ORIGINAL ARTICLE
EVALUATION OF WIDEBAND ABSORBANCE TYMPANOMETRY IN ADULTS WITH ABNORMAL POSITIVE AND NEGATIVE MIDDLE EAR PRESSURE
,
 
Animesh Barman 3, A,C-E
 
 
 
More details
Hide details
1
Audiology/Prevention of Communication Disorders, All India Institute of Speech and Hearing, India
 
2
Department of Audiology/Prevention of Communication Disorders, All India Institute of Speech and Hearing, India
 
3
Department of Audiology, All India Institute of Speech and Hearing, India
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2020-07-28
 
 
Final revision date: 2020-10-13
 
 
Acceptance date: 2020-11-10
 
 
Publication date: 2020-12-31
 
 
Corresponding author
Arunraj Karuppannan   

Audiology/Prevention of Communication Disorders, All India Institute of Speech and Hearing, Manasagangothri, 570006, Mysuru, India
 
 
J Hear Sci 2020;10(4):40-47
 
KEYWORDS
TOPICS
ABSTRACT
Background:
Middle ear pressure plays a vital role in the transmission of sound to the inner ear. However, limited research data exists to understand the effect of abnormal middle ear pressure on wideband absorbance (WBA) tympanometry. The purpose of the study was to evaluate WBA at peak pressure and ambient pressure in adults with abnormal positive and negative middle ear pressure and compare them with normal adult ears having normal middle ear pressure.

Material and methods:
Three groups of adults – normal middle ear pressure group (56 ears), negative middle ear pressure group (30 ears), and positive middle ear pressure group (15 ears) – in the age range 22 to 50 years were considered. WBA was measured at peak and ambient pressures across the frequencies from 250 to 8000 Hz.

Results:
WBA at peak pressure was observed to be higher than at ambient pressure in all the groups, with the difference seen mostly at low and mid-frequencies up to 2000 Hz. The negative middle ear pressure group showed the most considerable difference in mean WBA, seen between 600 Hz and 1000 Hz, followed by the positive middle ear pressure group, with a negligible difference for the normal middle ear pressure group.

Conclusions:
The study highlighted the importance of measuring WBA at peak pressure and ambient pressure. The results suggest that the comparison of WBA at peak and ambient pressures, especially from lower to mid-frequencies up to 2000 Hz, would help in differentiating abnormal negative/positive pressure from normal middle ear pressure and also between ears having negative and positive pressure.

 
REFERENCES (28)
1.
Player B. Earache. In: Kliegman R, Lye SP, Bordini JB, Toth H, Basel D, editors. Nelson Pediatric Symptom-Based Diagnosis. 20th ed. Philadelphia PA: Elsevier; 2018. p. 61–74.e1.
 
2.
Shahnaz N, Polka L. Standard and multifrequency tympanometry in normal and otosclerotic ears. Ear Hear, 1997; 18: 326–41.
 
3.
Nakajima HH, Pisano DV, Roosli C, et al. Comparison of earcanal reflectance and umbo velocity in patients with conductive hearing loss: a preliminary study. Ear Hear, 2012 Jan; 33: 35–43.
 
4.
Voss SE, Merchant GR, Horton NJ. Effects of middle-ear disorders on power reflectance measured in cadaveric ear canals. Ear Hear, 2012;33:195–208.
 
5.
Keefe DH, Levi E. Maturation of the middle and external ears: acoustic power-based responses and reflectance tympanometry. Ear Hear, 1996; 17: 361–73.
 
6.
Allen JB, Jeng PS, Levitt H. Evaluation of human middle ear function via an acoustic power assessment. J Rehabil Res Dev, 2005; 42: 63–77.
 
7.
Shaver MD, Sun X-M. Wideband energy reflectance measurements: effects of negative middle ear pressure and application of a pressure compensation procedure. J Acoust Soc Am, 2013; 134: 332–41.
 
8.
Onusko E. Tympanometry. Am Fam Physician, 2004 Nov; 70: 1713–20.
 
9.
Beers AN, Shahnaz N, Westerberg BD, Kozak FK. Wideband reflectance in normal Caucasian and Chinese school-aged children and in children with otitis media with effusion. Ear Hear, 2010; 31: 221–33.
 
10.
Hunter LL, Tubaugh L, Jackson A, Propes S. Wideband middle ear power measurement in infants and children. J Am Acad Audiol, 2008; 19: 309–24.
 
11.
Aithal S, Aithal V, Kei J, Anderson S, Liebenberg S. Eustachian tube dysfunction and wideband absorbance measurements at tympanometric peak pressure and 0 daPa. J Am Acad Audiol, 2019; 30: 781–91.
 
12.
Margolis RH, Saly GL, Keefe DH. Wideband reflectance tympanometry in normal adults. J Acoust Soc Am, 1999; 106: 265–80.
 
13.
Robinson SR, Thompson S, Allen JB. Effects of negative middle ear pressure on wideband acoustic immittance in normal-hearing adults. Ear Hear, 2016 Jul 1; 37: 452–64.
 
14.
Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol, 1970; 92: 311–24.
 
15.
Greenhouse SW, Geisser S. On methods in the analysis of profile data. Psychometrika, 1959 Jun; 24: 95–112.
 
16.
Śliwa L, Kochanek K, Jedrzejczak WW, Mrugała K, Skarżyński H. Measurement of wideband absorbance as a test for otosclerosis. J Clin Med, 2020 Jun 18; 9: 1908.
 
17.
Shahnaz N, Bork K. Wideband reflectance norms for Caucasian and Chinese young adults. Ear Hear, 2006 Dec; 27: 774–88.
 
18.
Feeney MP, Sanford CA. Age effects in the human middle ear: wideband acoustical measures. J Acoust Soc Am, 2004; 116: 3546–58.
 
19.
Wang S, Hao W, Xu C, Ni D, Gao Z, Shang Y. A study of wideband energy reflectance in patients with otosclerosis: data from a Chinese population. Biomed Res Int, 2019; 2019: 1–8.
 
20.
Shaw J. Comparison of Wideband Energy Reflectance and Tympanometric Measures Obtained With Reflwin Interacoustics, Mimosa Acoustics and GSI Tympstar Systems. MSc thesis, Uni British Columbia, 2009.
 
21.
Sanford CA, Brockett JE. Characteristics of wideband acoustic immittance in patients with middle-ear dysfunction. J Am Acad Audiol, 2014; 25: 425–40.
 
22.
Shaver MD. Wideband energy reflectance measurements: normative study and effects of negative and compensated middle ear pressures [Unpublished doctoral thesis]. Wichita State University, 2004.
 
23.
Sanford CA, Feeney MP. Effects of maturation on tympanometric wideband acoustic transfer functions in human infants. J Acoust Soc Am, 2008; 124: 2106–22.
 
24.
Feeney MP, Keefe DH. Acoustic reflex detection using wideband acoustic reflectance, admittance, and power measurements. J Speech Lang Hear Res, 1999; 42: 1029–41.
 
25.
Pickles J. An Introduction to the Physiology of Hearing. 4th ed. Bingley, UK. Brill Academic Publishers; 2012.
 
26.
Gea SLR, Decraemer WF, Funnell RWJ, Dirckx JJJ, Maier H. Tympanic membrane boundary deformations derived from static displacements observed with computerised tomography in human and gerbil. JARO, 2010; 11: 1–17.
 
27.
Jang CH, Park H, Choi CH, Cho YB, Park IY. The effect of increased inner ear pressure on tympanic membrane vibration. Int J Pediatr Otorhinolaryngol, 2009 Mar; 73: 371–5.
 
28.
Margolis RH, Hunter L. Acoustic immittance measurements. In: Roeser RJ, Valente M, Hosford-Dunn H, editors. Audiology Diagnosis. New York: Thieme Medical Publishers, 2000, pp. 381–423.
 
Journals System - logo
Scroll to top