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American Family Physician Nov 2004Tympanometry provides useful quantitative information about the presence of fluid in the middle ear, mobility of the middle ear system, and ear canal volume. Its use has... (Review)
Review
Tympanometry provides useful quantitative information about the presence of fluid in the middle ear, mobility of the middle ear system, and ear canal volume. Its use has been recommended in conjunction with more qualitative information (e.g., history, appearance, and mobility of the tympanic membrane) in the evaluation of otitis media with effusion and to a lesser extent in acute otitis media. It also can provide useful information about the patency of tympanostomy tubes. Tympanometry is not reliable in infants younger than seven months because of the highly compliant ear canals of infants. Tympanogram tracings are classified as type A (normal), type B (flat, clearly abnormal), and type C (indicating a significantly negative pressure in the middle ear, possibly indicative of pathology). According to the Agency for Healthcare Research and Quality guidelines on otitis media with effusion, the positive predictive value of an abnormal (flat, type B) tympanogram is between 49 and 99 percent. A type C curve may be useful when correlated with other findings, but by itself it is an imprecise estimate of middle ear pressure and does not have high sensitivity or specificity for middle ear disorders.
Topics: Acoustic Impedance Tests; Ear, Middle; Humans; Otitis Media; Otoscopy; Physical Examination; Predictive Value of Tests; Pressure; Sensitivity and Specificity
PubMed: 15554489
DOI: No ID Found -
Ear, Nose, & Throat Journal Apr 2021Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2, brings with it a plethora of...
Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2, brings with it a plethora of health concerns. Although most people have mild symptoms, which are respiratory in nature, some experience neurological symptoms, central nervous system manifestations, peripheral nervous manifestations, and skeletal muscle manifestations. But the damaging impact of COVID-19 virus on the hearing organs in the inner ear is a new finding yet to be explored. Currently, there is little evidence published connecting novel coronavirus and tinnitus directly. But according to the American Tinnitus Association, preexisting behavioral conditions make it more likely for patients to experience tinnitus due to the stress and depression associated with social isolation and infection avoidance. Hearing loss and Tinnitus is a common pathology seen in otolaryngology and there are numerous papers in literature describing its associations with other infections. However, this is the first reported case of hearing loss and tinnitus in a COVID-19 patient, in the State of Qatar, and this case report strives to contribute to the ocean of literature highlighting the need for otorhinolaryngologists to be aware of its correlation with COVID-19 virus.
Topics: Acoustic Impedance Tests; Adult; Audiometry, Pure-Tone; Audiometry, Speech; COVID-19; Female; Hair Cells, Auditory, Outer; Hearing Loss, Sensorineural; Humans; Otoacoustic Emissions, Spontaneous; SARS-CoV-2; Speech Perception; Time Factors; Tinnitus
PubMed: 33275033
DOI: 10.1177/0145561320974849 -
Hearing Research Dec 2023We recently discovered a unique type of otoacoustic emission (OAE) time-locked to the onset (and offset) of saccadic eye movements and occurring in the absence of... (Review)
Review
We recently discovered a unique type of otoacoustic emission (OAE) time-locked to the onset (and offset) of saccadic eye movements and occurring in the absence of external sound (Gruters et al., 2018). How and why these eye-movement-related eardrum oscillations (EMREOs) are generated is unknown, with a role in visual-auditory integration being the likeliest candidate. Clues to both the drivers of EMREOs and their purpose can be gleaned by examining responses in normal hearing human subjects. Do EMREOs occur in all individuals with normal hearing? If so, what components of the response occur most consistently? Understanding which attributes of EMREOs are similar across participants and which show more variability will provide the groundwork for future comparisons with individuals with hearing abnormalities affecting the ear's various motor components. Here we report that in subjects with normal hearing thresholds and normal middle ear function, all ears show (a) measurable EMREOs (mean: 58.7 dB SPL; range 45-67 dB SPL for large contralateral saccades), (b) a phase reversal for contra- versus ipsilaterally-directed saccades, (c) a large peak in the signal occurring soon after saccade onset, (d) an additional large peak time-locked to saccade offset and (e) evidence that saccade duration is encoded in the signal. We interpret the attributes of EMREOs that are most consistent across subjects as the ones that are most likely to play an essential role in their function. The individual differences likely reflect normal variation in individuals' auditory system anatomy and physiology, much like traditional measures of auditory function such as auditory-evoked OAEs, tympanometry and auditory-evoked potentials. Future work will compare subjects with different types of auditory dysfunction to population data from normal hearing subjects. Overall, these findings provide important context for the widespread observations of visual- and eye-movement related signals found in cortical and subcortical auditory areas of the brain.
Topics: Humans; Tympanic Membrane; Hearing; Otoacoustic Emissions, Spontaneous; Acoustic Impedance Tests; Sound
PubMed: 37979436
DOI: 10.1016/j.heares.2023.108899 -
Brazilian Journal of Otorhinolaryngology 2020
Topics: Acoustic Impedance Tests; Eustachian Tube
PubMed: 32209307
DOI: 10.1016/j.bjorl.2020.02.001 -
The Nigerian Postgraduate Medical... 2023This study assessed the eustachian tube (ET) function in adult patients with chronic rhinosinusitis (CRS) using tympanometry and nasal endoscope.
BACKGROUND
This study assessed the eustachian tube (ET) function in adult patients with chronic rhinosinusitis (CRS) using tympanometry and nasal endoscope.
MATERIALS AND METHODS
This was a hospital-based cross-sectional study conducted for 9 months. All participants underwent endoscopic evaluation of the pharyngeal end of their ETs, and the middle ear function was assessed using tympanometry. Endoscopic findings were graded based on a validated mucosal inflammatory endoscopic grading scale. Statistical analysis was carried out using SPSS version 24.
RESULTS
A total of 102 CRS patients and age- and sex-matched controls were recruited. Tympanograms suggestive of eustachian tube dysfunction (ETD) types B and C were found among 7.8% and 12.8% of the right and left ears of the CRS groups, respectively. Mucosal inflammatory endoscopic grade that is diagnostic of ETD Grades 3 and 4 was found among 24.5% and 38.2% of the right and left ET of CRS cases, respectively.
CONCLUSION
CRS predisposes patients to anatomical and functional impairment of ET. The relationship between tympanometry and mucosal inflammatory endoscopic grading scale in detecting ETD among CRS patients showed a strong relationship. However, a combination of the two will improve the diagnosis of ETD by evaluating the ET function directly and indirectly.
Topics: Adult; Humans; Acoustic Impedance Tests; Eustachian Tube; Cross-Sectional Studies; Nigeria; Sinusitis; Ear Diseases; Chronic Disease
PubMed: 37148114
DOI: 10.4103/npmj.npmj_31_23 -
Seminars in Hearing Feb 2023Clinical assessment of middle ear function has undergone multiple transformations and developments since the first acoustic impedance measurements were made in human... (Review)
Review
Clinical assessment of middle ear function has undergone multiple transformations and developments since the first acoustic impedance measurements were made in human ears nearly a century ago. The decades following the development of the first acoustic impedance bridge by Metz in 1946 witnessed a series of technological advancements leading to the widespread use of single-frequency admittance tympanometry in the 1960s. In the 1970s, multi-frequency and multi-component tympanometry (MFT) emerged for clinical use, allowing for a better understanding of the middle ear acoustic-mechanical response at frequencies between 200 and 2,000 Hz. MFT has not gained widespread clinical adoption despite its advantages over single-frequency tympanometry. More recent technological developments enabled assessment for frequencies greater than 2,000 Hz, leading to the advent of wideband acoustic immittance measures with capabilities for comprehensive assessment of middle ear acoustic mechanics, and a great potential for use of acoustic immittance testing in various diagnostic practices. This article reviews important historical markers in the development and operation of middle ear assessment tools and analysis methods. Technical and clinical factors underlying the emergence and adoption of different acoustic immittance tests as a standard of clinical practice are described. In addition, we discuss the likelihood for widespread adoption of wideband acoustic immittance and wideband tympanometry in future clinical practice.
PubMed: 36925655
DOI: 10.1055/s-0043-1764139 -
Frontiers in Neurology 2022Meniere's disease (MD) is a clinical syndrome characterized by spontaneous recurrent vertigo, usually accompanied by hearing loss, tinnitus, and aural fullness. The... (Review)
Review
Meniere's disease (MD) is a clinical syndrome characterized by spontaneous recurrent vertigo, usually accompanied by hearing loss, tinnitus, and aural fullness. The cause of MD remains unclear and is generally considered to be associated with endolymphatic hydrops. Studies showed that patients with MD could have eustachian tube dysfunction (ETD). ETD can disrupt the pressure balance between the middle and inner ear and impair the inner ear's function. In recent years, several studies have attempted to identify MD by using wideband tympanometry (WBT). However, there are limited studies in this area. There is no consensus on how to use WBT to diagnose Meniere's disease. Therefore, we endeavored to conduct a narrative review in this aspect based on the latest research findings. Reduction in resonance frequency and absorbance are characteristic of MD and can identify Meniere's disease. The use of an increase in the integrated area of absorbance as an indicator for identifying MD is controversial. WBT seems to be ineffective as a diagnostic tool during the acute episodes of Meniere's disease. Patients with MD may benefit from WBT. WBT has excellent potential for future use in Meniere's disease. However, further large sample sizes, multicenter studies are needed.
PubMed: 35153998
DOI: 10.3389/fneur.2022.808921 -
Ear, Nose, & Throat Journal Apr 2021
Review
Topics: Acoustic Impedance Tests; Audiometry, Pure-Tone; COVID-19; Hearing Loss; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Otitis Media; Otoacoustic Emissions, Spontaneous; SARS-CoV-2
PubMed: 32755405
DOI: 10.1177/0145561320946902 -
The Journal of International Advanced... Nov 2022Obstructive Eustachian tube dysfunction in adults is common. The purpose of this study was to examine whether balloon dilation of the Eustachian tube can improve... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Obstructive Eustachian tube dysfunction in adults is common. The purpose of this study was to examine whether balloon dilation of the Eustachian tube can improve ventilation of the middle ear among adult patients with mild chronic Eustachian tube dysfunction.
METHODS
This study included patients aged ≥18 years with unilateral chronic Eustachian tube dysfunction confirmed with an abnormal tympanometry and a retracted tympanic membrane. Patients were treated daily with nasal steroid spray and Valsalva maneuver for 2 months. If Eustachian tube dysfunction persisted, they were enrolled in the study and randomized to balloon dilation of the Eustachian tube or control. All patients underwent otomicroscopy, tympanometry, pure-tone audiometry and the Eustachian Tube Dysfunction Questionnaire-7. Follow-up visits were completed at 3 weeks, 3 months, and 6 months.
RESULTS
In total, 24 patients completed the study (13 balloon dilation of the Eustachian tube, 11 control). The balloon dilation of the Eustachian tube group showed normalization from retraction or serous otitis media in 9 out of 13 patients (P = .0006) compared to 0 out of 11 patients in the control group. In the balloon dilation of the Eustachian tube group, 9 out of 13 patients showed an improvement in tympanometry from B to C/A or from C to A (P = .04) compared to 3 out of 11 patients in the control group. The audiometric data showed no difference (P = .38). There was no significant difference in mean Eustachian Tube Dysfunction Questionnaire-7 score between the two groups (P = .35). In the balloon dilation of the Eustachian tube group, 69% answered that they had benefitted from the treatment.
CONCLUSION
The procedure is feasible and no complications were reported. The study indicates that balloon dilation of the Eustachian tube may be a beneficial treatment in a selected group of adult patients with mild chronic Eustachian tube dysfunction.
Topics: Adult; Humans; Adolescent; Eustachian Tube; Dilatation; Follow-Up Studies; Treatment Outcome; Ear Diseases
PubMed: 36349672
DOI: 10.5152/iao.2022.21198 -
Seminars in Hearing Feb 2023As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of...
As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of frequency in children with various middle ear pathologies. More recently, the use of wideband tympanometry has enabled clinicians to conduct WBA at ambient pressure (WBA ) as well as the pressurized mode (WBA ). This article reviews evidence for the ability of WBA measurements to accurately characterize the normal middle ear function across a wide range of frequencies and to aid in differential diagnosis of common middle ear disorders in children. Absorbance results in cases of otitis media with effusion, negative middle ear pressure, Eustachian tube malfunction, middle ear tumors, and pressure equalization tubes will be compared to age-appropriate normative data. Where applicable, WBA as well as WBA will be reviewed in these conditions. The main objectives of this article are to identify, assess, and interpret WBA and WBA outcomes from various middle ear conditions in children between the ages of 3 and 12 years.
PubMed: 36925660
DOI: 10.1055/s-0043-1763294