Assessment of Ear Disorders Using Power Reflectance

Abstract

This paper describes the effect of various pathologies on power reflectance (PR) and absorbance measured in human adults. The pathologies studied include those affecting the tympanic membrane, the middle-ear ossicles, the middle-ear cavity, the inner ear, and intracranial pressure. Interesting pathology-induced changes in PR that are statistically significant have been reported. Nevertheless, because measurements of PR obtained from normal-hearing subjects have large variations and some pathology-induced changes are small, it can be difficult to use PR alone for differential diagnosis. There are, however, common clinical situations without reliable diagnostic methods that can benefit from PR measurements. These conditions include ears with a normal-appearing tympanic membrane, aerated middle-ear cavity and unknown etiology of conductive hearing loss. PR measurements in conjunction with audiometric measurements of air-bone gap have promise in differentiating among stapes fixation, ossicular discontinuity and superior semicircular canal dehiscence. Another possible application is to monitor an individual for possible changes in intracranial pressure. Descriptions of mechanisms affecting PR change and utilization of PR measurements in clinical scenarios are presented.

Controlled exploration of the effects of conductive hearing loss on wideband acoustic immittance in human cadaveric preparations

“…For example, while similar changes in PR were seen for malleus and stapes fixation, stapes fixation generally results in more hearing loss or a larger decrease in SV . The combination of PR and hearing loss (as demonstrated by the air-bone gap) has been shown to aid in the differential diagnosis of various conductive pathologies in patient populations (Nakajima et al, 2013). …”

“…Recently, measurements of umbo velocity using laser-Doppler vibrometry (LDV) and wideband acoustic immittance ( WAI ) measured in ear canals over a wide frequency range have been shown to aid in the non-invasive diagnosis of conductive disorders with aerated middle ears, including ossicular fixation, disarticulation, and SCD (e.g. Rosowski et al, 2003; Whittemore et al, 2004; Feeney et al, 2003; Allen et al, 2005; Rosowski et al, 2008; Feeney et al, 2009; Shahnaz et al, 2009a; Shahnaz et al, 2009b; Withnell et al, 2009; Voss et al, 2012; Nakajima et al, 2012; Nakajima et al, 2013; Prieve et al, 2013; Merchant et al, 2015). Collectively, these studies demonstrate that broadband measurements of middle-ear mobility, including WAI, can aid in the non-invasive differential diagnosis of conductive pathologies.…”

Acoustic impedancometry: the evolution of diagnostic possibilities

“…Измеряется эта ве-личина от 0 (или 0%), что указывает на отсутствие отраже-ния, до 1 (или 100%), при этом отражается вся энергия. Для измерения рефлектанса используется широкополос-ный стимул (щелчок или chirp-сигнал), поступающий на постоянном уровне 55-60 дБ [36,37,38]. Существует не-сколько различных терминов в литературе для описания широкополосных измерений.…”

“…Абсорбанс -количе-ство поглощенной структурами уха звуковой энергии, представлен на линейной шкале в диапазоне от 0 до 1,0. Возможность цифровой обработки широкополосного акустического поглощения (абсорбанса) явилось послед-ним достижением в исследовании семейства акустиче-ских иммиттансных измерений [7,36,38]. Внедрение ши-рокополосных технологий в исследование состояния структур уха позволяет получить больший объем данных об особенностях проведения звуковой энергии при раз-личных патологических состояниях [7,36,37].…”

Reflectância de banda larga em indivíduos com artrite reumatoide

“…Os resultados encontrados por Roberts (2007) foram mais baixos entre as frequências de 250 a 2000 Hz e mais altos nas frequências acima de 4000 Hz comparando com o estudo de Shahnaz e Bork (2006), apesar de seus sujeitos apresentarem medidas dentro da faixa de 95% de normalidade obtida por Shahnaz e Bork. Nakajima et al (2013) argumentam que diferentes patologias de orelha média podem ser beneficiadas com o diagnóstico da RE, entretanto algumas patologias devem ser diagnosticadas com outras ferramentas além da RE, pois as mudanças de comportamento destas são muito sutis e a faixa de normalidade da RE é extensa.…”