Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants

Abstract

Objective The purpose of this study was to describe normative aspects of wideband acoustic immittance (WAI) measures obtained from healthy White neonates. Method In this cross-sectional study, wideband absorbance (WBA), admittance magnitude, and admittance phase were measured under ambient pressure condition in 326 ears from 203 neonates ( M age = 45.9 hr) who passed a battery of tests, including automated auditory brainstem response, high-frequency tympanometry, and distortion product otoacoustic emissions. Results Normative WBA data were in agreement with most previous studies. Normative data for both WBA and admittance magnitude revealed double-peaked patterns with the 1st peak at 1.25–2 kHz and the 2nd peak at 5–8 kHz, while normative admittance phase data showed 2 peaks at 0.8 and 4 kHz. There were no significant differences between ears or gender for the 3 WAI measures. Standard deviations for all 3 measures were highest at frequencies above 4 kHz. Conclusions The 3 WAI measures between 1 kHz and 4 kHz may provide the most stable response of the outer and middle ear. WAI measures at frequencies above 4 kHz were more variable. The normative data established in the present study may serve as a reference for evaluating outer and middle ear function in neonates.

Wideband Tympanometry Findings in Healthy Neonates

“…In general, absorbance was highest between 1 and 2.5 kHz and lowest between 0.25 and 8 kHz. These results concur with the results reported by Wali et al (2017) and Aithal et al (2017) for both pressurised WBA conditions in neonates. Several studies have reported the frequency region between 0.8 and 2 kHz as being the most sensitive region to identify reduced middle-ear transmission and particularly relevant for middle ear assessments [4,5,9,14].…”

“…Further, the pattern of WBA TPP in the Hunter et al study was different to that observed in the present study. Mean WBA TPP pattern in the present study exhibited a multipeaked pattern with two maxima around 1.25-1.5 kHz and 6 kHz which is similar to the WBA TPP pattern in earlier studies on neonates [15,16]. In…”

Assessment of Pediatric Middle Ear Effusions With Wideband Tympanometry

“…Test-retest reliability of WBT has been established, 1,2 and normative values are being developed for diverse pediatric patient populations. 2-6 When compared with traditional single-frequency tympanometry, WBT provides more information and demonstrates improved diagnostic potential for otitis media, middle ear effusion (MEE), and other pediatric conductive hearing–related pathologies, particularly at low-frequency ranges. 7-13…”

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

“…In our study, when calculating A, the Titan system used the area of the calibration tube as the Most clinical WAI research has been focused on A and R since these measures are theoretically insensitive to probe location in the ear canal. There is interest, however, in using Y as well as A in diagnostic applications both for objectively interpreted predictive models Myers et al, 2018a;Piskorski et al, 1999;Sanford et al, 2009), and subjectively interpreted visual displays of results (Aithal et al, 2017;Allen et al, 2005;Sanford & Brockett, 2014;Sanford & Feeney, 2008;Voss et al, 2016). Knowledge of developmental effects on Y are essential for both of these applications.…”

“…Knowledge of the effect of maturation is important for these measures also, as there is interest in using Y and Z, as well as A and R, for the diagnosis of middle ear pathology in infants (Aithal et al, 2017;Ellison et al, 2012;Keefe et al, 2003a;Myers et al, 2018a;Sanford et al, 2009;Voss, Herrmann, Horton, Amadei, & Kujawa, 2016). Keefe et al (1993) studied changes in Z in a sample of infants aged 1 to 24 months (n = 15 at 1 month, 18 at 3 months; 11 at 6 months; 23 at 12 months; and 11 at 24 months).…”