ORIGINAL ARTICLE
WIDEBAND ABSORBANCE PATTERNS IN ADULTS WITH CENTRAL AND MARGINAL TYMPANIC MEMBRANE PERFORATION
Animesh Barman 2, A,C-E
,
 
 
 
 
More details
Hide details
1
Tele Center for Persons with Communication Disorder, All India Institute of Speech and Hearing, Mysuru, India
 
2
Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
 
3
Department of Audiology/Prevention of Communication Disorders, All India Institute of Speech and Hearing, Mysuru, 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: 2024-07-24
 
 
Final revision date: 2024-08-28
 
 
Acceptance date: 2024-08-29
 
 
Publication date: 2024-09-05
 
 
Corresponding author
Arunraj Karuppannan   

Department of Audiology/Prevention of Communication Disorders, All India Institute of Speech and Hearing, Manasagangothri, 570006, Mysuru, India
 
 
J Hear Sci 2024;14(3):39-47
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study aimed to investigate the impact of central and marginal tympanic membrane perforations (TMP) on wideband absorbance (WBA) and compare it with normal ears.

Material and methods:
Three groups of individuals, aged 18 to 50 years: Group I with central TMP (n = 65), Group II with marginal TMP (n = 13), and Group III with normal middle ears (n = 20) were considered. WBA measurements were performed at peak and ambient pressure conditions across frequencies.

Results:
Significant differences in WBA were observed between the groups with central and marginal TMP and the normal ear group across all frequencies. Central TMP exhibited decreased absorbance at low frequencies and increased absorbance at high frequencies, peaking at 5000 Hz. Marginal TMP showed peaks at 600, 4000, and 6000 Hz with decreased absorbance at 2000 Hz. Central TMP exhibited lower absorbance than marginal TMP at lower frequencies, while marginal TMP showed decreased absorbance at mid and high frequencies.

Conclusions:
These findings highlight the role of WBA in differentiating normal ears from those with TMP. Understanding TM vibration patterns and frequency-dependent variations in absorbance enhances diagnostic accuracy and clinical management.

 
REFERENCES (34)
1.
Fay JP, Puria S, Steele CR. The discordant eardrum. Proc Natl Acad Sci USA. 2006; 103(52): 19743–8. https://doi.org/10.1073/pnas.0....
 
2.
Szymanski A, Toth J, Ogorevc M, Geiger Z. Anatomy, head and neck, ear tympanic membrane. StatPearls, 2019. Available from: http://europepmc.org/abstract/... [Accessed: 12.03.2024].
 
3.
Tonndorf J, Khanna SM. Tympanic-membrane vibrations in human cadaver ears studied by time-averaged holography. J Acoust Soc Am, 1972; 52(4B): 1221–33. https://doi.org/10.1121/1.1913....
 
4.
Voss SE, Rosowski JJ, Merchant SN, Peake WT. Acoustic responses of the human middle ear. Hear Res, 2000; 150(1–2): 43–69. https://doi.org/10.1016/s0378-....
 
5.
Selaimen FA, Rosito LPS, Da Silva MNL, De Souza Stanham V, Sperling N, Da Costa SS. Tympanic membrane perforations: a critical analysis of 1003 ears and proposal of a new classification based on pathogenesis. Eur Arch Otorhinolaryngol, 2021; 279(3): 1277–83. https://doi.org/10.1007/s00405....
 
6.
Hunter LL, Prieve BA, Kei J, Sanford CA. Pediatric applications of wideband acoustic immittance measures. Ear Hear, 2013; 34 (Suppl. 1): 36s–42s. https://doi.org/10.1097/aud.0b....
 
7.
Shahnaz N, Polka L. Standard and multifrequency tympanometry in normal and otosclerotic ears. Ear Hear, 1997; 18(4): 326–41. https://doi.org/10.1097/000034....
 
8.
Norrix LW, Burgan B, Ramirez N, Velenovsky DS. Interaural multiple frequency tympanometry measures: clinical utility for unilateral conductive hearing loss. J Am Acad Audiol, 2013; 24(3): 231–40. https://doi.org/10.3766/jaaa.2....
 
9.
Feeney MP, Stover B, Keefe DH, Garinis AC, Day JE, Seixas N. Sources of variability in wideband energy reflectance measurements in adults. J Am Acad Audiol, 2014; 25(5): 449–61. https://doi.org/10.3766/jaaa.2....
 
10.
Sanford CA, Keefe DH, Liu Y, Fitzpatrick D, McCreery RW, Lewis DE, Gorga MP. Sound-conduction effects on distortion-product otoacoustic emission screening outcomes in newborn infants: test performance of wideband acoustic transfer functions and 1-kHz tympanometry. Ear Hear, 2009; 30(6): 635–52. https://doi.org/10.1097/aud.0b....
 
11.
Hunter LL, Shanaz N. Acoustic Immittance Measures: Basic and Advanced Practice. San Diego: Plural Publishing, Inc; 2014.
 
12.
Liu Y, Sanford CA, Ellison JC, Fitzpatrick DF, Gorga MP, Keefe DH. Wideband absorbance tympanometry using pressure sweeps: system development and results on adults with normal hearing. J Acoust Soc Am, 2008; 124(6): 3708–19. https://doi.org/10.1121/1.3001....
 
13.
Ellison JC, Gorga M, Cohn E, Fitzpatrick D, Sanford CA, Keefe DH. Wideband acoustic transfer functions predict middle‐ear effusion. Laryngoscope, 2012; 122(4): 887–94. https://doi.org/10.1002/lary.2....
 
14.
Ibraheem W. Clinical diagnosis of middle ear disorders using wideband energy reflectance in adults. Adv Arab Acad Audio Vestibul J, 2014; 1(2): 87. https://doi.org/10.4103/2314-8....
 
15.
Karuppannan A, Barman A. Clinical validation of wideband absorbance tympanometry in detecting middle ear disorders [doctoral thesis]. University of Mysore, Shodhganga, 2021. Available from: http: //hdl.handle.net/10603/406811 [Accessed: 22.02.2024].
 
16.
Karuppannan A, Barman A. Evaluation of wideband absorbance tympanometry in adults with abnormal positive and negative middle ear pressure. J Hear Sci, 2020; 10(4): 40–7. https://doi.org/10.17430/jhs.2....
 
17.
Kim SY, Han JJ, Oh SH, Lee JH, Suh M, Kim MH, Park MK. Differentiating among conductive hearing loss conditions with wideband tympanometry. Auris Nasus Larynx, 2019; 46(1): 43–9. https://doi.org/10.1016/j.anl.....
 
18.
Nakajima HH, Rosowski JJ, Shahnaz N, Voss SE. Assessment of ear disorders using power reflectance. Ear Hear, 2013; 34 (Suppl. 1): 48s–53s. https://doi.org/10.1097/aud.0b....
 
19.
Karuppannan A, Barman A, Mamatha NM. Wideband absorbance pattern and its diagnostic value in adults with middle ear effusions and tympanic membrane perforation. J Int Adv Otol, 2024; 20(2): 158–63. https://doi.org/10.5152/iao.20....
 
20.
Allen JB, Jeng PS, Levitt H. Evaluation of human middle ear function via an acoustic power assessment. J Rehabil Res Dev, 2005; 42(4s): 63. https://doi.org/10.1682/jrrd.2....
 
21.
Sanford CA, Brockett JE, Aithal V, Al Makadma H. Implementation of wideband acoustic immittance in clinical practice: relationships among audiologic and otologic findings. Semin Hear, 2023; 44(01): 065–083. https://doi.org/10.1055/s-0043....
 
22.
Voss SE, Rosowski JJ, Merchant SN, Peake WT. Non-ossicular signal transmission in human middle ears: experimental assessment of the “acoustic route” with perforated tympanic membranes. J Acoust Soc Am, 2007; 122(4): 2135–53. https://doi.org/10.1121/1.2769....
 
23.
Bevis N, Sackmann B, Effertz T, Lauxmann M, Beutner D. The impact of tympanic membrane perforations on middle ear transfer function. Eur Arch Otorhinolaryngol, 2021; 279(7): 3399–406. https://doi.org/10.1007/s00405....
 
24.
Stomackin G, Kidd S, Jung TT, Martin GK, Dong W. Effects of tympanic membrane perforation on middle ear transmission in gerbil. Hear Res, 2019; 373: 48–58. https://doi.org/10.1016/j.hear....
 
25.
Cohen J. A power primer. Psychol Bull, 1992; 112(1): 155–9. https://doi.org/10.1037/0033-2....
 
26.
Kim J, Koo M. Mass and stiffness impact on the middle ear and the cochlear partition. J Audiol Otol, 2015; 19(1): 1–6. https://doi.org/10.7874/jao.20....
 
27.
Voss SE, Merchant GR, Horton NJ. Effects of middle-ear disorders on power reflectance measured in cadaveric ear canals. Ear Hear, 2012; 33(2): 195–208. https://doi.org/10.1097/aud.0b....
 
28.
Feeney MP, Grant IL, Marryott LP. Wideband energy reflectance measurements in adults with middle-ear disorders. J Speech Lang Hear Res, 2003; 46(4): 901–11. https://doi.org/10.1044/1092-4...).
 
29.
Jeng PS, Allen JB, Miller JA, Levitt H. Wideband power reflectance and power transmittance as tools for assessing middle-ear function. Perspect Hear Hear Disord Child, 2008; 18(2): 44–57. https://doi.org/10.1044/hhdc18....
 
30.
Aithal V, Aithal S, Kei J, Manuel A. Normative wideband acoustic immittance measurements in Caucasian and Aboriginal children. Am J Audiol, 2019; 28(1): 48–61. https://doi.org/10.1044/2018_a....
 
31.
Feeney MP, Keefe DH, Hunter LL, Fitzpatrick DF, Garinis AC, Putterman DB, McMillan GP. Normative wideband reflectance, equivalent admittance at the tympanic membrane, and acoustic stapedius reflex threshold in adults. Ear Hear, 2017; 38(3): e142–e160. https://doi.org/10.1097/aud.00....
 
32.
Schlagintweit M. Inter-aural difference norms for wideband absorbance (WBA): potential for identifying otosclerosis [dissertation]. University of British Columbia, Vancouver, Canada, 2018. https://doi.org/10.14288/1.037....
 
33.
Robinson SR, Thompson S, Allen JB. Effects of negative middle ear pressure on wideband acoustic immittance in normal-hearing adults. Ear Hear, 2016; 37(4): 452–64. https://doi.org/10.1097/aud.00....
 
34.
Shaver MD, Sun X. Wideband energy reflectance measurements: effects of negative middle ear pressure and application of a pressure compensation procedure. J Acoust Soc Am, 2013; 134(1): 332–41. https://doi.org/10.1121/1.4807....
 
Journals System - logo
Scroll to top