University Hospital, Athens, Greece
Private Practice, Tripoli, Greece
Audiological Department of the ENT Clinic, Hippokration University Hospital, Athens, Greece
ENT Department, Evgenideion Hospital, Athens, Greece
Publication date: 2014-12-31
Corresponding author
Agis Komis   

Agis Komis, ENT Clinic, Attikon University Hospital, 5 Efesou str, N. Iraklio Attikis, Athens, Greece, e-mail: agkomis@yahoo.gr tel: 0030-6938857941
J Hear Sci 2014;4(4):9-20
The medial olivocochlear system (MOCS), part of the efferent auditory pathway, causes an inhibitory effect on the outer hair cells, thus protecting them against extreme noise exposure and improving speech discrimination in noisy environments. This study aims to assess the MOCS function and aging in tinnitus patients with the use of contralateral suppression (CS) of otoacoustic emissions (OAEs).

Material and Methods:
136 subjects took part in this study, divided in 6 groups (control group, right-side tinnitus, left-side tinnitus, bilateral tinnitus, presbycusis without tinnitus and presbycusis with tinnitus). CS of transiently- evoked (TEOAEs) and distortion products OAEs (DPOAEs) was measured for each group and pair- wise comparisons between the groups were performed.

CS was less frequent and the mean values of CS were significantly lower in the tinnitus ears than normal ones. The mean values of CS of ears with presbycusis were in some cases higher than ears with presbycusis and tinnitus and also than ears with tinnitus and normal hearing. Not particular statistical differences were found between the method used (TEOAEs or DPOAEs) and the comparisons between the groups.

The absence and lower values of CS in tinnitus ears imply a MOCS dysfunction as a main factor of tinnitus generation. Tinnitus seems to have a more detrimental effect to the MOCS function than presbycusis. CS of TEOAEs and DPOAEs are equally sensitive methods in detecting MOCS dysfunction in patients with tinnitus.

American National Standards Institute. Specifications for audiometers, S3.6. New York, ANSI, 1969.
McFadden D. Tinnitus: Facts, Theories and Treatment. Washington DC: National Academy Press, 1982.
Jastreboff PJ. Phantom auditory perception (Tinnitus). Mechanisms of generation and perception. Neurosci Res, 1990; 8: 221–54.
Ami M, Abdullah A, Awang MA, Liyab B, Saim L. Relation of distortion product otoacoustic emissions with tinnitus. Laryngoscope, 2008; 118: 712–7.
Thabet EM. Evaluation of tinnitus patients with normal hearing sensitivity using TEOAEs and TEN test. Auris Nasus Larynx, 2009; 36: 633–6.
Duchamp C, Morgon A, Chery-Croze S. Tinnitus sufferers without hearing loss. In: Reich GE, Vermon JA (eds.). Proceedings of the Vth International Tinnitus Seminar 1995. Portland, OR: American Tinnitus Association, 1995: 266–9.
Kaltenbach J. ARC 2011 Current trends in the evaluation and treatment of tinnitus: Overview of the pathophysiology of tinnitus. Audiology Today, 2011; 23: 56–63.
Holgers KM, Erlandsson SI, Barrenas MI. Predictive factors for the severity of tinnitus. Audiology, 2000; 34: 11–20.
Walpunger V, Hebing-Lenartz G, Denecke H, Pietrowsky R. Habituation deficit in auditory- event-related potentials in tinnitus complainers. Hear Res, 2003; 181: 57–64.
Geyer MA, Tapson GS. Habituation of tactile startle is alerted by drugs acting on serotonin-2 receptors. Neuropharmacology, 1988; 1: 135–47.
Jastreboff PJ, Gray WC, Gold SL. Neurophysiological approach to tinnitus patients. Am J Otol, 1996; 17: 236–40.
Micheyl C, Perrot X, Collet L. Relationship between auditory intensity discrimination in noise and olivocochlear efferent system activity in humans. Behav Neurosc, 1997; 11(4): 801–7.
Komazec Z, Filipovic D, Milosevic D. Contralateral acoustic suppression of transient evoked otoacoustic emissions: activation of the medial olivocochlear bundle. Med Pregl, 2003; 56(3–4): 124–30.
Clarke EM, Ahmmed A, Adams C: Contralateral suppression of otoacoustic emissions in children with specific language impairment. Ear Hear, 2006, 27(2): 153–60.
Veuillet E, Magnan A, Ecalle J, Thai-Van H, Collet L. Auditory processing disorder in children with reading disabilities: effect of audiovisual training. Brain, 2007; 130(11): 2915–28.
Maison SF, Luebke AE, Liberman MC, Zuo J. Efferent protection from acoustic injury is mediated via alpha9 nicotinic acetylcholine receptors on outer hair cells. J Neurosci, 2002; 15: 10838–46.
Graham RL, Hazell JW: Contralateral suppression of transient evoked OAE: intra-individual variability in tinnitus and normal subjects. Br J Audiol, 1994; 28(4–5): 235–45.
Lind O. Transient-evoked otoacoustic emissions and contralateral suppression in patients with unilateral tinnitus. Scand Audiol, 1996; 25(3): 167–72.
Ceranic BJ, Prasher DK, Raglan E, Luxon LM. Tinnitus after head injury: evidence from otoacoustic emissions. J Neurol Neurosurg Psychiatry, 1998; 65(4): 523–9.
Riga M, Papadas T, Werner JA, Dalchow CV: A clinical study of the efferent auditory system in patients with normal hearing who have acute tinnitus. Otol Neurotol, 2007; 28(2): 185–90.
Paglialonga A, Del Bo L, Ravazzani P, Tognola G. Quantitative analysis of cochlear active mechanisms in tinnitus subjects with normal hearing sensitivity: multiparametric recording of evoked OAE and contralateral suppression. Auris Nasus Larynx, 2010; 37: 291–8.
Geven LI, de Kleine E, Free RH, van Dijk P. Contralateral suppression of OAEs in tinnitus patients. Otol Neurootol, 2011; 32(2): 315–21.
Riga M, Katomichelakis M, Danielides V. The potential role of the medial olivocochlear bundle in the generation of tinnitus: controversies and weaknesses in the existing clinical studies. Otol Neurotol 2014; (epub ahead of print).
Collet L, Kemp DT, Veuillet E. Effect of contralateral auditory stimuli on active cochlear micromechanical properties in human subjects. Hear Res, 1990; 43: 251–62.
Williams EA, Brookes GB, Prasher DK. Effects of olivocochlear bundle section on otoacoustic emissions in humans: efferent effects in comparison with control subjects. Acta Otolaryngol, 1994; 114(2): 121–9.
Guinan JJ, Backus BC, Lilaonitkul W, Aharonson V. Medial olivocochlear efferent reflex in humans: otoacoustic emission (OAE) measurement issues and the advantages of stimulus frequency OAEs. J Assoc Res Otolaryngol, 2003; 4(4): 521–40.
Khalfa S, Collet L. Functional asymmetry of medial olivocochlear system in humans: towards a peripheral auditory lateralization. Neuroreport, 1996; 7(5): 993–6.
Khalfa S, Morlet T, Micheyl C, Morgon A. Evidence of peripheral hearing asymmetry in humans: clinical implications. Acta Otolaryngol, 1997; 117: 192–6.
Favero ML, Sanchez TG, Bento RF, Nascimento AF. Contralateral suppression of otoacoustic emissions in patients with tinnitus. Rev Bras Otorrinolaryngol, 2006; 72(2): 223–6.
Lalaki P, Hatzopoulos S, Lorito G, Kochanek K, Silwo L, Skarzynski H. A connection between the efferent auditory system and noise-induced tinnitus generation: reduced contralateral suppression of TEOAEs in patients with noise-induced tinnitus. Med Sci Monit, 2011; 17(7): MT56–62.
Berlin CI, Hood LJ, Wen H, Szabo P, Cecola RP, Rigby P, Jackson DF. Contralateral suppression of non-linear click- evoked otoacoustic emissions. Hear Res, 1993; 71: 1–11.
Collet L, Veuillet E, Bene J, Morgon A. Effects of contralateral white noise on click-evoked emissions in normal and sensorineural ears: towards an explanation of the medial olivocochlear system. Audiology, 1992, 31(1): 1–7.
Gkoritsa E, Korres S, Segas I, Xenelis I, Apostolopoulos N, Ferekidis E. Maturation of the auditory system: 2. Transient otoacoustic emission suppression as an index of the medial olivocochlear bundle maturation. Int J Audiol, 2007; 46(6): 277–86.
Guinan JJ, Warr WB, Norris BE. Differential olivocochlear projections from lateral versus medial ones of the superior olivary complex. J Comp Neurophysiol, 1983; 226: 21–7.
Hsu SY, Wang PC, Yang TH, Lin TF, Hsu SH, Hsu CJ. Auditory efferent dysfunction in normal-hearing chronic idiopathic tinnitus. B-ENT, 2013; 9(2): 101–9.
Chery-Croze S, Truy E, Morgon A. Contralateral suppression of transiently-evoked otoacoustic emissions and tinnitus. Br J Audiol, 1994; 28(4–5): 255–66.
Graham RL, Hazell JW. Contralateral suppression of transient evoked otoacoustic emissions: intra-individual variability in tinnitus and normal subjects. Br J Audiol, 1994; 28(4–5): 235–45.
Geven LI, Wit HP, de Kleine E, van Dijk P. Wavelet analysis demonstrates no abnormality in contralateral suppression of otoacoustic emissions in tinnitus patients. Hear Res, 2012; 286(1–2): 30–40.
Chery-Croze S, Moulin A, Collet L, Morgon A. Medial olivocochlear system and tinnitus. Acta Otolaryngol, 1993; 113: 285–90.
Castor X, Veuillet E, Morgon A, Collet L. Influence of ageing on active cochlear micromechanical properties and on the medial olivocochlear system in humans. Hear Res, 1994; 77(1–2): 1–8.
Hood LJ, Hurley A, Goforth L, Bordelon J, Berlin CI. Ageing and efferent suppression of otoacoustic emissions. Abstracts of the Twentieth Midwinter Research meeting of the Association for Research in Otolaryngology, 1997; 20(20).
Keppler H, Dhooge I, Corthals P, Maes L, D’haenens W, Bockstael A, Philips B, Swinnen F, Vinck B. The effects of ageing on evoked otoacoustic emissions and efferent suppression of transient-evoked otoacoustic emissions. Clin Neurophysiol, 2010; 121(3): 359–65.
Kim S, Frisina DR, Frisina RD. Effects of age on contralateral suppression of distortion product otoacoustic emissions in human listeners with normal hearing. Audiol Neurootol, 2002; 7(6): 348–57.
Fu B, Le Prell C, Simmons D, Lei D, Schrader A, Chen A, Bao J. Age-related synaptic loss of the medial olivocochlear efferent innervation. Mol Neurodegen, 2010; 5: 53.
Ozimek E, Wicher A, Szyfter W, Szymiec E. Distortion product otoacoustic emission (DPOAE) in tinnitus patients. J Acoust Soc Am, 2006; 119(1): 527–38.
Journals System - logo
Scroll to top