Measurement of the sound intensity during suction of middle-ear fluid following myringotomy

Wang, J C; Allen, Susan J.; Rodriguez, Amanda; Zahner, C; Zupancic, Steven; Marchbanks, John

doi:10.1017/s0022215114001352

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…There are limited recommendations available to guide clinicians and researchers regarding safe sound exposure for diagnostic testing similar to that of VEMP testing (Portnuff et al 2017). Previous research investigating sound exposure following VEMP testing (Young 2006; Krause et al 2013; Stromberg et al 2015) or procedures such as suctioning of middle ear effusion (Wang et al 2014) have abided by standards used from the Occupational Safety and Health Administration (OSHA) and The National Institute for Occupational Safety and Health (NIOSH). These organizations recommend that the total sound energy exposure measured during a specific period (e.g., 8-hour work day), whether that be continuous, impulse, or intermittent noise, should not be greater than 140 dBC SPL.…”

Section: Introductionmentioning

confidence: 99%

Effects of High Sound Exposure During Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children and Young Adults

et al. 2018

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peSPL sound recordings in children's ears are significantly higher (~3 dB) than that in adults in response to high-intensity VEMP stimuli that are commonly practiced. Equivalent ECV contributes to peSPL delivered to the ear during VEMP testing and should be considered to determine safe acoustic VEMP stimulus parameters; children with smaller ECVs are at risk for unsafe sound exposure during routine VEMP testing, and stimuli should not exceed 120 dB SPL. Using 120 dB SPL stimulus level for children during VEMP testing yields no change to cochlear function and reliable VEMP responses.

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Section: Introductionmentioning

confidence: 99%

Effects of High Sound Exposure During Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children and Young Adults

et al. 2018

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“…Previous research has revealed a greater than 86 dB median intensity in 50% of recordings made during middle ear aspiration. 9 Wang et al 10 discovered 50% of ears enrolled in their study (out of a total of 44 ears) were exposed to intensity levels greater than 140 dB when fluid was removed from the middle ear space through suctioning. Therefore in this study, we measured ABR thresholds before and immediately after tube insertion as a means to determine the effect this procedure has on hearing.…”

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confidence: 99%

Effect of Tympanostomy Tube Placement on Intraoperative Auditory Brainstem Response

et al. 2020

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Background Intraoperative auditory brainstem response (ioABR) testing under general anesthesia is commonly performed on children when sleep-deprived ABR and behavioral testing are not reliable or feasible. Several studies have reported potential confounding results when tube insertion is combined with ABR testing. Purpose This article evaluates whether a temporary threshold shift (TTS) occurs following placement of tympanostomy tubes (TTs) in children who undergo ioABR testing. Research Design A case–control prospective study. Patients scheduled for combined TT and ioABR procedures were enrolled into this study. Study Sample Twenty children (38 ears), ranging in age from 6 months to 10.5 years, were enrolled. Data Collection and Analysis ABR thresholds for tone bursts with center frequencies of 2 and 4 kHz were compared before and after tube insertion. The indication for surgery, comorbidities, and status of the middle ear were also recorded. A paired t-test was used to determine statistical significance. Results Data collection did not necessarily indicate suctioning and tube placement were causing a TTS; however, fluid present in the middle ear space prior to TT placement appeared to influence results. Although a paired t-test did not show statistically significant differences in ABR thresholds between groups of individuals with and without fluid and before and after tube placement, 50% of patients with mucoid fluid (two out of four patients) were noted to have 10 dB or greater worsening in ABR thresholds in two out of six ears. Twenty-nine percent of patients with serous fluid (two out of seven patients) were noted to have at least a 10 dB worsening in ABR threshold in 2 out of 10 ears. Further testing is needed to confirm these trends. Conclusion This pilot study indicates that children with mucoid or serous fluid may experience worse ABR thresholds following TT insertion. ioABR testing immediately after TT tube placement and in the presence of middle ear fluid should be interpreted with caution. Additional studies with a larger sample size are needed to confirm these results.

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Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach

Kashani

Młyńczak

Zarabanda

et al. 2021

Sci Rep

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Otitis media, a common disease marked by the presence of fluid within the middle ear space, imparts a significant global health and economic burden. Identifying an effusion through the tympanic membrane is critical to diagnostic success but remains challenging due to the inherent limitations of visible light otoscopy and user interpretation. Here we describe a powerful diagnostic approach to otitis media utilizing advancements in otoscopy and machine learning. We developed an otoscope that visualizes middle ear structures and fluid in the shortwave infrared region, holding several advantages over traditional approaches. Images were captured in vivo and then processed by a novel machine learning based algorithm. The model predicts the presence of effusions with greater accuracy than current techniques, offering specificity and sensitivity over 90%. This platform has the potential to reduce costs and resources associated with otitis media, especially as improvements are made in shortwave imaging and machine learning.

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Measurement of the sound intensity during suction of middle-ear fluid following myringotomy

Abstract: Middle-ear aspiration during myringotomy caused noise levels within a potentially harmful range.

Cited by 3 publications

References 15 publications

Effects of High Sound Exposure During Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children and Young Adults

Effects of High Sound Exposure During Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children and Young Adults

Effect of Tympanostomy Tube Placement on Intraoperative Auditory Brainstem Response

Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach

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