Wideband middle ear power measurement in infants and children.

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.

[1]  J. Hirsch,et al.  Hearing Screening in the Newborn Intensive Care Nursery: Comparison of Methods , 1999, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[2]  J. Kei,et al.  High-frequency (1000 Hz) tympanometry in normal neonates. , 2003, Journal of the American Academy of Audiology.

[3]  D H Keefe,et al.  Ear-canal impedance and reflection coefficient in human infants and adults. , 1993, The Journal of the Acoustical Society of America.

[4]  P. Avan,et al.  Auditory Screening in Neonates by Means of Transient Evoked Otoacoustic Emissions: A Report of 2,842 Recordings , 1999, The Annals of otology, rhinology, and laryngology.

[5]  R. Eavey,et al.  Meconium contamination of the neonatal middle ear. , 1989, The Journal of pediatrics.

[6]  J. Paradise,et al.  Tympanometric detection of middle ear effusion in infants and young children. , 1976, Pediatrics.

[7]  R. Margolis,et al.  Developmental changes in multifrequency tympanograms. , 1991, Audiology : official organ of the International Society of Audiology.

[8]  C. Marchant,et al.  Objective diagnosis of otitis media in early infancy by tympanometry and ipsilateral acoustic reflex thresholds. , 1986, The Journal of pediatrics.

[9]  Jont B. Allen,et al.  Peripheral Auditory Mechanisms , 1986 .

[10]  J. Roush,et al.  Developmental changes in static admittance and tympanometric width in infants and toddlers. , 1995, Journal of the American Academy of Audiology.

[11]  Welfare Agencies,et al.  Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. , 2000, American journal of audiology.

[12]  M. Paparella,et al.  Residual Mesenchyme in Temporal Bones of Children , 1996, The Laryngoscope.

[13]  D H Keefe,et al.  Wideband reflectance tympanometry in normal adults. , 1999, The Journal of the Acoustical Society of America.

[14]  D. H. Keefe,et al.  Maturation of the Middle and External Ears: Acoustic Power‐Based Responses and Reflectance Tympanometry , 1996, Ear and hearing.

[15]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[16]  L. Hunter,et al.  Multifrequency Tympanometry: Current Clinical Application. , 1992, American journal of audiology.

[17]  Jont B. Allen,et al.  Measurement of Eardrum Acoustic Impedance , 1986 .

[18]  R. Eavey,et al.  Embryonic middle ear mesenchyme disappears by redistribution , 1998, The Laryngoscope.

[19]  B. Vohr,et al.  Identification of Neonatal Hearing Impairment: Ear-Canal Measurements of Acoustic Admittance and Reflectance in Neonates , 2000, Ear and hearing.

[20]  D. G. Roberts,et al.  Resolution of middle ear effusion in newborns. , 1995, Archives of pediatrics & adolescent medicine.

[21]  Stephen T Neely,et al.  Ear-canal acoustic admittance and reflectance measurements in human neonates. II. Predictions of middle-ear in dysfunction and sensorineural hearing loss. , 2003, The Journal of the Acoustical Society of America.

[22]  R. Margolis,et al.  Ear canal wall mobility and tympanometric shape in young infants. , 1990, The Journal of pediatrics.

[23]  J. Grose,et al.  Multifrequency tympanometry and evoked otoacoustic emissions in neonates during the first 24 hours of life. , 1997, Journal of the American Academy of Audiology.

[24]  Harry Levitt,et al.  Evaluation of human middle ear function via an acoustic power assessment. , 2005, Journal of rehabilitation research and development.

[25]  R. Margolis,et al.  Tympanometry in newborn infants--1 kHz norms. , 2003, Journal of the American Academy of Audiology.

[26]  D H Keefe,et al.  Method to measure acoustic impedance and reflection coefficient. , 1992, The Journal of the Acoustical Society of America.

[27]  Chris A. Sanford,et al.  Detection of the acoustic stapedius reflex in infants using wideband energy reflectance and admittance. , 2005, Journal of the American Academy of Audiology.

[28]  T. Balkany,et al.  Middle ear effusions in neonates , 1978, The Laryngoscope.

[29]  M. Paparella,et al.  Residual mesenchyme persisting into adulthood. , 1999, American Journal of Otolaryngology.

[30]  D. H. Keefe,et al.  Wideband reflectance tympanometry in chinchillas and humans , 2001 .

[31]  Chris A. Sanford,et al.  Age effects in the human middle ear: wideband acoustical measures. , 2004, The Journal of the Acoustical Society of America.

[32]  B. Vohr,et al.  Identification of Neonatal Hearing Impairment: Distortion Product Otoacoustic Emissions during the Perinatal Period , 2000, Ear and hearing.

[33]  Welfare Agencies,et al.  Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs , 2000, Pediatrics.

[34]  S. E. Voss,et al.  Measurement of acoustic impedance and reflectance in the human ear canal. , 1994, The Journal of the Acoustical Society of America.

[35]  A. Takala,et al.  Normative Values for Tympanometry in 7- and 24-month-old Children: Valores normativos para la Timpanometría en niños de 7 y 24 meses de edad , 2001, Audiology : official organ of the International Society of Audiology.