Choice of probe tone and classification of trace patterns in tympanometry undertaken in early infancy

Tympanometry using 226 Hz, 678 Hz, and 1000 Hz probe tones was undertaken on two groups of babies, age 2 to 21 weeks. A group of 104 babies with normal ABR thresholds or TEOAEs were compared with a second group of 107 babies who had evidence of temporary conductive hearing loss based on the findings of a test battery, which included air and bone conduction ABR. The tympanograms were classified by Method 1, a simple visual classification system, and Method 2, adapted from a system described by Marchant et al (). The majority of tympanograms recorded in both groups using the 226 Hz probe tone were ‘normal’ Type A, with no significant difference in middle ear pressure or static admittance. However, both classification methods demonstrated significant differences between the two groups using the higher frequency probe tones, with Method 2 being the preferred system of classification. Tympanometry using 226 Hz is invalid below 21 weeks and 1000 Hz is the frequency of choice. Sumario Se efectuaron timpanometrías con sondas de 226, 678 y 1000 Hz a dos grupos de bebés de 2 a 21 semanas. Un grupo de 104 bebés con ABR o TEOAE normales se comparó con un segundo grupo de 107 bebés con evidencia de hipoacusia conductiva temporal según los hallazgos de la batería de pruebas que incluyó ABR aéreo y óseo. Se clasificaron los timpanogramas por el método 1: una clasificación visual simple y por el método 2: la adaptación del sistema descrito por Marchant et al (1986). Cuando se utilizó la sonda de 226Hz, la mayoría de los timpanogramas obtenidos en ambos grupos fueron tipo A “normales”, sin diferencia significativa en la presión del oído medio o la admitancia estática. Sin embargo, ambos métodos de clasificación mostraron diferencias significativas entre los dos grupos al utilizar la frecuencia más alta; el método 2 fue el sistema preferido de clasificación. La timpanometría con 226Hz es inválida en menores de 21 semanas y 1000Hz es la frecuencia de elección.

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

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

[3]  C. Taylor,et al.  Screening for hearing loss and middle-ear disorders in children using TEOAEs. , 2000, American journal of audiology.

[4]  B. McPherson,et al.  Transient evoked otoacoustic emissions in 6-year-old school children: a normative study , 2000, Scandinavian Audiology.

[5]  P. Watkin,et al.  Confirmation of deafness in infancy , 1999, Archives of disease in childhood.

[6]  C. Jardine,et al.  Developmental changes in tympanometry: a case study. , 1997, British journal of audiology.

[7]  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.

[8]  J. Bamford,et al.  Otoacoustic emission versus ABR screening: the effect of external and middle ear abnormalities in a group of SCBU neonates. , 1996, British journal of audiology.

[9]  P. Gleadle,et al.  Tympanometry and otoacoustic emissions in a cohort of special care neonates. , 1996, British journal of audiology.

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

[11]  R. Amedee The effects of chronic otitis media with effusion on the measurement of transiently evoked otoacoustic emissions , 1995, The Laryngoscope.

[12]  S. Purdy,et al.  High frequency probe tone tympanometry in infants with middle ear effusion , 1995 .

[13]  Lars-Eric Stenfors,et al.  The tympanic membrane. , 1995, Acta oto-rhino-laryngologica Belgica.

[14]  M. Larossa,et al.  Tympanometry as a screening tool in the NICU: is it effective? , 1993, Neonatal network : NN.

[15]  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.

[16]  A R Thornton,et al.  External- and middle-ear factors affecting evoked otoacoustic emissions in neonates. , 1993, British journal of audiology.

[17]  M. J. McCoy,et al.  Influence of Otitis Media on Evoked Otoacoustic Emissions in Children , 1992 .

[18]  J. Stevens,et al.  Auditory screening in high risk neonates: selection of a test protocol. , 1991, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

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

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

[21]  M. Brocaar,et al.  Brainstem response audiometry. I. Its use in distinguishing between conductive and cochlear hearing loss. , 1988, Audiology : official organ of the International Society of Audiology.

[22]  G. Moushegian,et al.  A developmental study of bone conduction auditory brain stem response in infants. , 1987, Ear and hearing.

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

[24]  J. Nadol,et al.  Postnatal Growth of the Human Temporal Bone , 1986, The Annals of otology, rhinology, and laryngology.

[25]  C. Marchant,et al.  OBJECTIVE DIAGNOSIS OF OTITIS MEDIA (OM) IN EARLY INFANCY , 1984, Pediatric Research.

[26]  M. Bennett,et al.  The neonatal acoustic reflex. , 1980, Scandinavian audiology.

[27]  W. Altemeier,et al.  Otitis media in infancy: tympanometric findings. , 1979, Pediatrics.

[28]  G. Popelka,et al.  Tympanometry in normal neonates. , 1979, Journal of speech and hearing research.

[29]  R. W. Stream,et al.  Emerging Characteristics of the Acoustic Reflex in Infants , 1978, otolaryngology.

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

[31]  R. Keith,et al.  Stapedial reflex in neonates. , 1978, Scandinavian audiology.

[32]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[33]  S. Pelton,et al.  Tympanometry in the diagnosis of middle-ear effusion. , 1977, The New England journal of medicine.

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

[35]  J. Paradise Pediatrician's View of Middle Ear Effusions: More Questions than Answers , 1976, The Annals of otology, rhinology, and laryngology.

[36]  E. Cantekin,et al.  Tympanometric Pattern Classification in Relation to Middle Ear Effusions , 1975, The Annals of otology, rhinology, and laryngology.

[37]  M. Bennett Acoustic Impedance Bridge Measurements with the Neonate , 1975 .

[38]  V. J. Vanhuyse,et al.  On the W-Notching of Tympanograms , 1975 .

[39]  R. Keith,et al.  MIDDLE EAR FUNCTION OF NEONATES , 1974, Pediatric Research.

[40]  R. Keith Impedance audiometry with neonates. , 1973, Archives of otolaryngology.

[41]  J. Paradise,et al.  Audiometry and tympanometry in relation to middle ear effusions in children , 1973, The Laryngoscope.

[42]  D. Brooks Hearing Screening: A Comparative Study of an Impedance Method and Pure Tone Screening , 1973 .

[43]  J Jerger,et al.  Clinical experience with impedance audiometry. , 1970, Archives of otolaryngology.

[44]  B. Jaffe,et al.  Tympanic membrane mobility in the newborn (with seven months' follow‐up). , 1970, The Laryngoscope.

[45]  G. Lidén The scope and application of current audiometric tests , 1969, The Journal of Laryngology & Otology.

[46]  D. Brooks,et al.  An Objective Method of Detecting Fluid in the Middle Ear , 1968 .

[47]  C. Webb,et al.  Ear studies in the newborn infant: II. Age of spontaneous visibility of the auditory canal and tympanic membrane, and the appearance of these structures in healthy newborn infants , 1961 .

[48]  C. Webb,et al.  Ear studies in the newborn infant , 1957 .