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Saki N, Shirani M, Kardooni M, Mirmoemeni G, Bayat A. The effects of cochlear implantation on middle ear function: A prospective study. Int J Pediatr Otorhinolaryngol 2022; 163:111368. [PMID: 36327914 DOI: 10.1016/j.ijporl.2022.111368] [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: 06/03/2022] [Revised: 10/16/2022] [Accepted: 10/22/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Although sound conduction mechanisms may influence by cochlear implantation (CI), it is not very clear whether, how, and to what extent these mechanisms may be influenced the pediatric population. Wideband tympanometry (WBT) is a sensitive tool to evaluate alternations in the middle ear mechanics in a wide frequency range. The current study aimed to explore CI's impacts on sound conduction across the middle ear cavity using WBT in pediatrics. METHODS In a prospective design, 35 unilaterally implanted children (<24 months of age) with normal temporal bone anatomy were included in this study. Traditional tympanometry (226-Hz) and WBT measures were compared for each child in the implanted and non-implanted ears preoperatively and three months postoperatively. RESULTS No significant changes in the "static acoustic admittance" and "peak pressure" parameters were observed between the pre-CI and post-CI conditions in the implanted and non-implanted ears in the 226-Hz tympanometry test. Wideband absorbance recordings before CI surgery exhibited a double-peaked pattern over a frequency range of 250 to 8000 Hz. The pre- and postoperative acoustic energy absorbance comparisons indicated a significantly reduced mid-frequency (1260 to 3175 Hz) and high-frequency (5040 to 8000 Hz) absorbance in the implanted ears. However, our results indicated no significant differences in sound absorbance between the pre- and postoperative conditions in non-implanted ears. CONCLUSION Our findings suggested that WBT is a more sensitive method than traditional tympanometry for monitoring the mechanical status of the middle ear after cochlear implantation in pediatrics. Cochlear implantation in young children can significantly reduce mid- and high-frequency acoustic absorbance measured by WBT.
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Affiliation(s)
- Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahshid Shirani
- Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Kardooni
- Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Golshan Mirmoemeni
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Aithal S, Aithal V, Kei J, Wilson M. Wideband Tympanometry Findings in Healthy Neonates. J Am Acad Audiol 2022; 33:381-389. [PMID: 35977715 DOI: 10.1055/a-1925-7830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVES The objective of the present study was to describe pressurized wideband absorbance at tympanometric peak pressure (WBATPP) and 0 daPa (WBA0) in healthy Caucasian neonates. SUBJECTS A total of 249 ears from 249 neonates who passed a test battery of 1,000-Hz tympanometry, distortion product otoacoustic emissions and automated auditory brainstem response were included in the study. METHOD WBATPP and WBA0 were averaged in one-third octave frequencies from 0.25 to 8 kHz. Data were statistically analyzed for effects of frequency, ear, and gender. RESULTS Normative WBATPP and WBA0 data obtained from healthy neonates are presented. There was no significant difference between WBATPP and WBA0 at all frequencies. Both WBATPP and WBA0 demonstrated a multipeaked pattern with maxima of 0.80 and 0.72 at 1.25 to 1.5 and 6 kHz, respectively, and two minima of 0.45 and 0.49 at 0.4 to 0.5 and 4 kHz, respectively. The effects of ear and gender were not significant for both WBA measures. CONCLUSION Pressurized WBATPP and WBA0 data were provided for healthy Caucasian neonates. They will be useful for the assessment of middle ear function and assist in differentiating between conductive and sensorineural hearing losses in neonates.
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Affiliation(s)
- Sreedevi Aithal
- Department of Audiology, Townsville University Hospital, Queensland, Australia
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
- Department of Speech Pathology, School of Rehabilitation Sciences, James Cook University, Queensland, Australia
| | - Venkatesh Aithal
- Department of Audiology, Townsville University Hospital, Queensland, Australia
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
| | - Matthew Wilson
- Department of Audiology, Monash Health Melbourne, Australia
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Stuppert L, Nospes S, Bohnert A, Läßig AK, Limberger A, Rader T. Clinical benefit of wideband-tympanometry: a pediatric audiology clinical study. Eur Arch Otorhinolaryngol 2019; 276:2433-2439. [PMID: 31175454 DOI: 10.1007/s00405-019-05498-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Wideband-tympanometry (WBT) could give more informative data about the tympanic condition than the conventional tympanometry. In the actual literature, the clinical profit of wideband-tympanometry in pediatric audiological settings is not well evaluated. The aim of this study was to analyze the additional clinical benefit. METHODS 150 children (281 ears) with normal hearing, at the age from 11 days up to 14;10 years, checked with pure tone audiometry or auditory brainstem responses (ABR) participated in this retrospective study. We divided in four age ranges (≤ 6 month; > 6 month ≤ 3 years; > 3 years ≤ 11 years; > 11 years). All children were evaluated with ENT examination including ear microscopy, conventional 226-Hz or 1000-Hz tympanometry and WBT. Ear canal volumes were determined. RESULTS Compared with literature data, our patients aged ≤ 3 years showed smaller mean ear canal volumes (≤ 4 ml). We found a good statistical correlation between the WBT-results and 1000-Hz tympanometry but a rare correlation between WBT-results and ear microscopic findings. In the patients with pathologic ear microscopic results in all groups of age, a significant reduction of WBT-absorbance in 1000 Hz and 2000 Hz was found. CONCLUSIONS This study confirms that WBT collects additive data to detect the correct middle ear status. In pediatric audiology, WBT is an additional useful method to value middle ear problems and to analyze the character of infantile hearing loss. Standard guidelines for the interpretation of the pediatric population are needed. Hence, it will be necessary to determine these findings in a larger number of infantile ears.
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Affiliation(s)
- Laura Stuppert
- Audiological Acoustics Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, HNO-Universitätsklinik, Langenbeckstraße 1, 55131, Mainz, Germany.,Department of Acoustics and Audiology, Aalen University of Applied Sciences, Aalen, Germany
| | - Sabine Nospes
- Communication Disorders Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - Andrea Bohnert
- Audiological Acoustics Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, HNO-Universitätsklinik, Langenbeckstraße 1, 55131, Mainz, Germany.,Communication Disorders Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - Anne Katrin Läßig
- Communication Disorders Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - Annette Limberger
- Department of Acoustics and Audiology, Aalen University of Applied Sciences, Aalen, Germany
| | - Tobias Rader
- Audiological Acoustics Division, Department of Otolaryngology, Head and Neck Surgery, University of Mainz, HNO-Universitätsklinik, Langenbeckstraße 1, 55131, Mainz, Germany.
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Aithal V, Aithal S, Kei J, Manuel A. Normative Wideband Acoustic Immittance Measurements in Caucasian and Aboriginal Children. Am J Audiol 2019; 28:48-61. [PMID: 30938562 DOI: 10.1044/2018_aja-18-0065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The aims of this study were to develop normative data for wideband acoustic immittance (WAI) measures in Caucasian and Australian Aboriginal children and compare absorbance measured at 0 daPa (WBA0) and tympanometric peak pressure (TPP; WBATPP) between the 2 groups of children. Additional WAI measures included resonance frequency, equivalent ear canal volume, TPP, admittance magnitude (YM), and phase angle (YA). Method A total of 171 ears from 171 Caucasian children and 87 ears from 87 Aboriginal children who passed a test battery consisting of 226-Hz tympanometry, transient evoked otoacoustic emissions, and pure tone audiometry were included in the study. WAI measures were obtained under pressurized conditions using wideband tympanometry. Data for WBA0, WBATPP, YM, and YA were averaged in one-third octave frequencies from 0.25 to 8 kHz. Results There was no significant ear effect on all of the 7 measures for both groups of children. Similarly, there was no significant gender effect on all measures except for WBATPP in Aboriginal children. Aboriginal boys had significantly higher WBATPP than girls at 1.5 and 2 kHz. A significant effect of ethnicity was also noted for WBATPP at 3, 4, and 8 kHz, with Caucasian children demonstrating higher WBATPP than Aboriginal children. However, the effect size and observed power of the analyses were small for both effects. Conclusion This study developed normative data for 7 WAI measures, namely, WBA0, WBATPP, TPP, Veq, RF, YM, and YA, for Caucasian and Aboriginal children. In view of the high similarity of the normative data between Caucasian and Aboriginal children, it was concluded that separate ethnic-specific norms are not required for diagnostic purposes.
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Affiliation(s)
- Venkatesh Aithal
- Audiology Department, Townsville Hospital and Health Service, Douglas, Queensland, Australia
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Sreedevi Aithal
- Audiology Department, Townsville Hospital and Health Service, Douglas, Queensland, Australia
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Alehandrea Manuel
- Audiology Department, Townsville Hospital and Health Service, Douglas, Queensland, Australia
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A Longitudinal Analysis of Pressurized Wideband Absorbance Measures in Healthy Young Infants. Ear Hear 2019; 40:1233-1241. [PMID: 30807541 DOI: 10.1097/aud.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Wideband absorbance (WBA) is an emerging technology to evaluate the conductive pathway (outer and middle ear) in young infants. While a wealth of research has been devoted to measuring WBA at ambient pressure, few studies have investigated the use of pressurized WBA with this population. The purpose of this study was to investigate the effect of age on WBA measured under pressurized conditions in healthy infants from 0 to 6 months of age. DESIGN Forty-four full-term healthy neonates (17 males and 27 females) participated in a longitudinal study. The neonates were assessed at 1-month intervals from 0 to 6 months of age using high-frequency tympanometry, acoustic stapedial reflex, distortion product otoacoustic emissions, and pressurized WBA. The values of WBA at tympanometric peak pressure (TPP) and 0 daPa across the frequencies from 0.25 to 8 kHz were analyzed as a function of age. RESULTS A linear mixed model analysis, applied to the data, revealed significantly different WBA patterns among the age groups. In general, WBA measured at TPP and 0 daPa decreased at low frequencies (<0.4 kHz) and increased at high frequencies (2 to 5and 8 kHz) with age. Specifically, WBA measured at TPP and 0 daPa in 3- to 6-month-olds was significantly different from that of 0- to 2-month-olds at low (0.25 to 0.31 kHz) and high (2 to 5 and 8 kHz) frequencies. However, there were no significant differences between WBA measured at TPP and 0 daPa for infants from 3 to 6 months of age. CONCLUSIONS The present study provided clear evidence of maturation of the outer and middle ear system in healthy infants from birth to 6 months. Therefore, age-specific normative data of pressurized WBA are warranted.
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Chang YS, Ryu G, Kim K, Cho YS. Normative wideband absorbance measures in healthy neonates in Korea: A preliminary study. Int J Pediatr Otorhinolaryngol 2019; 117:6-11. [PMID: 30579090 DOI: 10.1016/j.ijporl.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The usefulness of wideband absorbance (WBA) in newborns is well-demonstrated. However, it is still not clear whether there might be a difference according to ethnicity with respect to ambient WBA; therefore, further investigation is necessary to evaluate ethnic-specific normative WBA values in newborns. METHODS Twenty-one newborns (41 ears) were recruited from the well-baby nursery at a tertiary referral center. All newborn infants who were born at 38 weeks' to 41 weeks' gestation with a normal birth weight (range: 2.5-4.5 kg) and who passed a newborn hearing screening test with distortion product otoacoustic emissions were enrolled. Ambient absorbance values were measured on frequencies ranging from 226 Hz to 6300 Hz (i.e., 250 Hz, 315 Hz, 400 Hz, 500 Hz, 620 Hz, 800 Hz, 1000 Hz, 1250 Hz, 1600 Hz, 2000 Hz, 2500 Hz, 3150 Hz, 4000 Hz, 5000 Hz, and 6300 Hz). The results of median absorbance were compared with the WBA values of Caucasian infants and Korean adults. RESULTS The gestational age of the study group was 38 weeks ± 6.67 days. In a gender comparison, absorbance of female neonate was significantly higher at 3150 Hz, 4000 Hz, and 5000 Hz than in male. Based on the test frequencies, the medians of the Korean infant WBA values and Caucasian infants are significantly different from one another, except at 1600 Hz, 3150 Hz, and 4000 Hz. The results of a median absorbance comparison between Korean infant and adults WBA values showed that the medians of the two studies were significantly different except at 1250 Hz. CONCLUSION We analyzed the normative WBA values measured at ambient pressures in Korean newborns. The comparative analysis between the normative values of two different ethnic groups may infer a possible difference in the normative WBA values. The absorbance from Korean infant ears is substantially different from that from adult's ears. A large-scale study is required to establish normative WBA values to be used for the screening of outer and middle ear status in newborns.
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Affiliation(s)
- Young-Soo Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea; Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Gwanghui Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyunga Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea; Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Yang-Sun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea.
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Development of a Diagnostic Prediction Model for Conductive Conditions in Neonates Using Wideband Acoustic Immittance. Ear Hear 2018; 39:1116-1135. [DOI: 10.1097/aud.0000000000000565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wali HA, Mazlan R. The Effect of Ethnicity on Wideband Absorbance of Neonates with Healthy Middle Ear Functions in Malaysia: A Preliminary Study. J Audiol Otol 2017; 22:20-27. [PMID: 29061035 PMCID: PMC5784368 DOI: 10.7874/jao.2017.00227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/04/2017] [Accepted: 09/08/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although ethnicity effect on wideband absorbance (WBA) findings was evident for adults, its effect on neonates has not been established yet. This study aimed to investigate the influence of ethnicity on WBA measured at 0 daPa from neonates with healthy middle ear functions. SUBJECTS AND METHODS Participants were 99 normal, healthy, full-term newborn babies with chronological age between 11 and 128 hours of age (mean=46.73, standard deviation=26.36). A cross-sectional study design was used to measure WBA at 16 one-third octave frequency points from 99 neonates comprising of three ethnic groups: Malays (n=58), Chinese (n=13) and Indians (n=28). A total of 165 ears (83.3%) that passed a battery of tests involving distortion product otoacoustic emissions, 1 kHz tympanometry and acoustic stapedial reflex were further tested using WBA. Moreover, body size measurements were recorded from each participant. RESULTS The Malays and Indians neonates showed almost identical WBA response across the frequency range while the Chinese babies showed lower absorbance values between 1.25 kHz and 5 kHz. However, the differences observed in WBA between the three ethnic groups were not statistically significant (p=0.23). Additionally, there were no statistically significant difference in birth weight, height and head circumference among the three ethnic groups. CONCLUSIONS This study showed that Malays, Chinese and Indians neonates were not significantly different in their WBA responses. In conclusion, to apply for the ethnic-specific norms is not warranted when testing neonates from population constitute of these three ethnicities.
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Affiliation(s)
- Hamzah A Wali
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia.,Department of Audiology, Ohud Hospital, Ministry of Health, Kingdom of Saudi Arabia, Madinah, Saudi Arabia
| | - Rafidah Mazlan
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
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Wali HA, Mazlan R, Kei J. Pressurized Wideband Absorbance Findings in Healthy Neonates: A Preliminary Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2965-2973. [PMID: 28975265 DOI: 10.1044/2017_jslhr-h-17-0120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The present study aimed to establish normative data for wideband absorbance (WBA) measured at tympanometric peak pressure (TPP) and 0 daPa and to assess the test-retest reliability of both measurements in healthy neonates. METHOD Participants of this cross-sectional study included 99 full-term neonates (165 ears) with mean chronological age of 46.7 hrs (SD = 26.3 hrs). Of the 99 neonates, 58 were Malay, 28 were Indian, and 13 were Chinese. The neonates who passed high-frequency (1 kHz) tympanometry, acoustic stapedial reflex, and distortion product otoacoustic emission screening tests were assessed using a pressurized WBA test (wideband tympanometry). To reduce the number of measurement points, the WBA responses were averaged to 16 one-third octave frequency bands from 0.25 to 8 kHz. A mixed-model analysis of variance was applied to the data to investigate the effects of frequency, ear, gender, and ethnicity on WBA. The analysis of variance was also used to compare between WBA measured at TPP and 0 daPa. An interclass correlation coefficient test was applied at each of the 16 frequency bands to measure the test-retest reliability of WBA at TPP and 0 daPa. RESULTS Both WBA measurements at TPP and 0 daPa exhibited a multipeaked pattern with 2 maxima at 1.25-1.6 kHz and 6.3 kHz and 2 minima at 0.5 and 4 kHz. The mean WBA measured at TPP was significantly higher than that measured at 0 daPa at 0.25, 0.4, 0.5, 1.25, and 1.6 kHz only. A normative data set was developed for absorbance at TPP and at 0 daPa. There was no significant effect of ethnicity, gender, and ear on both measurements of WBA. The test-retest reliability of WBA at TPP and 0 daPa was high with the interclass correlation coefficient ranging from 0.77 to 0.97 across the frequencies. CONCLUSIONS Normative data of WBA measured at TPP and 0 daPa for neonates were provided in the present study. Although WBA at TPP was slightly higher than the WBA measured at 0 daPa at some frequencies below 2 kHz, the WBA patterns of the 2 measurements were nearly identical. Moreover, the test-retest reliability of both WBA measurements was high.
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Affiliation(s)
- Hamzah A Wali
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur
- Department of Audiology, Ohud Hospital, Ministry of Health, Madinah, Kingdom of Saudi Arabia
| | - Rafidah Mazlan
- Department of Audiology, Ohud Hospital, Ministry of Health, Madinah, Kingdom of Saudi Arabia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Gouws N, Swanepoel DW, De Jager LB. Wideband acoustic immittance for assessing middle ear functioning for preterm neonates in the neonatal intensive care unit. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2017; 64:e1-e11. [PMID: 28697607 PMCID: PMC5843203 DOI: 10.4102/sajcd.v64i1.182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/01/2017] [Accepted: 02/11/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The primary aim of newborn hearing screening is to detect permanent hearing loss. Because otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR) are sensitive to hearing loss, they are often used as screening tools. On the other hand, false-positive results are most often because of transient outer- and middle ear conditions. Wideband acoustic immittance (WAI), which includes physical measures known as reflectance and absorbance, has shown potential for accurate assessment of middle ear function in young infants. OBJECTIVE The main objective of this study was to determine the feasibility of WAI as a diagnostic tool for assessing middle ear functioning in preterm neonates in the neonatal intensive care unit (NICU) designed for premature and ill neonates. A further objective was to indicate the difference between the reflectance values of tones and click stimuli. METHOD Fifty-six at-risk neonates (30 male and 26 female), with a mean age at testing of 35.6 weeks (range: 32-37 weeks) and a standard deviation of 1.6 from three private hospitals, who passed both the distortion product otoacoustic emission (DPOAE) and AABR tests, were evaluated prior to discharge from the NICU. Neonates who presented with abnormal DPOAE and AABR results were excluded from the study. WAI was measured by using chirp and tone stimuli. In addition to reflectance, the reflectance area index (RAI) values were calculated. RESULTS Both tone and chirp stimuli indicated high-power reflectance values below a frequency of 1.5 kHz. Median reflectance reached a minimum of 0.67 at 1 kHz - 2 kHz but increased to 0.7 below 1 kHz and 0.72 above 2 kHz for the tone stimuli. For chirp stimuli, the median reflectance reached a minimum of 0.51 at 1 kHz - 2 kHz but increased to 0.68 below 1 kHz and decreased to 0.5 above 2 kHz. A comparison between the present study and previous studies on WAI indicated a substantial variability across all frequency ranges. CONCLUSION These WAI measurements conducted on at-risk preterm NICU neonates (mean age at testing: 35.6 weeks, range: 32-37 weeks) identified WAI patterns not previously reported in the literature. High reflective values were obtained across all frequency ranges. The age of the neonates when tested might have influenced the results. The neonates included in the present study were very young preterm neonates compared to the ages of neonates in previous studies. WAI measured in at-risk preterm neonates in the NICU was variable with environmental and internal noise influences. Transient conditions affecting the sound-conduction pathway might have influenced the results. Additional research is required to investigate WAI testing in ears with and without middle ear dysfunction. The findings of the current study imply that in preterm neonates it was not possible to determine the feasibility of WAI as a diagnostic tool to differentiate between ears with and without middle ear pathology.
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Affiliation(s)
- Nandel Gouws
- Department of Speech-Language Pathology and Audiology, University of Pretoria.
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Aithal S, Kei J, Aithal V, Manuel A, Myers J, Driscoll C, Khan A. Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1417-1426. [PMID: 28395306 DOI: 10.1044/2016_jslhr-h-16-0237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/20/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of this study was to describe normative aspects of wideband acoustic immittance (WAI) measures obtained from healthy White neonates. METHOD In this cross-sectional study, wideband absorbance (WBA), admittance magnitude, and admittance phase were measured under ambient pressure condition in 326 ears from 203 neonates (M age = 45.9 hr) who passed a battery of tests, including automated auditory brainstem response, high-frequency tympanometry, and distortion product otoacoustic emissions. RESULTS Normative WBA data were in agreement with most previous studies. Normative data for both WBA and admittance magnitude revealed double-peaked patterns with the 1st peak at 1.25-2 kHz and the 2nd peak at 5-8 kHz, while normative admittance phase data showed 2 peaks at 0.8 and 4 kHz. There were no significant differences between ears or gender for the 3 WAI measures. Standard deviations for all 3 measures were highest at frequencies above 4 kHz. CONCLUSIONS The 3 WAI measures between 1 kHz and 4 kHz may provide the most stable response of the outer and middle ear. WAI measures at frequencies above 4 kHz were more variable. The normative data established in the present study may serve as a reference for evaluating outer and middle ear function in neonates.
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Affiliation(s)
- Sreedevi Aithal
- Department of Audiology, The Townsville Hospital, Queensland, Australia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Venkatesh Aithal
- Department of Audiology, The Townsville Hospital, Queensland, AustraliaHearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Alehandrea Manuel
- Department of Audiology, The Townsville Hospital, Queensland, AustraliaHearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Joshua Myers
- Department of Audiology, The Townsville Hospital, Queensland, AustraliaHearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Asaduzzaman Khan
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Pucci BPC, Roque NMCDF, Gamero MS, Durante AS. Acoustic absorbance measurements in neonates exposed to smoking during pregnancy. Int J Pediatr Otorhinolaryngol 2017; 95:51-56. [PMID: 28576533 DOI: 10.1016/j.ijporl.2017.01.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze acoustic absorbance using wideband tympanometry in neonates exposed to passive smoking during pregnancy. METHOD A study comprising 54 neonates in the control group (CG - unexposed) and 19 in the study group (SG - exposed) was carried out. Subjects were submitted to the wideband tympanometry test and subsequent analysis of absorbance of 17 frequencies. RESULT Low frequencies had a lower level of absorbance compared to high frequencies for both ambient and peak pressures, with no difference between the groups. CONCLUSION No effect of passive smoking on acoustic absorbance measurements in neonates was observed.
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Affiliation(s)
- Beatriz Paloma Corrêa Pucci
- School of Speech-Language Pathology and Audiology, Santa Casa de Sao Paulo School of Medical Sciences, R. Dr. Cesário Mota Júnior, 61 - 10° andar, Vila Buarque, CEP: 01221-020, São Paulo, SP, Brazil.
| | - Nayara Michelle Costa de Freitas Roque
- School of Speech-Language Pathology and Audiology, Santa Casa de Sao Paulo School of Medical Sciences, R. Dr. Cesário Mota Júnior, 61 - 10° andar, Vila Buarque, CEP: 01221-020, São Paulo, SP, Brazil
| | - Marcella Scigliano Gamero
- School of Speech-Language Pathology and Audiology, Santa Casa de Sao Paulo School of Medical Sciences, R. Dr. Cesário Mota Júnior, 61 - 10° andar, Vila Buarque, CEP: 01221-020, São Paulo, SP, Brazil
| | - Alessandra Spada Durante
- School of Speech-Language Pathology and Audiology, Santa Casa de Sao Paulo School of Medical Sciences, R. Dr. Cesário Mota Júnior, 61 - 10° andar, Vila Buarque, CEP: 01221-020, São Paulo, SP, Brazil
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Aithal S, Aithal V, Kei J. Effect of ear canal pressure and age on wideband absorbance in young infants. Int J Audiol 2017; 56:346-355. [DOI: 10.1080/14992027.2017.1284352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sreedevi Aithal
- Department of Audiology, The Townsville Hospital, Queensland, Australia and
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Venkatesh Aithal
- Department of Audiology, The Townsville Hospital, Queensland, Australia and
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Australia
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Aithal V, Kei J, Driscoll C, Murakoshi M, Wada H. Sweep frequency impedance measures in young infants: developmental characteristics from birth to 6 months. Int J Audiol 2016; 56:154-163. [PMID: 27780372 DOI: 10.1080/14992027.2016.1244867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE International Journal of Audiology To study the developmental characteristics of sweep frequency impedance (SFI) measures in healthy infants from birth to 6 months. DESIGN All infants were assessed using high-frequency tympanometry (HFT), distortion product otoacoustic emission (DPOAE) and SFI tests. SFI measures consisted of measurement of resonance frequency (RF) and mobility (ΔSPL) of the outer and middle ear. A mixed model analysis of variance was applied to the SFI data to examine the effect of age on RF and ΔSPL. STUDY SAMPLE Study included 117 ears from 83 infants of different age groups from birth to 6 months. RESULTS The mean RF of the outer ear increased from 279 Hz at birth to 545 Hz at 4 months, whereas mean ΔSPL of the outer ear decreased from 7.9 dB at birth to 3.7 dB at 4 months of age. In contrast, the mean RF and ΔSPL of the middle ear did not change significantly with age up to 6 months. CONCLUSIONS Developmental characteristics should be considered when evaluating the function of the outer and middle ear of young infants (≤6 months) using the SFI. The preliminary normative SFI data established in this study may be used to assist with the evaluation.
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Affiliation(s)
- Venkatesh Aithal
- a Department of Audiology , Townsville Hospital and Health Service , Douglas , QLD , Australia.,b Hearing Research Unit for Children School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , QLD , Australia
| | - Joseph Kei
- b Hearing Research Unit for Children School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , QLD , Australia
| | - Carlie Driscoll
- b Hearing Research Unit for Children School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , QLD , Australia
| | - Michio Murakoshi
- c Biomechanical Engineering Laboratory, Department of Mechanical Engineering , Kagoshima University , Kagoshima , Japan , and
| | - Hiroshi Wada
- d Department of Intelligent Information System , Tohoku Bunka Gakuen University , Sendai , Japan
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Pitaro J, Al Masaoudi L, Motallebzadeh H, Funnell WRJ, Daniel SJ. Wideband reflectance measurements in newborns: Relationship to otoscopic findings. Int J Pediatr Otorhinolaryngol 2016; 86:156-60. [PMID: 27260599 DOI: 10.1016/j.ijporl.2016.04.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Newborn hearing screening includes testing with otoacoustic emissions and the auditory brainstem response. Unfortunately, both tests are affected by the presence of material in the ear canal and middle ear such as vernix, meconium, and amniotic fluid. The objective of this study was to determine to what extent occlusion of the ear canal as seen on otoscopy affects wideband energy reflectance measurements in newborns. A secondary objective was to obtain additional normative wideband reflectance data in newborns. METHODS Newborns from a well-baby nursery were enrolled. Wideband energy reflectance measurements and otoscopy were done immediately after the hearing screening. Occlusion of the ear canal as seen on otoscopy was described on a scale of 0-100%. RESULTS A total of 156 babies were enrolled (mean age = 25 hours). A statistically significant difference in the reflectance at ambient pressure was found between the 0-70% and 80-100% occlusion groups. There was no significant difference in reflectance between the right and the left ears. The median reflectance pattern generally followed that of previous studies but in certain frequency regions the present reflectance values were higher. CONCLUSION A significant increase in reflectance occurs when 70%-80% of the ear-canal diameter is occluded. Taking otoscopy findings into account may improve the interpretation of reflectance measurements. However, further studies are required to better establish the relationship between canal occlusion and reflectance.
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Affiliation(s)
- Jacob Pitaro
- McGill Auditory Sciences Laboratory, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada
| | - Laila Al Masaoudi
- McGill Auditory Sciences Laboratory, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada
| | - Hamid Motallebzadeh
- McGill Auditory Sciences Laboratory, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of BioMedical Engineering, McGill University, 3775, rue University, Montréal, QC H3A 2B4, Canada
| | - W Robert J Funnell
- McGill Auditory Sciences Laboratory, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of BioMedical Engineering, McGill University, 3775, rue University, Montréal, QC H3A 2B4, Canada
| | - Sam J Daniel
- McGill Auditory Sciences Laboratory, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1, Canada; Department of Pediatric Surgery, McGill University, The Montréal Children's Hospital, 1001 Boul. Décarie, Montréal, QC H4A 3J1Canada.
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Effects of ear canal static pressure on the dynamic behaviour of outer and middle ear in newborns. Int J Pediatr Otorhinolaryngol 2016; 82:64-72. [PMID: 26857318 DOI: 10.1016/j.ijporl.2015.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/11/2015] [Accepted: 12/13/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The present study investigated the effect of ear canal pressure on the dynamic behaviour of the outer and middle ear in newborns with and without a conductive condition using the sweep frequency impedance (SFI) technology. METHODS A test battery consisting of automated auditory brainstem response (AABR), transient evoked otoacoustic emission (TEOAE) and 1000-Hz tympanometry (HFT) was performed on 122 ears of 86 healthy newborns and 10 ears of 10 newborns with a conductive condition (failed TEOAE and HFT). The dynamic behaviour of the outer and middle ear, when the pressure applied to the ear canal was varied from 200 to -200daPa, was evaluated in terms of the sound pressure level (SPL) in the ear canal, resonance frequency (RF) and displacement (ΔSPL). RESULTS Application of either a positive or negative static pressure to the ear canal of healthy newborns increased the resonance frequency of the outer (RF1) and middle ear (RF2), but decreased the displacements of the outer (ΔSPL1) and middle ear (ΔSPL2). Positive static pressures resulted in lower SPL while negative static pressures resulted in higher SPL than that at ambient pressure (0daPa). At -200daPa, more than 90% of ears showed signs of collapsed ear canal. The dynamic behaviour under various positive and negative static pressures for newborn ears with a conductive condition indicated similar pattern of SPL, RF1 and ΔSPL1 responses for the outer ear as per healthy ears, but abnormal responses for the middle ear. CONCLUSIONS While both positive and negative pressures applied to the ear canal have the same effect of stiffening the outer and middle ear, negative pressure of up to -200daPa resulted in more than 90% of ears with a collapsed ear canal. The results of the present study do not only offer useful clinical information for differentiating healthy ears from ears with a conductive condition, but also provide information on the maturation aspects of the outer and middle ear in newborns.
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Aithal V, Kei J, Driscoll C, Swanston A, Murakoshi M, Wada H. Sweep frequency impedance measures in Australian Aboriginal and Caucasian neonates. Int J Pediatr Otorhinolaryngol 2015; 79:1024-9. [PMID: 25930171 DOI: 10.1016/j.ijporl.2015.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/11/2015] [Accepted: 04/12/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Despite high prevalence of otitis media in Aboriginal children, the acoustic-mechanical properties of their outer and middle ear during the neonatal period remain obscured. The objective of this study was to compare the acoustic-mechanical properties of outer and middle ear using Sweep Frequency Impedance (SFI) measures between Australian Aboriginal and Caucasian neonates. METHODS SFI data from 40 ears of 24 Aboriginal neonates (16 males, 8 females) with mean gestational age of 39.57 weeks (SD = 1.25) and 160 ears of 119 Caucasian neonates (57 males, 62 females) with mean gestational age of 39.28 weeks (SD = 1.25) serving as controls were analysed. SFI data in terms of resonance frequency (RF) and mobility of the outer and middle ear (ΔSPL) were collected from neonates who passed a test battery that included automated auditory brainstem response, distortion product otoacoustic emissions test and 1000-Hz tympanometry. SFI data were analysed using descriptive statistics and analysis of variance. RESULTS There was no significant difference in mean gestational age, age of testing and birth weight between the Aboriginal and Caucasian neonates. The mean resonance frequencies for the outer ear (mean RF1 = 264.9 Hz, SD = 58.6 Hz) and middle ear (mean RF2 = 1144 Hz, SD = 228.8 Hz) for Aboriginal neonates were significantly lower than that of Caucasian neonates (mean RF1 = 295.3 Hz, SD = 78.4 Hz and mean RF2 = 1241.8 Hz, SD = 216.6 Hz). However, no significant difference in the mobility of outer ear (ΔSPL1) and middle ear (ΔSPL2) between the two groups was found. Middle ear resonance was absent in 22.5% (9 ears) of Aboriginal ears but present in all Caucasian ears. CONCLUSIONS This study provided evidence that despite passing the test battery, Aboriginal neonates had significantly lower resonance frequencies of the outer and middle ear than Caucasian neonates. Furthermore, 22.5% of Aboriginal neonates showed no middle ear resonance, indicating the possibility of subtle middle ear issues not detected by the test battery. Reasons for the different acoustic-mechanical properties between the two ethnic groups remain unclear and require further investigation.
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Affiliation(s)
- Venkatesh Aithal
- Audiology Department, Townsville Hospital and Health Service, Douglas, Australia; Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Andrew Swanston
- Department of ENT, Townsville Hospital and Health Service, Douglas, Australia
| | - Michio Murakoshi
- Department of Mechanical Engineering, Kagoshima University, Kagoshima, Japan
| | - Hiroshi Wada
- Department of Intelligent Information System, Tohoku Bunka Gakuen University, Sendai, Japan
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