Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power

Feeney, M. Patrick; Keefe, Douglas H.; Hunter, Lisa L.; Fitzpatrick, Denis; Putterman, Daniel; Garinis, Angela C.

doi:10.1097/aud.0000000000000968

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…The duration of the BBN pulse was 116 ms, as described in Feeney et al (2017). The wideband acoustic immittance system and the click stimulus presented to the probe ear were calibrated prior to each test session, as described in Feeney et al (2020), and testing was completed within 30 min of this calibration. The BBN stimulus was calibrated at least annually using a Brϋel & Kjaer head and torso simulator (Model 4128) connected to a Brϋel & Kjaer LanXi digitizer to record the stimuli.…”

Section: Wideband Memrmentioning

confidence: 99%

The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population

et al. 2022

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Purpose: Human studies of noise-induced cochlear synaptopathy using physiological indicators identified in animal models (auditory brainstem response [ABR] Wave I amplitude, envelope following response [EFR], and middle ear muscle reflex [MEMR]) have yielded mixed findings. Differences in the population studied may have contributed to the differing results. For example, due to differences in the intensity level of the noise exposure, noise-induced synaptopathy may be easier to detect in a military Veteran population than in populations with recreational noise exposure. We previously demonstrated a reduction in ABR Wave I amplitude and EFR magnitude for young Veterans with normal audiograms reporting high levels of noise exposure compared to non-Veteran controls. In this article, we expand on the previous analysis in the same population to determine if MEMR magnitude is similarly reduced. Method: Contralateral MEMR growth functions were obtained in 92 young Veterans and non-Veterans with normal audiograms, and the relationship between noise exposure history and MEMR magnitude was assessed. Associations between MEMR magnitude and distortion product otoacoustic emission, EFR, and ABR measurements collected in the same sample were also evaluated. Results: The results of the statistical analysis, although not conventionally statistically significant, suggest a reduction in mean MEMR magnitude for Veterans reporting high noise exposure compared with non-Veteran controls. In addition, the MEMR appears relatively insensitive to subclinical outer hair cell dysfunction, as measured by distortion product otoacoustic emissions, and is not well correlated with ABR and EFR measurements. Conclusions: When combined with our previous ABR and EFR findings in the same population, these results suggest that noise-induced synaptopathy occurs in humans. In addition, the findings indicate that the MEMR may be a good candidate for noninvasive diagnosis of cochlear synaptopathy/deafferentation and that the MEMR may reflect the integrity of different neural populations than the ABR and EFR. Supplemental Material: https://doi.org/10.23641/asha.18665645

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Section: Wideband Memrmentioning

confidence: 99%

The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population

et al. 2022

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“…Many studies have shown reduced absorbance, or increased reflectance, in otosclerotic ears, 14 15 16 17 18 19 particularly in the low frequency band. This reduction in absorbance occurs due to increased stiffness in the system, which leads to a decreased acoustic sensitivity to low frequencies and, consequently, increased reflection.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10][11] Compared with traditional tympanometry, absorbance or reflectance measurements provide much more information on the state of the middle ear and allow more comprehensive assessment of middle-ear disorders. 12,13 Many studies have shown reduced absorbance, or increased reflectance, in otosclerotic ears, [14][15][16][17][18][19] particularly in the low frequency band. This reduction in absorbance occurs due to increased stiffness in the system, which leads to a decreased acoustic sensitivity to low frequencies and, consequently, increased reflection.…”

Section: Introductionmentioning

confidence: 99%

Wideband Acoustic Absorbance in Otosclerosis: Does Stapedotomy Restore Normal Tympanic Cavity Function?*

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Nascimento

Almeida

et al. 2022

Int Arch Otorhinolaryngol

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Introduction Otosclerosis is characterized by the fixation of the stapes to the oval window, thereby impairing acoustic signal absorbance. A commonly used surgical technique for improving hearing in cases of otosclerosis is stapedotomy. However, it is unclear whether this surgery restores all the physical characteristics of the tympano-ossicular system. Objective To evaluate the tympano-ossicular system in individuals with fenestral otosclerosis pre and poststapedotomy using wideband tympanometry. Method A total of 47 individuals and 71 ears were assessed. The subjects were divided into three groups: presurgery otosclerosis; postsurgery; and a control group of normal-hearing adults. A handheld tympanometer with a wideband module (226–8,000 Hz) was used to take measurements at ambient pressure and under pressurized conditions. The level of statistical significance adopted was p ≤ 0.05. Results Acoustic absorbance at 226 Hz was low for all groups. At frequencies in the range 630 to 5,040 Hz, each group had a characteristic absorbance curve, allowing them to be distinguished from one another. In the presurgery group, absorbance values were below normal levels, with energy absorbance below 10%. Low energy absorbance was most evident at 1,000 Hz in the presurgery group, but this was not observed in the postsurgery group. Although there was an improvement in hearing, the surgery failed to restore the tympano-ossicular system to normal. Conclusion Wideband acoustic absorbance proved able to differentiate normal ears and otosclerotic ears pre and postsurgery, under both ambient pressure and pressurized conditions.

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“…Another advantage of WBT is the potential diagnostic utility of WAI at other static ear-canal pressures. For example, ossicular lesions might be diagnosed more accurately if WAI measurements are compared between TPP and very positive or very negative ear-canal static pressure, in which the TM and attached malleus are pushed medially or pulled distally (Hunter et al 2017; Feeney et al 2020). There may also be advantages of a wideband middle ear muscle reflex measured at TPP compared to standard reflex testing at ambient pressure and 226 Hz (Feeney et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Preserving Wideband Tympanometry Information With Artifact Mitigation

et al. 2021

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Objective: Absorbance measured using wideband tympanometry (WBT) has been shown to be sensitive to changes in middle and inner ear mechanics, with potential to diagnose various mechanical ear pathologies. However, artifacts in absorbance due to measurement noise can obscure information related to pathologies and increase intermeasurement variability. Published reports frequently present absorbance that has undergone smoothing to minimize artifact; however, smoothing changes the true absorbance and can destroy important narrow-band characteristics such as peaks and notches at different frequencies. Because these characteristics can be unique to specific pathologies, preserving them is important for diagnostic purposes. Here, we identify the cause of artifacts in absorbance and develop a technique to mitigate artifacts while preserving the underlying WBT information. Design: A newly developed Research Platform for the Interacoustics Titan device allowed us to study raw microphone recordings and corresponding absorbances obtained by WBT measurements. We investigated WBT measurements from normal hearing ears and ears with middle and inner ear pathologies for the presence of artifact and noise. Furthermore, it was used to develop an artifact mitigation procedure and to evaluate its effectiveness in mitigating artifacts without distorting the true WBT information. Results: We observed various types of noise that can plague WBT measurements and that contribute to artifacts in computed absorbances, particularly intermittent low-frequency noise. We developed an artifact mitigation procedure that incorporates a high-pass filter and a Tukey window. This artifact mitigation resolved the artifacts from low-frequency noise while preserving characteristics in absorbance in both normal hearing ears and ears with pathology. Furthermore, the artifact mitigation reduced intermeasurement variability. Conclusions: Unlike smoothing algorithms used in the past, our artifact mitigation specifically removes artifacts caused by noise. It does not change frequency response characteristics, such as narrow-band peaks and notches in absorbance at different frequencies that can be important for diagnosis. Also, by reducing intermeasurement variability, the artifact mitigation can improve the test–retest reliability of these measurements.

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Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power

Cited by 9 publications

References 26 publications

The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population

The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population

Wideband Acoustic Absorbance in Otosclerosis: Does Stapedotomy Restore Normal Tympanic Cavity Function?*

Preserving Wideband Tympanometry Information With Artifact Mitigation

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