Normative Multifrequency Tympanometry in Infants and Toddlers

Calandruccio, Lauren; Fitzgerald, Tracy S.; Prieve, Beth A.

doi:10.3766/jaaa.17.7.2

Cited by 57 publications

(77 citation statements)

References 17 publications

(28 reference statements)

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“…Silva30 and Callandrucio et al 31 carried out a study with infants using OAEs and the 1,000Hz test tone tympanometry and found good correlations between the tests, and the same was found in this study's sample. Vartiainem32 and Keefe et al 33 mention that the otoacoustic emissions are very sensitive to middle ear alterations, and this is in agreement with the findings of our study.…”

Section: Discussionsupporting

confidence: 82%

Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico

Garcia¹,

Azevedo²,

Testa³

2009

Rev. Bras. Otorrinolaringol.

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A avaliação audiológica do lactente deve ser composta pela verificação das condições de orelha média (medidas de imitância acústica e otoscopia) e pela avaliação coclear (Emissões Otoacústicas). OBJETIVO: Verificar qual tom teste da timpanometria (226Hz ou 1000Hz) tem maior correlação com o exame otoscópico e com o resultado das Emissões Otoacústicas por estímulo transiente. MÉTODO: Realizou-se emissões otoacústicas nos 60 lactentes da amostra, com idade entre de zero e quatro meses. Foram distribuídos em dois grupos, sendo o grupo I 30 lactentes com EOA presente e o grupo II 30 lactentes com EOA ausente. Foram submetidos à timpanometria de múltiplas freqüências, com tom teste de 226Hz e 1000Hz e avaliação otoscópica. RESULTADOS: Na timpanometria, o tom teste de 1000Hz apresentou mais sensibilidade para identificar as alterações de orelha média. Nas crianças com curva timpanométrica dentro da normalidade, ambos os tons-teste (226 e 1000Hz) apresentaram alta especificidade. Todas as correlações foram significantes com o tom teste de 1000Hz. CONCLUSÃO: O tom teste de 1000Hz apresentou maior correlação estatisticamente significante com as EOA e com a avaliação otoscópica para lactentes de zero a quatro meses.

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Section: Discussionsupporting

confidence: 82%

Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico

Garcia¹,

Azevedo²,

Testa³

2009

Rev. Bras. Otorrinolaringol.

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“…Tympanometry performed in the clinic is done using a probe frequency of 226 Hz, a frequency that is optimized for adult-sized middle-ear spaces. However, previous work, along with the current study, indicates that 226 Hz is often not sufficiently sensitive enough to rule out the presence of MEE (Orchik et al 1978;Wiederhold et al 1980;Margolis et al 1995;Rogers et al 2010), especially in infants that have smaller middle-ear volumes than adults (Paradise et al 1976;Calandruccio et al 2006). Margolis et al (1995) found that, similar to our current study, a 226-Hz probe frequency is not sensitive enough to detect 0.5 mL of fluid in the middle ear of adult chinchillas.…”

Section: Discussionmentioning

confidence: 55%

Conductive Hearing Loss Induced by Experimental Middle-Ear Effusion in a Chinchilla Model Reveals Impaired Tympanic Membrane-Coupled Ossicular Chain Movement

Thornton

Chevallier²,

Koka³

et al. 2013

JARO

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Otitis media with effusion (OME) occurs when fluid collects in the middle-ear space behind the tympanic membrane (TM). As a result of this effusion, sounds can become attenuated by as much as 30-40 dB, causing a conductive hearing loss (CHL). However, the exact mechanical cause of the hearing loss remains unclear. Possible causes can include altered compliance of the TM, inefficient movement of the ossicular chain, decreased compliance of the oval window-stapes footplate complex, or altered input to the oval and round window due to conduction of sound energy through middle-ear fluid. Here, we studied the contribution of TM motion and umbo velocity to a CHL caused by middle-ear effusion. Using the chinchilla as an animal model, umbo velocity (V U ) and cochlear microphonic (CM) responses were measured simultaneously using sinusoidal tone pip stimuli (125 Hz-12 kHz) before and after filling the middle ear with different volumes (0.5-2.0 mL) of silicone oil (viscosity, 3.5 Poise). Concurrent increases in CM thresholds and decreases in umbo velocity were noted after the middle ear was filled with 1.0 mL or more of fluid. Across animals, completely filling the middle ear with fluid caused 20-40-dB increases in CM thresholds and 15-35-dB attenuations in umbo velocity. Clinic-standard 226-Hz tympanometry was insensitive to fluid-associated changes in CM thresholds until virtually the entire middle-ear cavity had been filled (approximately 91.5 mL). The changes in umbo velocity, CM thresholds, and tympanometry due to experimentally induced OME suggest CHL arises primarily as a result of impaired TM mobility and TM-coupled umbo motion plus additional mechanisms within the middle ear.

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“…Multifrequency tympanometry has been shown to provide improved sensitivity to some middle-ear pathologies (Hunter and Margolis, 1992;Li et al, 1999;Margolis et al, 1999). Normative data in comparison to the Vanhuyse et al 1975 model are available for adults and children (e.g., Calandruccio et al, 2006;Hunter and Margolis, 1992;Margolis and Goycoolea, 1993) and for infants and toddlers (e.g., Calandruccio et al, 2006). Although these methods may increase the probability of detecting middle ear dysfunction, they require extra time to either sweep pressure at multiple probe frequencies or sweep probe frequency at multiple fixed pressures.…”

Section: Cmemr Test Construction-a Clinical Middle-ear Muscle Reflex mentioning

confidence: 99%

Wideband ipsilateral measurements of middle-ear muscle reflex thresholds in children and adults

Schairer

Ellison

Fitzpatrick

et al. 2007

The Journal of the Acoustical Society of America

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The goals of the current study were to: 1) evaluate the feasibility of a new wideband approach to measuring middle-ear muscle reflex (MEMR) status, and 2) to test the hypothesis that ipsilateral thresholds elicited with 1 or 2 kHz tones and broadband noise activators on a wideband acoustic transfer function (WATF) system are lower than thresholds elicited on a clinical system. Clinical MEMR tests have limitations, including the need for high activator levels to elicit a shift in a narrowband probe (e.g., a 0.226 or 1 kHz tone). Wideband MEMR tests using WATFs may elicit the reflex at lower levels because a wideband probe (click) is used and the threshold detection criterion can be wideband. Mean wideband MEMR thresholds across 40 normal-hearing adult ears were 2.2-4.0 dB lower than clinical MEMR thresholds, depending on the activator and specific WATF test used (admittance magnitude or energy reflectance). Wideband MEMR has potential clinical utility beyond the adult population, including use in newborn and preschool hearing screenings. In a newborn hearing screening, for example, wideband MEMR could be completed with the same system as otoacoustic emissions. However, further investigations in infants and young children are needed.

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Normative Multifrequency Tympanometry in Infants and Toddlers

Cited by 57 publications

References 17 publications

Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico

Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico

Conductive Hearing Loss Induced by Experimental Middle-Ear Effusion in a Chinchilla Model Reveals Impaired Tympanic Membrane-Coupled Ossicular Chain Movement

Wideband ipsilateral measurements of middle-ear muscle reflex thresholds in children and adults

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