Feasibility of 1000Hz tympanometry in infants: Tympanometric trace classification and choice of probe tone in relation to age

Hoffmann, Annette; Deuster, Dirk; Rosslau, Ken; Knief, Arne; Zehnhoff‐Dinnesen, Antoinette am; Schmidt, Catarina

doi:10.1016/j.ijporl.2013.05.001

Cited by 25 publications

(25 citation statements)

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“… 1 It is generally accepted that tympanometry with a 226 Hz probe tone is less effective in identifying middle ear effusion in young infants than is tympanometry with a 1000 Hz probe tone (e.g., Hoffman et al, 2013). However, the use of a less-than-optimal tympanometric screen cannot explain the results of this study.…”

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confidence: 99%

Infants’ and Adults’ Use of Temporal Cues in Consonant Discrimination

Cabrera¹,

Werner²

2017

Ear &Amp; Hearing

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Objectives Adults can use slow temporal envelope cues, or amplitude modulation (AM), to identify speech sounds in quiet. Faster AM cues and the temporal fine structure, or frequency modulation (FM), play a more important role in noise. This study assessed whether fast and slow temporal modulation cues play a similar role in infants’ speech perception by comparing the ability of normal-hearing 3-month-olds and adults to use slow temporal envelope cues in discriminating consonants contrasts. Design English consonant-vowel syllables differing in voicing or place of articulation were processed by two tone-excited vocoders to replace the original FM cues with pure tones in 32 frequency bands. AM cues were extracted in each frequency band with two different cut-off frequencies, 256 Hz or 8 Hz. Discrimination was assessed for infants and adults using an observer-based testing method, in quiet or in a speech-shaped noise. Results For infants, the effect of eliminating fast AM cues was the same in quiet and in noise: a high proportion of infants discriminated when both fast and slow AM cues were available, but less than half of the infants also discriminated when only slow AM cues were preserved. For adults, the effect of eliminating fast AM cues was greater in noise than in quiet: All adults discriminated in quiet whether or not fast AM cues were available, but in noise eliminating fast AM cues reduced the percentage of adults reaching criterion from 71% to 21%. Conclusions In quiet, infants appear to depend on fast AM cues more than adults do. In noise, adults appear to depend on FM cues to a greater extent than infants do. However, infants and adults are similarly affected by a loss of fast AM cues in noise. Experience with the native language appears to change the relative importance of different acoustic cues for speech perception.

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confidence: 99%

Infants’ and Adults’ Use of Temporal Cues in Consonant Discrimination

Cabrera¹,

Werner²

2017

Ear &Amp; Hearing

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“…Pneumatic otoscopy is difficult and unreliable in infants with accuracy varying widely between otoscopists (Chianese et al, 2007;Smith et al, 2006). Tympanometry using a low-frequency (226 Hz) probe tone (LFT) is inaccurate in young infants, and some large-scale studies using stringent reference standards such as otomicroscopy and myringotomy have found poor sensitivity in older infants (Hoffmann et al, 2013;Palmu & Syrjänen, 2005). High-frequency tympanometry (HFT) is more accurate than LFT in young infants but has poor sensitivity in neonates (Margolis, Bass-Ringdahl, Hanks, Holte, & Zapala, 2003;Swanepoel et al, 2007).…”

Section: Overviewmentioning

confidence: 99%

“…However, myringotomy may not be a perfect gold standard, as use of nitrous oxide during anaesthesia can increase pressure in the middle ear and cause fluid to drain through the Eustachian tube prior to surgery (Nozza, Bluestone, Kardatzke, & Bachman, 1992;Sassen, Aarem, & Grote, 1994). Use of myringotomy or medical imaging as gold standards in otitis media research is limited to clinical studies, as it is unethical to perform these procedures in healthy infants (Aithal, Aithal, Kei, & Driscoll, 2012;Hoffmann et al, 2013).…”

Section: Myringotomy and Medical Imagingmentioning

confidence: 99%

“…Limitations of otomicroscopy are that the test requires a highly trained otologist and expensive equipment (Lee, 2010). Even for otologists, the procedure is difficult in young infants because of the tiny structures of the ear and need for cooperation (Hoffmann et al, 2013). No studies have investigated the feasibility or diagnostic accuracy of otomicroscopy in young infants.…”

Section: Otoscopy and Otomicroscopymentioning

confidence: 99%

“…However, only DPOAEs were used as the reference standard in these studies (Margolis et al, 2003;Swanepoel et al, 2007). Research using a stronger reference standard (otomi-croscopy or ABR) have shown much better sensitivity but these studies have had a broader age range, including young infants as well as neonates (Baldwin, 2006;Hoffmann et al, 2013). HFT studies including young infants 2 weeks to 6 months old have all reported high sensitivity and specificity (Baldwin, 2006;Hoffmann et al, 2013;Zhiqi, Kun, & Zhiwu, 2010).…”

Section: Tympanometrymentioning

confidence: 99%

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Diagnosing conductive dysfunction in infants using wideband acoustic immittance: development and validation of predictive models

Myers¹

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Background. Infants with early onset of otitis media have greater risk of recurrent and chronic infections that can affect language and development. Diagnostic tools able to quickly and accurately identify middle ear pathology early in infancy could help to facilitate timely intervention for these children.Wideband acoustic immittance (WAI) is an emerging technology for assessing middle ear function with significant advantages over established clinical tests such as tympanometry. WAI does not require pressurization of the ear canal, and is a high-resolution test, measuring middle ear function over a wider frequency range than is possible with tympanometry. Preliminary studies in infants have shown promising results, but further research assessing the diagnostic performance of WAI is needed. Also, the large amount of data generated by WAI can make results difficult to interpret. Research into suitable quantitative techniques to analyse results is still in its infancy. Prediction models are an attractive method for analysis of multivariate data as they can provide individualized probabilities that an infant has middle ear dysfunction. A clinically useful prediction model must be able to accurately discriminate between normal ears and those with middle ear dysfunction, and be well calibrated (i.e., give accurate predictions). However, the number of variables generated by WAI can cause issues with overfitting when developing multivariate models. An overfitted model will accurately describe the data it was developed on, but is likely to perform poorly when applied to new samples. Some form of data reduction or penalization is therefore necessary when modelling WAI. Another issue with developing WAI models is that there are substantial maturational effects on WAI through infancy that need to be controlled for. This can be achieved by either developing models for specific age groups (e.g., a model specifically for neonates), or by controlling for the effect of age by including interactions between age and WAI variables in a model, or by only using developmentally stable regions as predictor variables.Objective. The aim of this work was to investigate the diagnostic performance of WAI in infants by developing predictive models. Data reduction strategies such as selecting predictors based on prior research and principal component analysis were used to increase the likelihood that models would generalize to new samples. The effect of age was initially accounted for by developing age-specific models for neonates, 6-month infants, and 12-month infants (Chapters 2, 3 and 4, respectively). Longitudinal developmental effects on WAI through infancy were then investigated in Chapter 5, and this knowledge was used to develop a model controlling for the effect of age through infancy (6 to 18 months) (Chapter 6, Study 1). The neonate model was assessed for generalizability by applying the model to results from a new sample of infants (Chapter 6, Study 2)ii Methods. Tympanometry, distortion product otoacoustic emissions (DPOAEs) and ...

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Hearing characteristics and otoradiological abnormalities in three patients with novel pathogenic variants of KMT2D‐related Kabuki syndrome

Zheng,

Ding,

Wang

et al. 2023

Molec Gen & Gen Med

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BackgroundKabuki syndrome 1 (KS1; OMIM:147920), which is characterized by distinctive dysmorphic facial features (such as arched eyebrows, long palpebral fissures with eversion of the lower lid, and large protuberant ears), intellectual disability, short stature, and dermatoglyphic and skeletal abnormalities, is brought on by pathogenic variants in KMT2D (OMIM:602113). In this work, three individuals with novel pathogenic KMT2D gene variants had their longitudinal audiological manifestations and ear structural characteristics outlined.MethodsThe longitudinal audiological data from neonatal hearing screening and a battery of several hearing tests were evaluated. The battery of hearing tests included tympanometry, distortion product otoacoustic emission (DPOAE), click‐evoked air‐conduction auditory brain‐stem response (AC‐ABR), click‐evoked bone‐conduction auditory brain‐stem response (BC‐ABR), narrow band CE‐chirp auditory steady‐state response (NB CE‐chirp ASSR), and pure‐tone audiometry (PTA). Phenotype identification and whole exome sequencing (WES) were performed on recruited individuals.ResultsAll three patients (two females and on male; last evaluations at 14 months, 11 months, and 5.7 years, respectively) failed the newborn hearing screening, and the audiological follow‐up data revealed mild to profound fluctuating hearing loss, which was directly influenced by the incidence and severity of otitis media with effusion (OME). When OME occurred, the AC‐ABR thresholds increased from 30–75 dBnHL to 45–90 dBnHL. The threshold for the BC‐ABR and BC‐PTA was between 25 and 50 dBnHL, indicating mild to moderate sensorineural hearing loss (SNHL). The high‐resolution computed tomography (HRCT) pictures indicated that all three patients had middle and inner ear abnormalities. Middle ear anomalies showed as diminished mastoid gasification and ossicle dysplasia. Cochlear dysplasia, a dilated vestibule, fusion of the vestibule with the horizontal semicircular canals, and a short and thick horizontal semicircular canal were visible on images of the inner ear. This study recruited three individuals with three novel pathogenic variants (c.5104C>T, c.10205delA, and c.12840delC) of KMT2D who were identified at ages 27 days, 2 months, and 5.5 years.ConclusionsHearing characteristics of three individuals with three novel pathogenic variants of KMT2D range from mild to profound fluctuating hearing loss with mild to moderate SNHL. HRCT scans showed that all three individuals had anatomical middle and inner ear abnormalities. KS 1 patients must get clinical therapy for OME, frequent auditory monitoring, and prompt intervention.

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Feasibility of 1000Hz tympanometry in infants: Tympanometric trace classification and choice of probe tone in relation to age

Cited by 25 publications

References 20 publications

Infants’ and Adults’ Use of Temporal Cues in Consonant Discrimination

Infants’ and Adults’ Use of Temporal Cues in Consonant Discrimination

Diagnosing conductive dysfunction in infants using wideband acoustic immittance: development and validation of predictive models

Hearing characteristics and otoradiological abnormalities in three patients with novel pathogenic variants of KMT2D‐related Kabuki syndrome

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