Otoacoustic emissions (OAEs) are responses of the outer hair cells within the cochlea that indicate normal peripheral function of the auditory system. OAE detection is dependent upon the integrity of the ear canal, middle-ear, ossicular chain and cochlea. Any disruption along this path may preclude the detection of OAEs. One such disruption includes the presence of deviant middle-ear pressure. This article reviews some of the literature indicating that compensation for deviant middle-ear pressure improves OAE detection. The authors also present a case that shows pressurizing the ear canal to the pressure of the peak compliance of the middle ear (-167 daPa) via a Titan instrument increases the DPOAE response by ~5 to 10 dB below 2 kHz relative to non-compensated DPOAEs. This suggests that accounting for deviant middle-ear pressure via the Titan OAE module improves detection of OAEs when negative middle ear pressure is present.