Predictive Accuracy of Wideband Absorbance at Ambient and Tympanometric Peak Pressure Conditions in Identifying Children with Surgically Confirmed Otitis Media with Effusion

Abstract Background Wideband absorbance (WBA) measured at ambient pressure (WBAA) does not directly account for middle ear pressure effects. On the other hand, WBA measured at tympanometric peak pressure (TPP) (WBATPP) may compensate for the middle ear pressure effects. To date, there are no studies that have compared WBAA and WBATPP in ears with surgically confirmed otitis media with effusion (OME). Purpose The purpose of this study was to compare the predictive accuracy of WBAA and WBATPP in ears with OME. Research Design Prospective cross-sectional study. Study Sample A total of 60 ears from 38 healthy children (mean age = 6.5 years, SD = 1.84 years) and 60 ears from 38 children (mean age = 5.5 years, SD = 3.3 years) with confirmed OME during myringotomy were included in this study. Data Collection and Analysis Results were analyzed using descriptive statistics and analysis of variance. The predictive accuracy of WBAA and WBATPP was determined using receiver operating characteristics (ROC) analyses. Results Both WBAA and WBATPP were reduced in ears with OME compared with that in healthy ears. The area under the ROC (AROC) curve was 0.92 for WBAA at 1.5 kHz, whereas that for WBATPP at 1.25 kHz was 0.91. In comparison, the AROC for 226-Hz tympanometry based on the static acoustic admittance (Ytm) measure was 0.93. Conclusions Both WBAA and WBATPP showed high and similar test performance, but neither test performed significantly better than 226-Hz tympanometry for detection of surgically confirmed OME.

[1]  J. Kei,et al.  Eustachian Tube Dysfunction and Wideband Absorbance Measurements at Tympanometric Peak Pressure and 0 daPa , 2019, Journal of the American Academy of Audiology.

[2]  Denis F. Fitzpatrick,et al.  Identifying Otosclerosis with Aural Acoustical Tests of Absorbance, Group Delay, Acoustic Reflex Threshold, and Otoacoustic Emissions , 2017, Journal of the American Academy of Audiology.

[3]  R. Dowell,et al.  Consequences of Early Conductive Hearing Loss on Long-Term Binaural Processing , 2017, Ear and hearing.

[4]  Amber D. Shaffer,et al.  The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate , 2017, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[5]  Joshua M Alexander,et al.  Minimal Hearing Loss: From a Failure-Based Approach to Evidence-Based Practice. , 2016, American journal of audiology.

[6]  E. Dursun,et al.  Diagnostic value of the wideband acoustic absorbance test in middle-ear effusion , 2015, The Journal of Laryngology & Otology.

[7]  S. Neely,et al.  Air-Leak Effects on Ear-Canal Acoustic Absorbance , 2014, Ear and hearing.

[8]  Chris A. Sanford,et al.  Characteristics of wideband acoustic immittance in patients with middle-ear dysfunction. , 2014, Journal of the American Academy of Audiology.

[9]  K. Schairer,et al.  Wideband Acoustic Immittance Normative Data: Ethnicity, Gender, Aging, and Instrumentation , 2013, Ear and hearing.

[10]  Denis F. Fitzpatrick,et al.  Wideband aural acoustic absorbance predicts conductive hearing loss in children , 2012, International journal of audiology.

[11]  Denis F. Fitzpatrick,et al.  Wideband acoustic transfer functions predict middle‐ear effusion , 2012, The Laryngoscope.

[12]  L. Hunter,et al.  Wideband Reflectance in Newborns: Normative Regions and Relationship to Hearing-Screening Results , 2010, Ear and hearing.

[13]  M. Valente,et al.  Audiology Answers for Otolaryngologists , 2010 .

[14]  B. Westerberg,et al.  Wideband Reflectance in Normal Caucasian and Chinese School-Aged Children and in Children with Otitis Media with Effusion , 2010, Ear and hearing.

[15]  Denis F. Fitzpatrick,et al.  Sound-Conduction Effects on Distortion-Product Otoacoustic Emission Screening Outcomes in Newborn Infants: Test Performance of Wideband Acoustic Transfer Functions and 1-kHz Tympanometry , 2009, Ear and hearing.

[16]  N. Longridge,et al.  Energy Reflectance and Tympanometry in Normal and Otosclerotic Ears , 2009, Ear and hearing.

[17]  Chris A. Sanford,et al.  Effects of maturation on tympanometric wideband acoustic transfer functions in human infants. , 2008, The Journal of the Acoustical Society of America.

[18]  Al Yonovitz,et al.  Perceptual Consequences of Conductive Hearing Loss: Speech Perception in Indigenous Students Learning English as a 'School' Language , 2008 .

[19]  Lisa L Hunter,et al.  Wideband middle ear power measurement in infants and children. , 2008, Journal of the American Academy of Audiology.

[20]  D. Bagger-sjöbäck,et al.  Wideband reflectance associated with otitis media in infants and children with cleft palate , 2008, International journal of audiology.

[21]  Kathy R Vander Werff,et al.  Test-Retest Reliability of Wideband Reflectance Measures in Infants under Screening and Diagnostic Test Conditions , 2007, Ear and hearing.

[22]  Rollanda E. O'Connor,et al.  Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. , 2007, The New England journal of medicine.

[23]  Navid Shahnaz,et al.  Wideband Reflectance Norms for Caucasian and Chinese Young Adults , 2006, Ear and hearing.

[24]  A. Yonovitz,et al.  Tonal Masking Level Differences in Aboriginal Children: Implications for Binaural Interaction, Auditory Processing Disorders and Education , 2006 .

[25]  K. Hutchinson,et al.  The use of tympanometry and pneumatic otoscopy for predicting middle ear disease. , 2005, American journal of audiology.

[26]  P. Kaleida.  Evidence assessment of the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion. , 2004, The Journal of pediatrics.

[27]  Alejandro Hoberman,et al.  Clinical Practice Guideline: Otitis Media with Effusion , 2004, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[28]  J. Kei,et al.  Speech perception abilities of children with and without histories of recurrent otitis media: an overview , 2004 .

[29]  D. H. Keefe,et al.  Energy transmittance predicts conductive hearing loss in older children and adults. , 2003, The Journal of the Acoustical Society of America.

[30]  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.

[31]  L. Hunter,et al.  High‐Frequency Hearing Loss and Wideband Middle Ear Impedance in Children with Otitis Media Histories , 2000, Ear and hearing.

[32]  Olav Klausen.  Lasting Effects of Otitis Media with Effusion on Language Skills and Listening Performance , 2000, Acta oto-laryngologica. Supplementum.

[33]  A. Takala,et al.  Diagnostic value of tympanometry in infants in clinical practice. , 1999, International journal of pediatric otorhinolaryngology.

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

[35]  A. Freeland,et al.  The predictive value of tympanometry in the diagnosis of middle ear effusion. , 1997, Clinical otolaryngology and allied sciences.

[36]  J H Grose,et al.  Long-term effects of chronic otitis media on binaural hearing in children. , 1995, Archives of otolaryngology--head & neck surgery.

[37]  L. Hunter,et al.  Identification of Hearing Loss in Children with Otitis Media , 1994, The Annals of otology, rhinology & laryngology. Supplement.

[38]  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.

[39]  C. Bluestone,et al.  Towards the validation of aural acoustic immittance measures for diagnosis of middle ear effusion in children. , 1992, Ear and hearing.

[40]  S. Friel-Patti,et al.  Tympanometry and otoscopy prior to myringotomy: issues in diagnosis of otitis media. , 1992, International journal of pediatric otorhinolaryngology.

[41]  J. Shanks,et al.  Basic principles and clinical applications of tympanometry. , 1991, Otolaryngologic clinics of North America.

[42]  P. Menyuk,et al.  Otitis media in infancy and intellectual ability, school achievement, speech, and language at age 7 years. Greater Boston Otitis Media Study Group. , 1990, The Journal of infectious diseases.

[43]  S. Friel-Patti,et al.  Language learning in a prospective study of otitis media with effusion in the first two years of life. , 1990, Journal of speech and hearing research.

[44]  R. Ruben,et al.  Otitis media, auditory sensitivity, and language outcomes at one year , 1988, The Laryngoscope.

[45]  G. Gates,et al.  Workshop on effects of otitis media on the child. , 1983, Pediatrics.

[46]  J. Hanley,et al.  The meaning and use of the area under a receiver operating characteristic (ROC) curve. , 1982, Radiology.

[47]  S. Geisser,et al.  On methods in the analysis of profile data , 1959 .

[48]  J. Kei,et al.  Normative wideband reflectance measures in healthy neonates. , 2013, International journal of pediatric otorhinolaryngology.

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

[50]  L S Chan,et al.  Diagnosis, natural history, and late effects of otitis media with effusion. , 2002, Evidence report/technology assessment.

[51]  E. Cantekin,et al.  Hearing acuity of children with otitis media with effusion. , 1985, Archives of otolaryngology.

[52]  J. Tyberghein,et al.  Hearing in children. , 1984, Acta oto-rhino-laryngologica Belgica.