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Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, Zhao F, Liu W. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon 2024; 10:e33776. [PMID: 39040356 PMCID: PMC11261878 DOI: 10.1016/j.heliyon.2024.e33776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024] Open
Abstract
Objectives This study aimed to assess the clinical significance of Wideband Absorbance (WBA) in children with Large Vestibular Aqueduct Syndrome (LVAS), which could potentially serve as diagnostic and predictive markers for LVAS in children. Design This was a single-center retrospective case-control study. Audiological measurements and Wideband Acoustic Immittance (WAI) were performed. Propensity score matching (PSM) was considered to treat group imbalance. The Receiver Operating Characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the sensitivity and specificity of WBA. Study sample Participants included 42 children with LVAS and 163 normal children aged 6 months -11 years recruited from clinical audiology settings between 2019 and 2021. Results The WBA at Tympanometric Peak Pressure (WBATPP) and Ambient Pressure (WBAA) in the LVAS group were significantly lower than those of the control group at 1259-2000 Hz but higher at 4000-6349 Hz (p < 0.05, power >0.8). The WBAA (1587 Hz) AUC value was 0.805, identifying a score ≤0.565 as indicative of a LVAS risk. Conclusions WBA holds promise in distinguishing LVAS from the normal condition and warrants further exploration as a tool to examine the influence of inner ear pressure on acoustic energy transmission in the middle ear.
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Affiliation(s)
- Wen Jiang
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Xuanyi Li
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yi Mu
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Huiying Zhang
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Naveena Konduru
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yuehua Qiao
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK, Wales
| | - Wen Liu
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
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Zhao Z, Ren C, Fan X, Zha D, Lin Y. Study on characteristics of wideband acoustic immittance in patients with Inner Ear Malformations. Int J Pediatr Otorhinolaryngol 2024; 176:111802. [PMID: 38041987 DOI: 10.1016/j.ijporl.2023.111802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/07/2023] [Accepted: 11/19/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE To compare the differences in wideband absorbance and the resonance frequency (RF) between patients with inner ear malformations and normal control, and to explore the auditory diagnostic value of wideband acoustic immittance (WAI). METHODS A total of 38 patients (59 ears) with enlarged vestibular aqueduct (EVA), 13 patients (14 ears) with incomplete partition type I (IP-I) and 13 patients (26 ears) with incomplete partition type II (IP-II) were included. 50 normal control (100 ears). All subjects underwent WAI tests to compare the absorbance configuration and resonance frequency. RESULTS All the group showed lower absorbance at ambient pressure than at peak pressure in certain frequencies under 2000Hz. Under 1000Hz, the absorbance of EVA was higher than that of other groups. The average absorbance and highest absorbance of IP-I were the lowest(P<0.05). However, IP-II and normal group had similarity on some characteristics. The three IEM groups mainly different at low and high frequencies, but not at medium frequencies. The highest absorbance of all the groups were appeared around 3000Hz. The RF of all the groups from low to high were EVA<IP-II<normal control<IP-I, and the lowest was EVA(P<0.05). CONCLUSION Inner ear malformations can affect energy absorbance and RF. WAI is sensitive and non-invasive to provide useful information about inner ear status and facilitate detection of ear pathology.
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Affiliation(s)
- Zhemaiwei Zhao
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Cuncun Ren
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Xiaoqin Fan
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Dingjun Zha
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Ying Lin
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
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Li G, Zhao F, Peng S, Yin H, Yao X, Xu K. Comparison of wideband acoustic immittance in Chinese infants under three months of age with normal and abnormal middle ear function. Int J Pediatr Otorhinolaryngol 2023; 174:111739. [PMID: 37757708 DOI: 10.1016/j.ijporl.2023.111739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES This study aims to compare the characteristics of Wideband Acoustic Immittance (WAI) in Chinese infants under three months of age, with either normal or abnormal middle ear function. METHODS We recruited 98 infants with either normal or abnormal middle ear function, and subsequently divided them into four groups based on their middle ear function and chronological age. The absorbances at tympanometric peak pressure (TPP) were collected across 1/3rd octave frequencies ranging from 226 to 8000 Hz. RESULTS Among infants with normal middle ear function, no significant differences were observed concerning ear laterality. However, significant differences were noted at 3364 Hz and 4000 Hz with respect to age. For infants with either normal or abnormal middle ear function, we found significant differences at the majority of frequencies. Additionally, the receiver operating characteristic (ROC) curves and maxima Youden index indicated that absorbances at 1682 Hz and 1297 Hz could be employed to evaluate the middle ear function of infants at 1 and 2 months of age. CONCLUSION This study demonstrates that WAI holds promise as a valuable tool for assessing the middle ear condition of infants at 1 and 2 months of age. Infants aged 1 and 2 years, having absorbance values equal to or greater than 0.7470 at 1682 Hz and 0.6775 at 1297 Hz respectively, may indicate normal middle ear function. Furthermore, it underscores the necessity of establishing ethnicity- and age-specific norms for WAI in infants under 3 months of age.
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Affiliation(s)
- Gang Li
- Department of Audiology and Speech Language Pathology/Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Zhao
- Center for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Shan Peng
- Department of Audiology and Speech Language Pathology/Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Huilin Yin
- Department of Audiology and Speech Language Pathology/Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Xinyi Yao
- Department of Audiology and Speech Language Pathology/Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ke Xu
- Department of Audiology and Speech Language Pathology/Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
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Li A, Du H, Gao J, Xu Y, Zhao N, Gao S, Xing Y, Qian X, Gao X, Yang Y. Characteristics of large vestibular aqueduct syndrome in wideband acoustic immittance. Front Neurosci 2023; 17:1185033. [PMID: 37304035 PMCID: PMC10248168 DOI: 10.3389/fnins.2023.1185033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Objective To describe the characteristics of large vestibular aqueduct syndrome (LVAS) in wideband acoustic immittance (WAI) and to explore whether inner ear deformity has an impact on WAI results. Methods Subjects with typical LVAS (LVAS group) and control subjects with a normal anatomical structure of the inner ear (control group) were screened from pediatric patients with cochlear implants using thin-slice computed tomography (CT) images of the temporal bone. With inflammation of the auditory canal and middle ear excluded by routine ear examination and 226 Hz acoustic immittance, WAI data were acquired. Then, the maximum absorbance as the major observation indicator on the mean tympanogram was compared between the LVAS group and control group, and a descriptive comparison of the mean tympanogram and frequency-absorbance curve at peak pressure was performed between the two groups. Results The LVAS group included 21 cases (38 ears), and the control group included 27 cases (45 ears). All LVAS subjects met the Valvassori criteria, and the VA at the horizontal semicircular canal displayed flared expansion. On the mean tympanogram, the maximum absorbance in the LVAS group (0.542 ± 0.087) was significantly higher than that in the control group (0.455 ± 0.087) (p < 0.001). The tympanogram in the LVAS group showed an overall elevation, and the absorbance at all pressure sampling points was significantly higher than that in the control group (p < 0.001). The frequency-absorbance curve at peak pressure first increased and then decreased in both groups, and the LVAS group showed higher absorbance than the control group in the frequency range below 2,828 Hz. The absorbance at 343-1,124 Hz was significantly different between the two groups (p < 0.001), and 343-1,124 Hz was the major frequency range at which the maximum absorbance on the mean tympanogram increased in the LVAS group. Conclusion Large vestibular aqueduct syndrome (LVAS) shows increased absorbance in low and medium frequency ranges in WAI. The maximum absorbance on the mean tympanogram can serve as a reliable evaluation indicator. Inner ear factors must be considered when middle ear lesions are analyzed by WAI.
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Affiliation(s)
- Ao Li
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Haoliang Du
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Junyan Gao
- Department of Technical Counseling, Jiangsu Children’s Rehabilitation Research Center, Nanjing, China
| | - Yuqin Xu
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Ning Zhao
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Song Gao
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Yuxuan Xing
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Xiaoyun Qian
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Xia Gao
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Ye Yang
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology-Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
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Araújo ES, Jacob LCB, Oliveira MTDD, Chaves JN, Oliveira EB, Saters TL, Alvarenga KDF. Wideband absorbance for the assessment of pressure equalizing tubes patency in children. Int J Pediatr Otorhinolaryngol 2022; 162:111309. [PMID: 36099781 DOI: 10.1016/j.ijporl.2022.111309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/27/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyze the feasibility of using wideband absorbance to verify the patency of pressure equalizing tubes (PETs) in clinical practice and to present the response pattern of this measure for ears with patent PET. METHODS This observational case-control type study evaluated 48 ears of 30 children with severe or profound hearing loss, aged 10-44 months, of both sexes. The subjects were subdivided into two groups: 24 ears with Sheppard type PET (experimental group - EG) and 24 ears with normal middle ear (control group - CG), paired with the EG, according to age, sex, and ear evaluated. To obtain the wideband absorbance, a Middle-Ear Power Analyzer, version 5.0 (Mimosa Acoustics), was used, and absorbance values for pure tone and chirp stimuli were analyzed. RESULTS There was no influence of ear (right or left) on the measurements obtained. The EG showed higher absorbance values at low frequencies. Although the two stimuli made it possible to identify the difference in acoustic transfer function between the groups studied, compared to pure tone, the chirp stimulus allowed identification of differences in a higher number of frequencies. CONCLUSIONS Ears with a patent PET present an acoustic transfer pattern that differs from that obtained for normal middle ears, with a higher absorbance at low frequencies. Both pure tone and chirp stimuli can be used to identify such differences, nevertheless, the use of chirp stimulus is recommended, since it allows differentiation over a wider frequency range.
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Affiliation(s)
- Eliene Silva Araújo
- Department of Speech-Language Pathology and Audiology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Lilian Cassia Bornia Jacob
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry / University of São Paulo, FOB / USP, Bauru, São Paulo, Brazil
| | - Maria Taiany Duarte de Oliveira
- Graduate Program in Speech, Language and Hearing Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Juliana Nogueira Chaves
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Eduardo Boaventura Oliveira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Thais Lenharo Saters
- Graduate Program in Speech, Language and Hearing Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Kátia de Freitas Alvarenga
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry / University of São Paulo, FOB / USP, Bauru, São Paulo, Brazil
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Sundgaard JV, Bray P, Laugesen S, Harte J, Kamide Y, Tanaka C, Christensen AN, Paulsen RR. A deep learning approach for detecting otitis media from wideband tympanometry measurements. IEEE J Biomed Health Inform 2022; 26:2974-2982. [PMID: 35290196 DOI: 10.1109/jbhi.2022.3159263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In this study, we propose an automatic diagnostic algorithm for detecting otitis media based on wideband tympanometry measurements. METHODS We develop a convolutional neural network for classification of otitis media based on the analysis of the wideband tympanogram. Saliency maps are computed to gain insight into the decision process of the convolutional neural network. Finally, we attempt to distinguish between otitis media with effusion and acute otitis media, a clinical subclassification important for the choice of treatment. RESULTS The approach shows high performance on the overall otitis media detection with an accuracy of 92.6%. However, the approach is not able to distinguish between specific types of otitis media. CONCLUSION Out approach can detect otitis media with high accuracy and the wideband tympanogram holds more diagnostic information than the commonly used techniques wideband absorbance measurements and simple tympanograms. SIGNIFICANCE This study shows how advanced deep learning methods enable automatic diagnosis of otitis media based on wideband tympanometry measurements, which could become a valuable diagnostic tool.
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