Wideband Middle Ear Power Measurement in Infants and Children

Abstract

Wideband middle ear power (WMEP) measurement is a method of middle ear analysis that may provide improved diagnostic capability over single-frequency tympanometry. However, normative data, information about test-retest reliability, and results in clinical disorders are needed for clinical application. Normative and reliability data on WMEP in children three days to 47 months of age were obtained using a prototype commercial instrument. A prospective study was conducted in children enrolled from a well-child pediatric clinic (n = 97), with comparisons of age, gender, and middle ear status and stimulus type (broadband chirp and sine wave). No significant age effect for power reflectance across the age range of this study was found, except at 6000 Hz. Significantly higher-power reflectance was found for ears with poor ear status, specifically otitis media with effusion. Smaller but nonsignificant differences in power reflectance were found for ears with positive and negative tympanometric peak pressure. Intraclass correlation coefficients showed significant correlations of 0.68 to 0.97 at various test frequencies using the chirp stimulus. Multivariate analysis of variance showed no significant effect of stimulus type (sine wave vs broadband chirp), ear, or gender. These results provide normative data for wideband middle ear power analysis for infants and children from birth to age four years.

Medidas de imitância acústica de banda larga com estímulo chirp e tom puro em lactentes com normalidade de orelha média

“…there is only one published study that analyzed wideband power reflectance in neonates with 27 to 78 hours of life (12) . Also, previous studies have shown a significant difference when comparing ethnic (13,14) and age groups (15) . Thus.…”

Efeito da estimulação contralateral nas medidas de reflectância acústica

“…Por medir uma ampla faixa de frequências, e pelo fato de não necessitar pressurizar o canal auditivo para a realização do exame, estas tornaram-se, por exemplo, uma alternativa para casos de pacientes com perfuração da membrana timpânica. Na triagem auditiva neonatal, sua utilidade traz mais segurança a respeito da interpretação dos resultados obtidos, como mostram alguns trabalhos com esta população em específico (Keefe et al, 2000;Hunter et al, 2008; Lira e Silva, 2011).…”

“…A diferença isolada em tais frequências não configura uma diferença homogênea entre orelhas, sendo a orelha direita a que apresentou maior reflectância. Tal achado não está de acordo com a literatura estudada, pois as pesquisas mencionam equivalência de respostas entre orelhas para esta variável (Hunter et al, 2008; Lira e Silva, 2011)…”

Wideband absorbance measures in neonates and young infants

“…Several normative studies have shown that, at all ages, power absorbance is lowest at frequencies below 1000 Hz and above 4000 Hz and highest in the frequency region between 1000 and 4000 Hz, which corresponds to the most effective frequency region of the middle ear transfer function Hunter, Tubaugh, Jackson & Propes, 2008b;Margolis, Saly & Keefe, 1999;). …”