-
Ear and Hearing 2021The objective of this work is to determine whether there is a systematic effect of middle ear effusion volume on wideband acoustic immittance in children with surgically...
OBJECTIVES
The objective of this work is to determine whether there is a systematic effect of middle ear effusion volume on wideband acoustic immittance in children with surgically confirmed otitis media with effusion.
DESIGN
Wideband acoustic immittance was measured in 49 ears from children (9 months to 11 years) who had a diagnosis of otitis media with effusion and compared to 14 ears from children (10 months to 10 years) without a recent history of otitis media. For children with otitis media with effusion, wideband acoustic immittance testing took place in the child's preoperative waiting room before surgical placement of tympanostomy tubes. Testing was completed in a pressurized condition (wideband tympanometry) for all ears as well as in an ambient condition in a subset of ears. Intraoperative findings regarding effusion volume were reported by the surgeons immediately before tube placement and confirmed following myringotomy. This classified the volume of effusion as compared to middle ear volume categorically as either full, partial, or clear of effusion. The type of wideband acoustic immittance explored in this work was absorbance. Absorbance responses were grouped based on effusion volume into one of four groups: full effusions, partial effusions, ears clear of effusion at the time of surgery, and normal control ears. Standard tympanometry was also completed on all ears.
RESULTS
Absorbance is systematically reduced as the volume of the middle ear effusion increases. This reduction is present at most frequencies but is greatest in the frequency range from 1 to 5 kHz. A multivariate logistic regression approach was utilized to classify ears based on effusion volume. The regression approach classified ears as effusion present (full and partial ears) or absent (clear ears and normal control ears) with 100% accuracy, ears with effusion present as either partial or full with 100% accuracy, and ears without effusion as either normal control ears or ears clear of effusion with 75% accuracy. Regression performance was also explored when the dataset was split into a training set (70% of the data) and a validation test set (30% of the data) to simulate how this approach would perform on unseen data in a clinical setting. Accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve are reported. Overall, this approach demonstrates high sensitivity and specificity for classifying ears as effusion being present or absent and as present effusions being full or partial with areas under the curve ranging from 1 to 0.944. Despite the lack of effusion present in both clear ears and normal control ears, this approach was able to distinguish between these ears, but with a more moderate sensitivity and specificity. No systematic effect of effusion volume was found on standard tympanometry.
CONCLUSIONS
Wideband acoustic immittance, and more specifically, absorbance, is a strong and sensitive indicator of the volume of a middle ear effusion in children with otitis media with effusion.
Topics: Acoustic Impedance Tests; Acoustics; Child; Diagnosis, Differential; Humans; Otitis Media; Otitis Media with Effusion
PubMed: 33928915
DOI: 10.1097/AUD.0000000000001037 -
Acta Otorrinolaringologica Espanola 2016In the first 6 months of life, 226Hz tympanometry is considered an ineffective procedure for the diagnosis of otitis media with effusion. With the introduction of... (Comparative Study)
Comparative Study
INTRODUCTION AND OBJECTIVE
In the first 6 months of life, 226Hz tympanometry is considered an ineffective procedure for the diagnosis of otitis media with effusion. With the introduction of universal hearing screening, the use of high frequency 1000Hz (1kHz) tympanometry has been recommended. To optimise the diagnosis of neonatal hearing loss, we present this comparison, from the clinical point of view, of the results of 226Hz and 1kHz tympanometry in infants.
MATERIALS AND METHODS
We designed a prospective study of 100 children under 9 months of age proceeding from our hearing screening program. We compare the result of tympanometry with binocular microscopy and transient evoked otoacoustic emissions.
RESULTS
The application of transient otoacoustic emissions, otomicroscopy and 226Hz and 1kHz tympanometry has shown its usefulness in the management of otitis media with effusion of young infants, with a similar effectiveness between the 4 tests.
CONCLUSION
The joint use of otomicroscopy, transient otoacoustic emissions and 226Hz and 1kHz tympanometry, has allowed us to diagnose otitis media with effusion in young infants more accurately than each test separately. We recommend initial use of 1kHz tympanometry, at least in children younger than 7 months, but in the presence of hearing loss or an unclear result, 226Hz tympanometry is a good diagnostic complement.
Topics: Acoustic Impedance Tests; Female; Hearing Loss; Humans; Infant; Infant, Newborn; Male; Microscopy; Otoscopy; Prospective Studies
PubMed: 27181223
DOI: 10.1016/j.otorri.2016.01.001 -
The South African Journal of... Jun 2021Limited research exists regarding South African audiologists' practice with acoustic immittance. This study was part of a bigger study titled 'Wideband acoustic...
BACKGROUND
Limited research exists regarding South African audiologists' practice with acoustic immittance. This study was part of a bigger study titled 'Wideband acoustic immittance in adults living with human immunodeficiency virus'.
OBJECTIVES
The purpose of the study was to explore current practice of South African audiologists regarding acoustic immittance measures, and to explore their perceived knowledge and views on acoustic immittance advancements.
METHOD
A quantitative survey with a cross sectional design was employed. An electronic questionnaire was distributed to participants via professional associations of audiologists. Data was analysed through descriptive and inferential statistics.
RESULTS
Most audiologists worked in private practice and conducted tympanometry with 226Hz probe tone and ipsilateral acoustic reflexes. There was no association between clinical setting, levels of qualification, and the use of tympanometry. None of the participants included multifrequency and multicomponent tympanometry (MFT) and/or wideband acoustic immittance (WAI) in their test battery. Most of the participants were not familiar with MFT and WAI. Familiarity with MFT and WAI were only associated with the level of qualification. Limited training and lack of equipment were major barriers to conducting some of the acoustic immittance measures. Most participants believed that they would include MFT and/or WAI in their test battery if they had access to the equipment.
CONCLUSION
Current findings raise training and clinical implications for the South African audiologists, including training institutions. These findings provide motivation for strategic resource allocation, planning and distribution of audiology clinics in the country if positive preventive audiology outcomes are to be achieved.
Topics: Acoustic Impedance Tests; Acoustics; Adult; Audiologists; Cross-Sectional Studies; Ear, Middle; Humans
PubMed: 34212745
DOI: 10.4102/sajcd.v68i1.818 -
European Review For Medical and... Mar 2019Adenoidectomy is a surgical procedure with potential adverse events. Effective nonsurgical therapy could reduce patient risk and harm. The aim of this study was to...
OBJECTIVE
Adenoidectomy is a surgical procedure with potential adverse events. Effective nonsurgical therapy could reduce patient risk and harm. The aim of this study was to evaluate the role of bacteriotherapy to reduce the necessity of adenoid surgery.
PATIENTS AND METHODS
This experimental study was conducted as an open study in 44 children (30 males and 14 females, mean age 4.9 years) who were candidates for adenoidectomy and tympanocentesis as treatment for adenoidal hypertrophy and otitis media with effusion. Twenty-two children were treated with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray, administered as 2 puffs per nostril twice a day for a week for 3 months (study group). The other half of the children was treated with hypertonic saline nasal lavage on the same schedule (control group). Tympanometry and adenoid size assessment were evaluated throughout the intervention period.
RESULTS
In the study group, 6/22 children required surgery, compared to 20/22 children in the study group (p<0.0001). The clinical change in the treated children was a significant reduction of adenoid size (p<0.0001) and improvement of middle ear effusion measured with tympanometry (p<0.0001).
CONCLUSIONS
Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray could significantly reduce the need for adenoid surgery.
Topics: Acoustic Impedance Tests; Adenoidectomy; Adenoids; Administration, Intranasal; Child, Preschool; Female; Humans; Male; Otitis Media with Effusion; Probiotics; Streptococcus oralis; Streptococcus salivarius
PubMed: 30920631
DOI: 10.26355/eurrev_201903_17348 -
Clinics (Sao Paulo, Brazil) 2021To evaluate the relationship between cognitive performance and long-latency auditory evoked potentials in an elderly population.
OBJECTIVE
To evaluate the relationship between cognitive performance and long-latency auditory evoked potentials in an elderly population.
METHODS
The sample consisted of adults between 20 and 58 years of age and elderly adults between 60 and 70 years of age. The screening procedures adopted were an inspection of the external auditory canal, tonal and vocal audiometry, tympanometry, brain stem auditory evoked potential, the Montreal Cognitive Assessment test, and long-latency auditory evoked potential.
RESULTS
The latency and amplitude values of cortical components by age group showed significant differences under the following conditions: (i) signals evoked by the speech stimulus /da/ and by the pure-tone stimulus at 2,000 Hz for the N2 amplitude (p=0.008 and p=0.001, respectively) , which were both higher for adults, and (ii) signals evoked by the speech stimulus /da/ for N1 latency (p=0.018) and by the pure-tone stimulus at 2,000 Hz for P2 latency (p=0.017), which were both higher in the elderly population. The cognitive component (P300) showed a significant difference when evoked by speech stimuli, with higher latency in the elderly population (p=0.013). When correlated with cognitive processes, the latency and amplitude of cortical potentials showed direct and medium-strength correlations between abnormal scores obtained on the Montreal Cognitive Assessment test and P2 amplitude (p<0.001 and r=0.452).
CONCLUSION
There is a relationship between long-latency potentials and cognitive performance in the elderly, which was observed by the increase in the P2 amplitude and the impairment of the process of sound decoding.
Topics: Acoustic Impedance Tests; Acoustic Stimulation; Adult; Aged; Aging; Cognition; Evoked Potentials, Auditory; Humans; Middle Aged; Speech
PubMed: 33503169
DOI: 10.6061/clinics/2021/e1567 -
Wideband Tympanometry and Absorbance for Diagnosing Middle Ear Fluids in Otitis Media with Effusion.The Journal of International Advanced... Mar 2023Surgical tympanostomy tube insertion is a standard procedure in Otitis media with effusion after proper follow-up. During the surgery, the presence of serous or mucoid...
BACKGROUND
Surgical tympanostomy tube insertion is a standard procedure in Otitis media with effusion after proper follow-up. During the surgery, the presence of serous or mucoid fluids, atelectatic tympanic membrane, or empty ear may be observed, despite all patients having the same diagnosis. A better method based on a non-invasive approach can help avoid unnecessary surgery. This study aimed to compare surgically confirmed otitis media with effusion with wideband tympanometry and absorbance tests.
METHODS
A total of 122 children diagnosed with otitis media with effusion were included. Eighty healthy children were included as controls. Ears were divided into 4 groups: serous, mucoid, atelectasis, and empty. Resonance frequency, 226 Hz and 1000 Hz compliance, wideband peak pressure, and absorbance data were used for comparison.
RESULTS
The most practical tests were the average of 500, 1000, and 2000 Hz absorbance according to positive likelihood ratio (4.8) and model 2 according to negative likelihood ratio (0.11). It was better than the standard 226 Hz and 1000 Hz compliance tests. Although some statistically significant parameters were observed between serous fluid and empty ear, they were not sufficiently impactful for a differential diagnosis. No parameter could help us differentiate between serous and mucous fluids.
CONCLUSION
According to negative likelihood ratio (0.11), a person with normal middle ear is 9 times more likely to have negative test with the use of resonance frequency, wideband tympanometry, and average absorbance together. To differentiate serous fluid from the empty ear, using only 226 Hz or 1000 Hz compliance for surgical indication can potentially cause wrong decisions according to negative likelihood ratios.
Topics: Child; Humans; Acoustic Impedance Tests; Otitis Media with Effusion; Ear, Middle; Tympanic Membrane; Body Fluids
PubMed: 36975086
DOI: 10.5152/iao.2023.22697 -
The Journal of International Advanced... Nov 2021The effect of postmenopausal osteoporosis on the middle ear mechano-acoustic system is unknown. The aim of this study is to investigate whether or not middle ear...
BACKGROUND
The effect of postmenopausal osteoporosis on the middle ear mechano-acoustic system is unknown. The aim of this study is to investigate whether or not middle ear resonance frequency is affected in females with postmenopausal osteoporosis.
METHODS
The study included postmenopausal women aged 45-60 years, separated into 2 groups as females with postmenopausal osteoporosis and healthy postmenopausal females (control group). A detailed anamnesis was taken from all subjects and then the ear, nose, and throat examinations were done followed by pure tone audiometry, tympanometry, and multifrequency tympanometry tests. The groups were compared in respect of pure tone average, bone conduction threshold, RF, static admittance, and tympanometric peak pressure values.
RESULTS
The mean age of the patients was 59.2 ± 4.53 years (range, 48-65 years) in the postmenopausal osteoporosis group and 57.11 ± 4.27 years (range, 48-65 years) in the control group (P > .05). The mean resonance frequency values for the postmenopausal osteoporosis and control group were 954.41 ± 127.47 and 935.29 ± 126.39 Hz (P > .05 ). The mean static admittance values for the postmenopausal osteoporosis and control group were 0.82 ± 0.33 and 0.85 ± 0.3 mmho, and mean tympanometric peak pressure values were -7.35 ± 18.52 and -6.94 ± 19.52 daPa (P > .05 for both static admittance and tympanometric peak pressure). The mean pure tone averagevalues for the postmenopausal osteoporosis and control group were 20.96 ± 6.82 and 15.60 ± 7.81 dB, and mean bone conduction threshold values were 17.57 ± 6.03 and 12.10 ± 6.52 dB (P < .05 for both pure tone average and bone conduction threshold).
CONCLUSIONS
The results showed that the middle ear resonance frequency values were not affected in postmenopausal osteoporosis patients, but there was seen to be greater sensorineural hearing loss in females with postmenopausal osteoporosis compared to healthy postmenopausal females.
Topics: Acoustic Impedance Tests; Aged; Audiometry, Pure-Tone; Bone Conduction; Ear, Middle; Female; Humans; Middle Aged; Osteoporosis, Postmenopausal
PubMed: 35177390
DOI: 10.5152/iao.2021.21069 -
CoDAS Sep 2018Identify the characteristics of the clinical audiological evaluation of individuals with Williams syndrome by means of a systematic literature review. (Review)
Review
PURPOSE
Identify the characteristics of the clinical audiological evaluation of individuals with Williams syndrome by means of a systematic literature review.
RESEARCH STRATEGIES
The following research question was initially determined: "What are the characteristics of clinical auditory assessment in individuals with Williams syndrome?". From this, a bibliographic search was conducted in four databases using the descriptors: Williams syndrome, Hearing loss, and Audiology.
SELECTION CRITERIA
Only full articles with evidence levels 1 or 2, published in Brazilian Portuguese or English, were selected.
DATA ANALYSIS
Results obtained in the auditory tests used in the clinical routine, namely: immittance test, pure-tone audiometry, otoacoustic emissions, and brainstem auditory evoked potential were analyzed.
RESULTS
Two hundred nine studies were found, but only 12 met the inclusion criteria for the study. It was possible to observe prevalence of type A tympanometry curve, which may occur with absence of acoustic reflexes, mild to moderate sensorineural hearing loss, affecting mainly the high frequencies, absent or less amplified otoacoustic emissions, and brainstem auditory evoked potential without retrocochlear alteration.
CONCLUSION
Cochlear impairment is common in individuals with Williams syndrome and the main disorders found in the hearing assessment in this population are absence of otoacoustic emissions and acoustic reflexes, as well as presence of mild to moderate sensorineural hearing loss, mainly in the high-frequency range, observed by audiometry.
Topics: Acoustic Impedance Tests; Audiology; Audiometry, Pure-Tone; Brazil; Evoked Potentials, Auditory, Brain Stem; Hearing Loss; Humans; Otoacoustic Emissions, Spontaneous; Williams Syndrome
PubMed: 30231111
DOI: 10.1590/2317-1782/20182017267 -
World Journal of Gastroenterology Sep 2014A biosensor is an analytical device used for the detection of analytes, which combines a biological component with a physicochemical detector. Recently, an increasing... (Review)
Review
A biosensor is an analytical device used for the detection of analytes, which combines a biological component with a physicochemical detector. Recently, an increasing number of biosensors have been used in clinical research, for example, the blood glucose biosensor. This review focuses on the current state of biosensor research with respect to efficient, specific and rapid detection of hepatitis B virus (HBV). The biosensors developed based on different techniques, including optical methods (e.g., surface plasmon resonance), acoustic wave technologies (e.g., quartz crystal microbalance), electrochemistry (amperometry, voltammetry and impedance) and novel nanotechnology, are also discussed.
Topics: Acoustics; Animals; Biosensing Techniques; DNA, Viral; Electrochemical Techniques; Equipment Design; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Antigens; Hepatitis B virus; Humans; Nanomedicine; Predictive Value of Tests; Surface Plasmon Resonance; Transducers; Viral Load
PubMed: 25253948
DOI: 10.3748/wjg.v20.i35.12485 -
International Journal of Occupational... Dec 2021It is generally held that exposure to both high-pressure and long-lasting contact with water makes diving a potentially hazardous sports activity as far as the ears are...
OBJECTIVES
It is generally held that exposure to both high-pressure and long-lasting contact with water makes diving a potentially hazardous sports activity as far as the ears are concerned. There is a number of research investigating the condition of the middle ear in a short period following diving; however, the knowledge regarding the long-term effects of regularly repeated diving remains limited.
MATERIAL AND METHODS
The aim of this study is to evaluate the function of the middle ear after a diving season in a group of 31 adults diving regularly (1-17 years) by means of the following methods: 1) interview, 2) otoscopy, 3) pure tone audiometry, 4) classic tympanometry, and 5) wideband tympanometry.
RESULTS
Periodic problems with pressure equalization in the middle ear were observed in 12 individuals (38.7%). In all the analyzed cases, the authors found a normal condition of the external auditory canal and the tympanic membrane in otoscopy, normal hearing in pure tone audiometry, curve type A, and normal gradient in both classic and wideband tympanometry.
CONCLUSIONS
Safe diving (according to safety precautions) does not have any long-term negative effects on the condition of the middle ear. However, these observations should be verified in a larger group of divers. Int J Occup Med Environ Health. 2021;34(6):779-88.
Topics: Acoustic Impedance Tests; Adult; Audiometry, Pure-Tone; Diving; Ear, Middle; Humans
PubMed: 34060513
DOI: 10.13075/ijomeh.1896.01735