Wideband Tympanometry Findings in School-aged Children: Effects of Age, Gender, Ear Laterality, and Ethnicity

Abstract

Objectives: Wideband tympanometry (WBT) measures middle-ear function across a range of frequencies (250 to 8000 Hz) while the earcanal pressure is varied from +200 to -300 daPa. WBT is a suitable test to evaluate middle-ear function in children, but there is a lack of age-, ear-, gender-, or ethnicity-specific data throughout the literature. The purpose of this study was to investigate the effects of age, ear laterality, gender, and ethnicity on the WBT data retrieved from children aged 4 to 13 years determined to have normal middle-ear function.Design: Data were collected cross-sectionally from 924 children aged 4 to 13 years who passed a test battery consisting of 226-Hz tympanometry, ipsilateral acoustic stapedial reflexes, and pure-tone screening, and without significant history of middle-ear dysfunction. Participants were grouped according to their age: 4 to 6 years, 7 to 9 years, 10 to 13 years. Wideband absorbance values were extracted at 0 daPa (WBA 0 ) and tympanometric peak pressure (WBA TPP ). Results:The effects of age, frequency, and pressure (WBA 0 versus WBA TPP ) were statistically significant. There were significant differences between WBA 0 and WBA TPP for all age groups such that WBA 0 had lower absorbance at low frequencies (250 to 1600 Hz) and greater absorbance at mid to high frequencies (2500 to 8000 Hz). Statistically significant effects of age were present for WBA 0 and WBA TPP such that absorbance generally increased with age from 250 to 1250 Hz and decreased with age from 2000 to 5000 Hz. There were no significant main effects of gender, ear, or ethnicity. Conclusions:Gender-, ear-, and ethnicity-specific clinical WBA 0 and WBA TPP norms are not required for diagnostic purposes; however, agespecific norms may be necessary. Age-related changes in middle-ear function were observed across WBA 0 and WBA TPP . The data presented in this study are a suitable clinical reference for evaluating the outer-and middle-ear function of school-aged children.

Absorbance Measurements From Normal-hearing Ears in the National Health and Nutrition Examination Survey, 2015–2016 and 2017–2020

“…Figure 3 compares the NHANES normal-hearing measurements to published measurements from Downing et al (2022); Groon et al (2015), and Rosowski et al (2012); these three studies were chosen because their results are representative of the larger literature. An important conclusion from Figure 3 is that the NHANES measurements are consistent with the wider WAI literature.…”

“…The NHANES data were collected with version 3 of the Titan Suite measurement system (Interacoustics 2022), which appears to result in a characteristic pattern with small and systematic oscillations in frequency in all of the means; it is likely that this pattern results from slight imperfections in the calibration cavities associated with version 3 of the Titan. The Downing et al (2022) measurements were collected with version 4 of the Titan system, which has an updated calibration cavity design, and no measurement oscillations. Nonetheless, the two systems produced similar results across similar age groups.…”

“…The NHANES data are summarized by plotting the NHANES mean data from the two age groups that are most different from the overall NHANES mean. Impedance angle data are not available for Downing et al (2022). The comparison data were plotted by accessing them through the WAI database hosted at Smith College (Voss and Horton, 2022).…”

“…Ears that met the following four criteria were defined as normal and selected for inclusion in the normative data reported here: (1) normal otoscopy upon examination, (2) pure-tone thresholds ≤ 20 dB at frequencies 500, 1000, 2000, and 4000 Hz, (3) tympanometric peak pressures in the range −50 to 50 daPa, and (4) tympanometric compliance in the range 0.3 to 1.5 mmho (Keefe et al 2017; Downing et al 2022). Within the 2015–2016 dataset (ages 20 to 69 years), audiometric measurements were reported from 4582 subjects (8554 ears); a total of 3609 of these ears met the normal-hearing inclusion criteria.…”

Characteristics of large vestibular aqueduct syndrome in wideband acoustic immittance

“…The influencing factors for middle ear sound transmission include elastic stiffness and mass. Elastic stiffness has a greater impact on the transmission efficiency of low-frequency sound signals, while mass has a greater impact on the transmission efficiency of high-frequency sound signals ( Kaya et al, 2020 ; Downing et al, 2022 ; Miehe et al, 2022 ; Aithal et al, 2023 ). The available results are believed to be related to changes in the anatomical structure and biochemical properties of LVAS and the frequency of the stimulus sound.…”