Ear &Amp; Hearing

2009

DOI: 10.1097/aud.0b013e3181976a14

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Energy Reflectance and Tympanometry in Normal and Otosclerotic Ears

¹

,

Karin T. Bork²,

³

et al.

Abstract: The present findings show that the overall changes of ER across frequencies can distinguish otosclerotic ears from normal ears and from other sources of conductive hearing loss. Incorporating ER in general practice will improve the identification of otosclerotic ears when conventional tympanometry and MFT may fail to do so. To further improve the false alarm rate, ER should be interpreted in conjunction with other audiologic test batteries because it is unlikely that signs of a conductive component, including … Show more

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Cited by 132 publications

(117 citation statements)

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“…Energy reflectance measure has been shown to provide superior performance in prediction of conductive hearing loss [4] and help improve newborn hearing screening outcomes [5]. The measure could be useful in the diagnosis of middle ear pathologies, e.g., otitis media with effusion [6], otosclerosis [7], and negative middle ear pressure [8]. The energy reflectance or absorbance measurement can also be performed with air pressure varied in the ear canal, known as wideband tympanometry [9,10].…”

Section: Editorialmentioning

confidence: 99%

Assessment of Conductive Dysfunction: Wideband Acoustic Immittance

Sun¹

2014

Commun Disord Deaf Stud Hearing Aids

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EditorialThe conductive mechanism plays an important role in our hearing: the first stage of signal processing in the auditory system. While it consists of the ear canal, the crucial portion is the middle ear system, which transforms airborne sound into mechanical vibration and helps improve sound transmission into the fluid-filled inner ear. Hearing loss due to dysfunction of the middle ear system may be threatening to the quality of life for humans. For example, conductive hearing loss may significantly impact normal speech and language development of children. Assessment of middle ear dysfunction is essential for audiological diagnosis of hearing loss and differential diagnosis of ear diseases. For instance, middle ear dysfunction may cloud outcomes of newborn hearing screening. Acoustic immittance is the current clinical technique for assessment of middle ear dysfunction. The major procedures include tympanometry and acoustic reflex test. In these procedures, a single-frequency probe tone (e.g., 226 Hz and 1000 Hz) is used to estimate the acoustic impudence/admittance of the middle ear. Although they have been a clinical routine in audiology since 1970s, value of these procedures in assessment of conductive dysfunction has been limited.Wideband Acoustic Immittance (WAI) is the most recently developed technique for evaluating middle ear transfer function. Compared with the conventional acoustic immittance technique, WAI uses a different calibration technique with the sound pressure in the ear canal measured in the presence of a probe single [1]. On the basis, several measures could be derived such as acoustic impedance/ admittance and pressure reflectance. Energy reflectance (defined as the squared pressure reflectance, sometimes called power reflectance) has been investigated the most [2,3]. It represents the proportion of energy that is reflected back from the middle ear, which varies from 0 to 1. Its complement is referred to as energy absorbance. One advantage of WAI is that the outcome is minimally influenced by the position of probe in the ear canal if the reflectance measure is used. In other words, the reflectance measured at the canal is a good approximation of the reflectance at the eardrum. Another advantage of this technique is utilization of wideband probe signals, e.g. clicks and tone chirps. Thus, the middle ear transfer function is evaluated in a wide frequency range (e.g. from 226 to 8000 Hz).Research on WAI has extensively initiated, for example, normative study in adults and infants [2]. Energy reflectance measure has been shown to provide superior performance in prediction of conductive hearing loss [4] and help improve newborn hearing screening outcomes [5]. The measure could be useful in the diagnosis of middle ear pathologies, e.g., otitis media with effusion [6], otosclerosis [7], and negative middle ear pressure [8]. The energy reflectance or absorbance measurement can also be performed with air pressure varied in the ear canal, known as wideband tympanometry [9,10].WAI is an emerging...

“…Energy reflectance measure has been shown to provide superior performance in prediction of conductive hearing loss [4] and help improve newborn hearing screening outcomes [5]. The measure could be useful in the diagnosis of middle ear pathologies, e.g., otitis media with effusion [6], otosclerosis [7], and negative middle ear pressure [8]. The energy reflectance or absorbance measurement can also be performed with air pressure varied in the ear canal, known as wideband tympanometry [9,10].…”

Section: Editorialmentioning

confidence: 99%

Assessment of Conductive Dysfunction: Wideband Acoustic Immittance

Sun¹

2014

Commun Disord Deaf Stud Hearing Aids

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EditorialThe conductive mechanism plays an important role in our hearing: the first stage of signal processing in the auditory system. While it consists of the ear canal, the crucial portion is the middle ear system, which transforms airborne sound into mechanical vibration and helps improve sound transmission into the fluid-filled inner ear. Hearing loss due to dysfunction of the middle ear system may be threatening to the quality of life for humans. For example, conductive hearing loss may significantly impact normal speech and language development of children. Assessment of middle ear dysfunction is essential for audiological diagnosis of hearing loss and differential diagnosis of ear diseases. For instance, middle ear dysfunction may cloud outcomes of newborn hearing screening. Acoustic immittance is the current clinical technique for assessment of middle ear dysfunction. The major procedures include tympanometry and acoustic reflex test. In these procedures, a single-frequency probe tone (e.g., 226 Hz and 1000 Hz) is used to estimate the acoustic impudence/admittance of the middle ear. Although they have been a clinical routine in audiology since 1970s, value of these procedures in assessment of conductive dysfunction has been limited.Wideband Acoustic Immittance (WAI) is the most recently developed technique for evaluating middle ear transfer function. Compared with the conventional acoustic immittance technique, WAI uses a different calibration technique with the sound pressure in the ear canal measured in the presence of a probe single [1]. On the basis, several measures could be derived such as acoustic impedance/ admittance and pressure reflectance. Energy reflectance (defined as the squared pressure reflectance, sometimes called power reflectance) has been investigated the most [2,3]. It represents the proportion of energy that is reflected back from the middle ear, which varies from 0 to 1. Its complement is referred to as energy absorbance. One advantage of WAI is that the outcome is minimally influenced by the position of probe in the ear canal if the reflectance measure is used. In other words, the reflectance measured at the canal is a good approximation of the reflectance at the eardrum. Another advantage of this technique is utilization of wideband probe signals, e.g. clicks and tone chirps. Thus, the middle ear transfer function is evaluated in a wide frequency range (e.g. from 226 to 8000 Hz).Research on WAI has extensively initiated, for example, normative study in adults and infants [2]. Energy reflectance measure has been shown to provide superior performance in prediction of conductive hearing loss [4] and help improve newborn hearing screening outcomes [5]. The measure could be useful in the diagnosis of middle ear pathologies, e.g., otitis media with effusion [6], otosclerosis [7], and negative middle ear pressure [8]. The energy reflectance or absorbance measurement can also be performed with air pressure varied in the ear canal, known as wideband tympanometry [9,10].WAI is an emerging...

“…For instance, jRj 2 in ears with large eardrum perforations can approximate normal ears despite the likely presence of a conductive hearing loss (Voss et al, 2001a;Voss et al, 2012;Mehta et al, 2006). Moreover, test batteries that combine either A or jRj 2 with the air-bone gap-a measure of sound transmission through the ME-have been shown to perform better than those relying on either A or jRj 2 alone (Shahnaz et al, 2009;Nakajima et al, 2012). An objective, non-invasive estimate of ME efficiency could improve the clinical utility of wideband-acoustic immittance measures.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive estimation of middle-ear input impedance and efficiency

¹

,

²

2015

The Journal of the Acoustical Society of America

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A method to transform the impedance measured in the ear canal, Z EC , to the plane of the eardrum, Z ED , is described. The portion of the canal between the probe and eardrum was modeled as a concatenated series of conical segments, allowing for spatial variations in its cross-sectional area. A model of the middle ear (ME) and cochlea terminated the ear-canal model, which permitted estimation of ME efficiency. Acoustic measurements of Z EC were made at two probe locations in 15 normal-hearing subjects. Z EC was sensitive to measurement location, especially near frequencies of canal resonances and anti-resonances. Transforming Z EC to Z ED reduced the influence of the canal, decreasing insertion-depth sensitivity of Z ED between 1 and 12 kHz compared to Z EC . Absorbance, A, was less sensitive to probe placement than Z EC , but more sensitive than Z ED above 5 kHz. Z ED and A were similarly insensitive to probe placement between 1 and 5 kHz. The probe-placement sensitivity of Z ED below 1 kHz was not reduced from that of either A or Z EC . ME efficiency had a bandpass shape with greatest efficiency between 1 and 4 kHz. Estimates of Z ED and ME efficiency could extend the diagnostic capability of wideband-acoustic immittance measurements.

“…Specifically, it measures the middle ear functions that are often compromised in CHL cases. [4,5] It has been found to be highly sensitive in identifying various middle ear disorders. [6,7] In fact, tympanometry has been included as part of the routine audiological test battery in providing clinical services for decades.…”

Section: Introductionmentioning

confidence: 99%

Effects of ethnicity and gender on the middle ear function in Asian adults

¹

,

²

,

³

et al. 2017

Indian J Otol

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Original Article inTroducTionHearing loss is common among adults and children. [1][2][3] If the external ear or middle ear is compromised, conductive hearing loss (CHL) occurs. Tympanometry offers an objective and convenient way to diagnose CHL. Specifically, it measures the middle ear functions that are often compromised in CHL cases. [4,5] It has been found to be highly sensitive in identifying various middle ear disorders. [6,7] In fact, tympanometry has been included as part of the routine audiological test battery in providing clinical services for decades.To determine the middle ear functions, tympanometric parameters including static admittance (SA) (ml), ear canal volume (ECV) (ml), tympanometric peak pressure (TPP) (daPa) and tympanometric width (TW) (daPa) are used. Each of these parameters has specific diagnostic values. For instance, in typical cases of otitis media with effusion, the SA values are abnormally low and TW values are abnormally large. [8,9] In Eustachian tube dysfunction cases, whereas the SA, TW, and ECV values are within the normal ranges, the TPP values are abnormally negative. [10] Previous studies have found that the tympanometric values in participants from different ethnic groups are different. [11][12][13] This warrants the need of tympanometric normative data for specific ethnic categories for accurate diagnoses of middle ear disorders. In a multiracial Asian country like Malaysia, the population census showed that the majority of residents were natives (mostly Malay) (67.4%) and followed by Chinese (24.6%). [14] As an effort to serve these two ethnic groups, previous studies have determined the tympanometric normative data for Chinese and Malay subjects. [12,15] However, no study has been conducted to directly compare the tympanometric results between these two ethnic categories. Furthermore, the gender effect on tympanometric results remains debatable. While some studies found significant gender effects on SA, ECV, and TW, [13,16] other studies revealed no gender difference in SA and TW parameters. [12,15] Introduction: Tympanometry is a standard clinical test to measure the middle ear function objectively. Ethnicity and gender may affect tympanometric results, and specific normative data are required for diagnosing middle ear disorders accurately. Aim: This study aimed to determine the effects of ethnicity (Malay vs. Chinese) and gender on tympanometric results among Asian adults. Materials and Methods: A total of 72 young adults aged 20-25 years participated in this comparative study. They comprised two ethnic groups: Malay (n = 31 [14 males and 17 females]) and Chinese (n = 41 [20 males and 21 females]) participants. All participants fulfilled the inclusion criteria (no history of ear and hearing difficulties and normal findings in routine audiological assessments) and underwent a standard 226 Hz tympanometric testing. Tympanometric parameters including static admittance (SA), ear canal volume (ECV), tympanometric peak pressure (TPP), and tympanometric width (TW) ...

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