Acoustic Transmission Characteristics of a Eustachian Tube Volitionally Opened in Two Living Subjects

Amoako-Tuffour, Yaw; Jufas, Nicholas; Quach, Jack; Le, Lisa W.; Earle, Guy; Kotiya, Akhilesh A.; Bance, Manohar

doi:10.1097/mao.0000000000001130

Cited by 5 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Fast Fourier Transform was performed on these recorded responses to determine the power contributed from each frequency bin. Based on the results of a previous case study indicating range of frequencies that are most enhanced by ET opening, the spectral power contributions from the frequency range of 780–3125 Hz were divided by the spectral power contributions from all other frequencies below and above this band, up to 10 kHz [13]. In this sense, a power ratio was calculated for each click response that compared the power in the frequency band of interest, to the power outside of this band.…”

Section: Methodsmentioning

confidence: 99%

Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: A retrospective case -control study

Pyne

Amoako-Tuffour

Earle

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

Self Cite

View full text Add to dashboard Cite

BackgroundEustachian tube (ET) dysfunction can be very difficult to diagnose accurately. Our aim is to determine whether a newly developed sonotubometric test using clicks can reliably detect ET opening during swallowing in normal ET subjects, and patulous ET (PET) in subjects with ET dysfunction.MethodsSixteen subjects (19 normal ET ears and 6 PET ears) were individually placed in a sound-isolated audiometry booth and subjected to a 1000Hz click train stimulus, played through the nose. PET subjects were identified through the ET clinic at our institution, while healthy subjects were recruited. Transmission through the ET was recorded by a microphone in the ear ipsilateral to the presenting nostril, during no swallow and swallow states, and this was used to compute a power ratio (power in the frequency range of interest to the whole frequency range). The power transmission ratio both before and after the swallow was averaged, and represented the baseline (BaseR). The power transmission ratio during swallow represented the peak (PeakR). The same process was repeated in the absence of a stimulus to account for swallowing noise. Wilcoxon rank rum tests were performed to determine statistical significance.ResultsIt was found that for healthy ET patients, the median difference between the PeakR and BaseR was 0.51 (p = 0.004). For the PET patients in this study, the median difference between the PeakR and the BaseR was 3.30 (p = 0.041). Comparing the baseline between groups revealed that PET patients had a median BaseR 1.05 higher than healthy ET patients. PET patients had a median PeakR of 3.84 higher than healthy ET patients. Both were deemed to be statistically significant (p = 0.003, p = 0.003 respectively). A significant difference was found between median PeakR for the stimulus and no-stimulus condition for the healthy ET group (0.59, p < 0.001) and for the PET group (4.39, p = 0.031), indicating that it was unlikely that swallowing noise caused false positive results.ConclusionThe results of this study suggest that a novel click stimulus is capable of detecting ET opening during swallowing in healthy patients as well as highlighting PET in diseased subjects.

show abstract

Section: Methodsmentioning

confidence: 99%

Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: A retrospective case -control study

Pyne

Amoako-Tuffour

Earle

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…15 Sonotubometry is a promising modality also, but at present its use in PET is poorly understood and it has been primarily used for dilatory failure (obstructive) ET dysfunction. There are many new developments in this area, some that we have described, 16,17 that make this likely to be perhaps the most useful future investigation modality.…”

Section: Testingmentioning

confidence: 99%

Patulous Eustachian tube (PET), a practical overview

Bance

Tysome

Smith

2019

World j. otorhinolaryngol.-head neck surg.

Self Cite

View full text Add to dashboard Cite

Symptoms of patulous Eustachian tube (ET), particularly autophony, can overlap with other conditions, and can arise from a variety of causes. We review the pathophysiology of “speech hyper-resonance syndromes”, and possible mechanisms, including resonances in the tympanic membrane, Eustachian tube and nasopharynx. Treatment can be directed at the eardrum or the ET depending on site of pathology. We review typical presentations, examination findings, and useful clinical tests to distinguish PET from other disorders, and our philosophy of management.

show abstract

“…Compliance over time using 226 Hz pure tones has been shown to identify PET via respiratory-synchronous middle ear compliance with occlusion of the contralateral nostril and forced ipsilateral nostril breathing [ 10 , 22 – 24 ]. Nonetheless, we have found in our ET practice that alterations in COT measurements using a 678 Hz pure tone is more powerfully predictive of PET than any other tone used before.…”

Section: Introductionmentioning

confidence: 99%

The 678 Hz acoustic immittance probe tone: a more definitive indicator of PET than the traditional 226 Hz method

Pyne

Lawen

Floyd

et al. 2018

J of Otolaryngol - Head & Neck Surg

Self Cite

View full text Add to dashboard Cite

BackgroundThe accurate diagnosis of Eustachian tube (ET) dysfunction can be very difficult. Our aim is to determine whether a 678 Hz probe tone is a more accurate indicator of Patulous ET (PET) than the 226 Hz probe tone when used in compliance over time (COT) testing.MethodsTwenty subjects (11 normal ET ears and 7 PET ears) were individually seated in an examination room and connected to a GSI TympStar Middle Ear Analyzer. The order of probe tone frequency (678 or 226 Hz) was randomized. Baseline “testing” COT recordings for each ear undergoing testing were completed. Subjects were instructed to occlude their contralateral nostril and to breathe forcefully in and out through their ipsilateral nostril until the test had run to completion. This process was repeated with the probe tone that had not been previously run. For the control group, each subject had one random ear tested. For the experimental group, only the affected ear(s) was tested. Wilcoxon rank rum tests were performed to determine statistical significance.ResultsThe baseline COT measurements for the control group and PET group were similar, 0.86 mL (SD = 0.34) and 0.74 (SD = 0.33) respectively. Comparing the 226 Hz tone between groups revealed that PET patients had a median COT difference 0.19 mL higher than healthy ET patients, and for the 678 Hz tone, PET patients had a median COT difference of 0.57 mL higher than healthy ET patients. Both were deemed to be statistically significant (p = 0.002, p = 0.004 respectively). The was a statistically significant median COT difference between the 678 Hz and 226 Hz of 0.61 mL (p = 0.034) for the PET group, while the same comparison for the control group of 0.05 mL was not significant (p = 0.262), suggesting that the 678 Hz tone yields a larger response for PET than the 226 Hz tone, and no difference for the control group, thus making it less prone to artifact noise interference.ConclusionThe 678 Hz probe tone is a more reliable indicator of ET patency, and should be preferably used over the 226 Hz tone for future COT testing.

show abstract

Acoustic Transmission Characteristics of a Eustachian Tube Volitionally Opened in Two Living Subjects

Cited by 5 publications

References 15 publications

Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: A retrospective case -control study

Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: A retrospective case -control study

Patulous Eustachian tube (PET), a practical overview

The 678 Hz acoustic immittance probe tone: a more definitive indicator of PET than the traditional 226 Hz method

Contact Info

Product

Resources

About