Wideband aural acoustic absorbance predicts conductive hearing loss in children

Abstract

Objective This study tested the hypothesis that wideband aural absorbance predicts conductive hearing loss (CHL) in children medically classified as having otitis media with effusion. Design Absorbance was measured in the ear canal over frequencies from 0.25 to 8 kHz at ambient pressure or as a swept tympanogram. CHL was defined using criterion air-bone gaps of 20, 25 and 30 dB at octaves from 0.25 to 4 kHz. A likelihood-ratio predictor of CHL was constructed across frequency for ambient absorbance and across frequency and pressure for absorbance tympanometry. Performance was evaluated at individual frequencies and for any frequency at which a CHL was present. Study Sample Absorbance and conventional 226-Hz tympanograms were measured in children of age 3 to 8 years with CHL and with normal hearing. Results Absorbance was smaller at frequencies above 0.7 kHz in the CHL group than the control group. Based on the area under the receiver operating characteristic curve, wideband absorbance in ambient and tympanometric tests were significantly better predictors of CHL than tympanometric width, the best 226-Hz predictor. Accuracies of ambient and tympanometric wideband absorbance did not differ. Conclusions Absorbance accurately predicted CHL in children and was more accurate than conventional 226-Hz tympanometry.

Predictions of middle-ear and passive cochlear mechanics using a finite element model of the pediatric ear

“…These soft tissues are listed in the left column of After the viscoelastic parameters of the normal ear were determined, the behavior of the FE model in MEE ear was further validated against measurement data from two clinical otitis media groups reported by Ellison et al (2012) and Keefe et al (2012). The material properties of all middle-ear tissues and the cochlea in the MEE condition were the same as in normal ear model.…”

“…The material properties of all middle-ear tissues and the cochlea in the MEE condition were the same as in normal ear model. The comparison between the modelderived EA in the MEE condition and the measured data from two clinical otitis media groups Keefe et al, 2012) provided a validation of the model with different middle ear condition.…”

“…The pediatric FE model was validated by simulating the MEE ear (of age 4 years) against measurement data of two clinical otitis media groups reported by Ellison et al (2012) and Keefe et al (2012). Figure 3 shows the predicted EA in comparison with the clinical measurements in the two otitis media groups by Keefe et al (2012) and Ellison et al (2012) across the frequency range of 0.2 to 8.0 kHz.…”

“…In Keefe et al (2012), one such group included 35 ears of 24 patients with a conductive hearing loss who were medically classified as having otitis media with effusion. In Ellison et al (2012), the other such group included 53 ears of 44 patients who were scheduled for myringotomy and tube placement, such that the EA test was performed within one hour of their surgery.…”

“…The normal group in the Keefe et al (2012) study included 43 ears from 26 subjects that satisfied the following criteria: no otitis media within the last six months, no history of surgery to insert pressure-equalization tubes in the TM, air-conduction thresholds not exceeding 15 dB hearing level (HL) at any octave frequency from 0.25 to 8.0 kHz, and airbone gaps not exceeding 15 dB at any octave frequency from 0.25 to 4.0 kHz. The normal group in the Ellison et al (2012) study included 59 ears of 44 children with normal pneumatic otoscopic findings, and no history of ear disease or middle-ear surgery.…”