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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 -
Brazilian Journal of Otorhinolaryngology 2020
Topics: Acoustic Impedance Tests; Eustachian Tube
PubMed: 32209307
DOI: 10.1016/j.bjorl.2020.02.001 -
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 -
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 -
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 -
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 -
Indian Journal of Otolaryngology and... Dec 2022The tympanic membrane (TM) undergoes a number of pathological changes in middle ear disease which can be detected by a video-otoendoscope. Middle ear disease is also...
The tympanic membrane (TM) undergoes a number of pathological changes in middle ear disease which can be detected by a video-otoendoscope. Middle ear disease is also accompanied by changes in middle ear pressure which can be assessed by tympanometry. The objectives of this study were to find the correlation between video-otoendoscopy and tympanometry in acute middle ear infections and to deduce which of the two is more efficient and reliable for early diagnosis. 75 patients with AOM or OME were included over 1 year where each patient was followed for 21 days. Detailed history and clinical examination with videootoendoscope and tympanometry was done on each visit. Each TM was graded using OMGRADE scale. Symptoms and clinical findings consistent with acute otitis media were given a clinical score (CO Score). The results were collected and correlation between video-otoendoscopy and tympanometry was determined and their individual sensitivity, specificity and diagnostic accuracy was calculated. The sensitivity, specificity and diagnostic accuracy for tympanometry and video-otoendoscopy was calculated individually for each of the 4 visits and positive correlation between the 2 was found. Our study showed that tympanometry had a higher overall sensitivity than video-otoendoscopy. While, video-otoendoscopy showed a higher specificity than Tympanometry. Otoendoscopy is good for ruling out AOM/OME but cannot rule out persisting Middle Ear Effusion and Tympanometry is a better tool for detecting MEE but cannot differentiate well between AOM and OME. We found that tympanometry plus otoendoscopy together greatly increase the chances of detecting AOM and OME thus improving diagnostic accuracy, reducing financial costs associated with over or mis-diagnosis.
PubMed: 34226866
DOI: 10.1007/s12070-021-02701-x -
Indian Journal of Otolaryngology and... Aug 2022Eustachian tube (ET) is a tube connecting the middle ear cavity with the nasopharynx and has an important role in equalization of pressure around TM. Many studies...
UNLABELLED
Eustachian tube (ET) is a tube connecting the middle ear cavity with the nasopharynx and has an important role in equalization of pressure around TM. Many studies investigated the role of ET function tests on the results of myringoplasty/tympanoplasty. Our aim is to assess the effect of successful myringoplasty on Eustachian tube function. A prospective study included 37 patients admitted to the E.N.T Department at Sohag University Hospital in the period between March 2018 and March 2019 suffering from dry central perforation necessitating myringoplasty. Pre-operative E.T function tests using tympanometry and methylene blue dye test were done. Post-operative follow-up tympanometry was done after 3 months for those with successful myringoplasty and compared to the preoperative assessment. Thirty-one (83%) patients had functioning ET, 6 (17%) had non-functioning ET and 32 patients (86.5%) had successful myringoplasty (taken healthy graft). According to the effect of myringoplasty on ET function test 3 months following surgery, (9%) were affected, either improved (3%) or worsen (6%), while (91%) were not affected by tympanometry in those with taken healthy graft cases. In our study, there was no significant effect of myringoplasty on E.T function.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12070-021-02534-8.
PubMed: 36032907
DOI: 10.1007/s12070-021-02534-8 -
Ear and Hearing 2022Absorbance measured using wideband tympanometry (WBT) has been shown to be sensitive to changes in middle and inner ear mechanics, with potential to diagnose various...
OBJECTIVE
Absorbance measured using wideband tympanometry (WBT) has been shown to be sensitive to changes in middle and inner ear mechanics, with potential to diagnose various mechanical ear pathologies. However, artifacts in absorbance due to measurement noise can obscure information related to pathologies and increase intermeasurement variability. Published reports frequently present absorbance that has undergone smoothing to minimize artifact; however, smoothing changes the true absorbance and can destroy important narrow-band characteristics such as peaks and notches at different frequencies. Because these characteristics can be unique to specific pathologies, preserving them is important for diagnostic purposes. Here, we identify the cause of artifacts in absorbance and develop a technique to mitigate artifacts while preserving the underlying WBT information.
DESIGN
A newly developed Research Platform for the Interacoustics Titan device allowed us to study raw microphone recordings and corresponding absorbances obtained by WBT measurements. We investigated WBT measurements from normal hearing ears and ears with middle and inner ear pathologies for the presence of artifact and noise. Furthermore, it was used to develop an artifact mitigation procedure and to evaluate its effectiveness in mitigating artifacts without distorting the true WBT information.
RESULTS
We observed various types of noise that can plague WBT measurements and that contribute to artifacts in computed absorbances, particularly intermittent low-frequency noise. We developed an artifact mitigation procedure that incorporates a high-pass filter and a Tukey window. This artifact mitigation resolved the artifacts from low-frequency noise while preserving characteristics in absorbance in both normal hearing ears and ears with pathology. Furthermore, the artifact mitigation reduced intermeasurement variability.
CONCLUSIONS
Unlike smoothing algorithms used in the past, our artifact mitigation specifically removes artifacts caused by noise. It does not change frequency response characteristics, such as narrow-band peaks and notches in absorbance at different frequencies that can be important for diagnosis. Also, by reducing intermeasurement variability, the artifact mitigation can improve the test-retest reliability of these measurements.
Topics: Acoustic Impedance Tests; Artifacts; Ear, Inner; Hearing; Humans; Reproducibility of Results
PubMed: 34387582
DOI: 10.1097/AUD.0000000000001117 -
Brazilian Journal of Otorhinolaryngology 2022Endolymphatic hydrops is the pathophysiological substrate of Ménière's disease. The changes in the inner ear, transmitted to the middle ear through changes in the...
INTRODUCTION
Endolymphatic hydrops is the pathophysiological substrate of Ménière's disease. The changes in the inner ear, transmitted to the middle ear through changes in the ossicular chain mobility, can be quantified by wideband tympanometry, through the measurement of the acoustic absorbance at multiple frequencies, represented by the sound energy absorbed by the middle ear, even at its early stages. Studying the behavior of the middle ear through the absorbance in patients with endolymphatic hydrops under ambient pressure and under peak pressure can be useful for detecting Ménière's disease.
OBJECTIVE
To characterize acoustic absorbance behavior in subjects with symptomatic and asymptomatic Ménière's disease compared to controls, in order to verify the ability of wideband tympanometry to detect Ménière's disease.
METHODS
We carried out a cross-sectional study with a diagnostic approach comparing the findings of wideband tympanometry at ambient pressure and peak pressure between the ears of the control group (n = 30), the asymptomatic group (n = 21) and the symptomatic group (n = 9).
RESULTS
Different peak pressure values were found between the ears of the control group (0 daPa), the asymptomatic group (-11 daPa) and the symptomatic group (-192 daPa), with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction. Different absorbance values were found between the ears of the symptomatic group and the asymptomatic group compared to the control group for low frequencies at ambient pressure and peak pressure, with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction.
CONCLUSIONS
The Wideband Tympanometry test was capable of identifying the presence of Ménière´s disease, and to differentiate between asymptomatic and symptomatic patients, when comparing them with healthy individuals.
Topics: Acoustic Impedance Tests; Cross-Sectional Studies; Ear, Inner; Endolymphatic Hydrops; Humans; Meniere Disease
PubMed: 32782123
DOI: 10.1016/j.bjorl.2020.05.029