Differentiating among conductive hearing loss conditions with wideband tympanometry

Kim, So Young; Han, Jae Joon; Oh, Seung Ha; Lee, Jun Ho; Suh, Myung‐Whan; Kim, Me Hee; Park, Moo Kyun

doi:10.1016/j.anl.2018.05.013

Cited by 15 publications

(7 citation statements)

References 27 publications

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“…We know from previous works regarding absorbance results, that the conductive alterations generate less sound absorbance, due to the greater rigidity of the system [ 22 – 25 ]. Even though, the values observed were within the normal range in high frequencies, the C group has the absorbance values closer to the expected normality.…”

Section: Discussionmentioning

confidence: 99%

“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”

Lopes

Bento

Gebrim

et al. 2021

Eur Arch Otorhinolaryngol

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Objective To evaluate the esthetic and functional results of an osteoplastic flap for mastoid cavity closure in cochlear implant surgery. Study design Double-blind, prospective, randomized clinical trial. Setting: tertiary referral center. Intervention(s) On hundred and twenty-six patients were randomized in 2 groups for cochlear implant surgery. Cases ( n : 63) underwent simple mastoidectomy using an anteriorly pedicled osteoplastic flap for mastoid closure. In controls ( n : 63), a traditional periosteal flap was used. Evaluation with the POSAS questionnaire was performed 1 year after surgery to assess surgical wound esthetics. Sixteen patients from each group had postoperative CT-scans and wideband tympanometry to assess mastoid aeration and middle ear absorbance. Gender and time after surgery were correlated. Main outcome measure(s) Evaluation of the quality of the surgical wound with the application of a questionnaire validated in the medical literature and translated into Portuguese language called POSAS, considering the perception of the blinded patient and doctor regarding the surgical technique proceeded. A lower POSAS score suggests better esthetics of the surgical wound. Secondary outcomes are volumetric measurement of aeration inside mastoid cavity using 3D computer tomography exam, which aims to analyze the influence of fibrocicatricial retraction in the surgical wound into the mastoid and the interference of its aeration volume in the absorption of sound in the middle ear, using the wideband tympanometry exam. Results The POSAS questionnaire in the Case group showed a lower level of local pain and itchiness, a skin color and thickness more similar to the surrounding skin and less irregularity and stiffness, with no influence from time after surgery and gender compared to the Control group. The median tomographic volume was 6.37 cc in the cases and 4.60 cc in controls. Wideband tympanometry showed general smaller sound absorbance in the Case group results, specially, at 1000 Hz frequency. No intraoperative or postoperative complications were observed with the osteoplastic flap. Conclusions This technique is an effective and safe alternative to alleviate common problems of mastoid surgery for cochlear implantation. In addition to esthetic benefits, it has less interference in middle ear physiology of sound absorbance and less fibrous tissue into the mastoid cavity during the follow-up of more than 1 year. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06907-1.

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Section: Discussionmentioning

confidence: 99%

“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”

Lopes

Bento

Gebrim

et al. 2021

Eur Arch Otorhinolaryngol

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“…It can also provide more information about patients with mastoid problems [8,9]. Data from a recent study justifies the larger applications of WBT, as it can differentiate between different conductive hearing loss conditions [10]. Otoacoustic emissions have low diagnostic value, the presence of conductive hearing loss is sufficient to reduce the clinical utility of distortion product otoacoustic (DPOAE).…”

Section: Discussionmentioning

confidence: 99%

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Mallouk¹,

Halily²,

Hammouda³

et al. 2020

IJO

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Objective: Our study aims to analyze the epidemiological, clinical, radiological, and etiological aspects of this disease. Methods: We reviewed data from patients who consulted the same seigneur for hearing loss and in whom the otoscopic examination was normal with a conductive hearing loss objectively confirmed on tonal audiometry, for a period of one year (from October 2018 to October 2019). Epidemiological, clinical and paraclinical data were collected and recorded onfarm records. Results: The average age is 36 years. The M/F sex ratio was 1.5 in favor of the men. None of our patients reported a personal otologic history. Three patients reported a notion of head trauma and a similar case in the family was found in four patients. Hearing loss is the most frequent reason for consultation. Otoscopic examination shows a normal tympanic membrane without perforation in all patients. CT scan of the temporal bone was performed in all patients (100%); it was normal in 4 cases (17%), which required surgical exploration. However, he showed images of otosclerosis in 15 cases (65%), an image of congenital cholesteatoma in a single patient, tympanic glomus in a single patient, an incudo-malleolar dislocation in a single patient (4.5%), and an incudo-stapedial dislocation in a single patient (4.5%). Conclusion: Conductive hearing loss (CHL) is a diagnostic challenge for the physician that requires a schematic approach. The diagnosis is based on a combination of clinical and paraclinical arguments.

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“…WBA performed at ambient air pressure (WBA a ) is well suited to identify CHL and middle-ear pathology. Reduced WBA a values can identify these conditions in adults (Margolis et al 1999; Shahnaz et al 2009; Kim et al 2019) and children (Keefe & Simmons 2003; Beers et al 2010; Ellison et al 2012; Keefe et al 2012) with high accuracy. Further, WBA a is a more accurate predictor of CHL in children, for whom CHL is highly prevalent, than conventional tympanometry (Keefe & Simmons 2003; Beers et al 2010; Keefe et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Wideband Tympanometry Findings in School-aged Children: Effects of Age, Gender, Ear Laterality, and Ethnicity

et al. 2021

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Objectives: Wideband tympanometry (WBT) measures middle-ear function across a range of frequencies (250 to 8000 Hz) while the earcanal pressure is varied from +200 to -300 daPa. WBT is a suitable test to evaluate middle-ear function in children, but there is a lack of age-, ear-, gender-, or ethnicity-specific data throughout the literature. The purpose of this study was to investigate the effects of age, ear laterality, gender, and ethnicity on the WBT data retrieved from children aged 4 to 13 years determined to have normal middle-ear function.Design: Data were collected cross-sectionally from 924 children aged 4 to 13 years who passed a test battery consisting of 226-Hz tympanometry, ipsilateral acoustic stapedial reflexes, and pure-tone screening, and without significant history of middle-ear dysfunction. Participants were grouped according to their age: 4 to 6 years, 7 to 9 years, 10 to 13 years. Wideband absorbance values were extracted at 0 daPa (WBA 0 ) and tympanometric peak pressure (WBA TPP ). Results:The effects of age, frequency, and pressure (WBA 0 versus WBA TPP ) were statistically significant. There were significant differences between WBA 0 and WBA TPP for all age groups such that WBA 0 had lower absorbance at low frequencies (250 to 1600 Hz) and greater absorbance at mid to high frequencies (2500 to 8000 Hz). Statistically significant effects of age were present for WBA 0 and WBA TPP such that absorbance generally increased with age from 250 to 1250 Hz and decreased with age from 2000 to 5000 Hz. There were no significant main effects of gender, ear, or ethnicity. Conclusions:Gender-, ear-, and ethnicity-specific clinical WBA 0 and WBA TPP norms are not required for diagnostic purposes; however, agespecific norms may be necessary. Age-related changes in middle-ear function were observed across WBA 0 and WBA TPP . The data presented in this study are a suitable clinical reference for evaluating the outer-and middle-ear function of school-aged children.

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Differentiating among conductive hearing loss conditions with wideband tympanometry

Cited by 15 publications

References 27 publications

“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”

“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”

Conductive Hearing Loss with an Intact Tympanic Membrane: Diagnosed Approaches

Wideband Tympanometry Findings in School-aged Children: Effects of Age, Gender, Ear Laterality, and Ethnicity

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