Understanding the Developmental Course of the Acoustic Properties of the Human Outer and Middle Ear Over the First 6 Months of Life by Using a Longitudinal Analysis of Power Reflectance at Ambient Pressure

Shahnaz, Navid; Cai, Anika; Li, Qi

doi:10.3766/jaaa.25.5.8

Cited by 23 publications

(67 citation statements)

References 47 publications

(135 reference statements)

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“…The largest changes in ambient energy reflectance in infants relative to adults occur below 0.5 kHz and above 2 kHz between 1 and 6 months of age (Aithal, Kei, & Driscoll, 2014; Keefe, Bulen, Arehart, & Burns, 1993; Shahnaz, Cai and Qi, 2014). There is up to a 30% change in mean energy reflectance and admittance magnitude from 0.25 - 0.75 kHz between 4 and 24 weeks of age (Sanford and Feeney, 2008).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal development of wideband reflectance tympanometry in normal and at-risk infants

et al. 2016

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Purpose The goals of this study were to measure normal characteristics of ambient and tympanometric wideband acoustic reflectance, which was parameterized by absorbance and group delay, in newborns cared for in well-baby and Neonatal Intensive Care Unit (NICU) nurseries, and to characterize the normal development of reflectance over the first year after birth in a group of infants with clinically normal hearing status followed longitudinally from birth to one year of age. Methods Infants were recruited from a well-baby and NICU nursery, passed newborn otoacoustic emissions (OAE) and automated auditory brainstem response (ABR) tests as well as follow-up diagnostic ABR and audiometry. They were tested longitudinally for up to one year using a wideband middle ear acoustic test battery consisting of tympanometry and ambient-pressure tests. Results were analyzed for ambient reflectance across frequency and tympanometric reflectance across frequency and pressure. Results Wideband absorbance and group delay showed large effects of age in the first 6 months. Immature absorbance and group delay patterns were apparent in the low frequencies at birth and one month, but changed substantially to a more adult-like pattern by age 6 months for both ambient and tympanometric variables. Area and length of the ear canal estimated acoustically increased up to age 1 year. Effects of race (African American and others compared to Caucasian) were found in combination with age effects. Mean and confidence intervals are provided for use as a normative longitudinal database for newborns and infants up to one year of age, for both well-baby and NICU infants.

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Section: Introductionmentioning

confidence: 99%

Longitudinal development of wideband reflectance tympanometry in normal and at-risk infants

et al. 2016

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“…Studies evaluating test-retest reliability of WBA in infants have reported good reliability (Hunter et al, 2008a;Shahnaz et al, 2014;. In the study by Vander Werff et al They also found that the reliability results were equivalent irrespective of the type of stimuli (broadband chirps and specific sine waves) used for the WBA measure.…”

Section: Reliability Of Wbamentioning

confidence: 97%

“…Hunter et al and Merchant et al suggested that the reason they did not find developmental changes compared to other studies could be partly attributed to methodological differences including the age of subjects and differences in the equipment and probe tips. and In a recent study, Shahnaz, Cai and Qi (2014) established normative WBA data in infants from birth to six months of age (Figure 1.5). Using a longitudinal paradigm, they also studied the time course and rate at which functional maturation of the middle ear occurs in 18 infants from birth through to six months of age.…”

Section: Developmental Trends In Wbamentioning

confidence: 99%

“…To date, there has been only one longitudinal study by Shahnaz et al (2014) that has tracked the developmental WBA pattern during early infancy. However, earlier studies have assessed infants across a wide age range.…”

Section: Justification For Conducting the Present Studymentioning

confidence: 99%

“…To date, there is only one study by Shahnaz et al (2014) that has followed the maturational changes in WBA in 18 infants from birth to six months of age. Future studies should employ a longitudinal design with larger sample size to more accurately track developmental changes in the conductive properties of the outer and middle ear of infants at shorter time intervals from birth to six months.…”

Section: Limitations Of the Investigationmentioning

confidence: 99%

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Wideband absorbance measures in neonates and young infants

Aithal¹

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Evaluation of middle ear status in young infants is a challenge in both screening and diagnostic contexts due to a lack of valid and objective tools of middle ear assessment . The standard tools used to determine the middle ear status in older children are neither efficient nor accurate in evaluating young infants.Wideband absorbance (WBA) is recommended as a tool for middle ear assessment in young infants due to its time efficiency, reliability, objectivity and ability WBA. The neonates were tested prior to their discharge from the hospital. In addition, a total of 36, 30, 33 and 30 infants were seen at 1, 2, 4, and 6 months of age, respectively. These infants were tested using HFT, DPOAE and WBA.The results revealed that conductive hearing loss was common among infants referred through NHS. Australian Aboriginal infants had significantly higher rates of middle ear pathology and conductive hearing loss at birth and showed poor resolution of middle ear pathology over time compared to non-Aboriginal infants. Use of a test of middle ear function (eg. WBA) as an adjunct to the screening tool to facilitate management and prioritisation of infants for further testing was recommended (Chapter Two). Normative ambient pressure WBA data were established for 66 neonates who passed a test battery of AABR, HFT, ASR, TEOAE and DPOAE tests. There was a significant difference in WBA across frequencies from 250 to 8000 Hz (Chapter Three). Test performance of WBA was compared across four single tests and five test battery reference standards in 192 neonates. The test performance of WBA against the test battery reference standards was better than that against single test reference standards (Chapter Four). Despite equal pass rates as determined by a test battery of HFT and DPOAE, the WBA of Aboriginal neonates who passed the test battery was significantly lower suggesting that Aboriginal neonates had more significant outer/middle ear conditions than Caucasian neonates. WBA appeared to be more sensitive to middle ear status than test battery comprising HFT and DPOAE (Chapter Five). In a cross sectional study of infants, developmental effects were evident during the first six months of life, with WBA reducing with age. Although data from the study could be used as reference standard for detecting middle ear disorders, further development of age-specific normative WBA was recommended (Chapter Six).

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Maturation of middle ear transmission in children

2017

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The goal of the current study was to characterize the normative features of wideband acoustic immittance in children for describing the functional maturation of the middle ear in 5 to 12-year-old children. Absorbance and group delay were measured in adults and three groups of children, 5–6, 7–9 and 10–12-year-olds, in a cross-sectional design. Absorbance showed significant effects of the age group in four out of ten center frequencies of one-half-octave bins from 211 to 6000 Hz, while there was no significant effect for group delay at any frequency. Older children (10–12 years) showed absorbance similar to adults. Test-retest reliability was high for absorbance for all age groups. However, group delay was modestly reliable only for adults. We conclude that the middle ear transmission follows a protracted period of maturation for high frequencies and reaches adult-like feature by 10 to 12 years of age.

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Understanding the Developmental Course of the Acoustic Properties of the Human Outer and Middle Ear Over the First 6 Months of Life by Using a Longitudinal Analysis of Power Reflectance at Ambient Pressure

Cited by 23 publications

References 47 publications

Longitudinal development of wideband reflectance tympanometry in normal and at-risk infants

Longitudinal development of wideband reflectance tympanometry in normal and at-risk infants

Wideband absorbance measures in neonates and young infants

Maturation of middle ear transmission in children

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