Audiologie Evaluation of the Otitis Media Patient

Correlation between recovery time of extended high-frequency audiometry and duration of inflammation in patients with acute otitis media

OBJECTIVES

To explore the rule of extended high-frequency (EHF) audiometry recovery in patients with acute otitis media.

METHODS

From January 2016 to July 2019, patients with acute otitis media in the outpatient department of otology were studied. The diagnosis was made according to the otoscopy and acoustic impedance tests, and antibiotics and other treatment programs were given. The patients were followed up to compare the effects of different recovery time on extended high-frequency audiometry in patients with acute otitis media.

RESULTS

146 patients with acute otitis media (69 in the left ear and 77 in the right ear) were selected for observation and follow-up. The patients were divided into three groups according to the time from the onset to the disappearance of hyperacusis and earache symptoms: ≤ 5 days group (26 patients, 17.8%), 6-10 days group (74 patients, 50.7%), and > 10 days group (46 patients, 31.5%). The threshold of EHF in the study group was significantly higher than that in the control group in the early stage. According to the study design for follow-up, we found that with the prolongation of the duration of acute otitis media, the extended high frequency of different groups had different changes.

CONCLUSIONS

Our results show that the recovery time of EHF in patients with acute otitis media was later than that of the standard audiogram and was closely related to the course of the disease. This is of great significance for discovering the hidden hearing loss of the patients and taking the treatment plan as soon as possible.

Extended high frequency audiometry in secretory otitis media

The objective of the present study was to determine the status of extended high frequencies in subjects with secretory otitis media. The study evaluated 30 ears of 20 subjects with secretory otitis media in the age group of 15-30 years. This data was compared with 20 ears of 10 volunteers of the same age group with clinically normal hearing. Pure tone air conduction thresholds were analyzed in three frequency groups: low frequency (LF: 0.25, 0.5, and 1 kHz), high frequency (HF: 2, 4, and 8 kHz) and extended high frequency (EHF: 10, 12, and 16 kHz). The results showed elevated extended high frequency thresholds (EHFG) as compared to control group and comparatively better thresholds at high frequencies(HFG)s as compared to low (LFG)and extended high frequencies(EHFG) in the study group. This validates the importance of including an extended high frequency audiometry in the test battery of patients with secretory otitis media.

The change in the acoustic admittance phase angle: a study in children suffering from acute otitis media

Middle ear mechanics, in normal and in pathological conditions, is the subject of this research, with acoustic impedance measurements as the cornerstone. Previous studies have established the importance of admittance-phase tympanograms, mainly in frequencies higher than the conventional 226 Hz. The purpose of the present study was to record how acute otitis media (AOM) affects the middle ear system and function by evaluating the recordings of the change in phase angle parameter (deltatheta) provided by an automated tympanometer using the sweep-frequency technique. Multifrequency and conventional tympanograms were obtained from 70 children suffering from AOM on consecutive visits. Values of deltatheta from these subjects were compared to normative data previously acquired in our Department. It appears that changes in the mechanical status of the middle ear after AOM are reflected in abnormal deltatheta values, despite the normal findings of conventional tympanometry. A positive history of AOM did not seem to influence the behaviour of the middle ear. In most cases, abnormal deltatheta values coexisted with abnormal values of resonance frequency (RF), i.e. the frequency at which mass and stiffness of the middle ear are in balance, and total susceptance (deltaB) reaches 0mmhos and the converse. The deltatheta seems to be an important indicator of middle ear mechanical status that can record changes occurring in the system after AOM and undetected by low probe-tone tympanometry.

Comparison of risk of conductive hearing loss among three ethnic groups of Arctic audiology patients

The purpose of the study was to investigate the relative contributions of age, gender, ethnic background, and a history of middle ear disease on the amount of conductive hearing impairment among native and non-native audiology patients in the Canadian North. A second goal of the study was to determine risk factors for conductive hearing loss in the patients studied. Three ethnic groups were represented among the 3,094 patients: Inuit, American Indian, and non-native. Loglinear and logit statistical models were applied, and these data were best explained by a 3-way interaction of history of middle ear disease, ethnic group, and hearing loss, and the 2-way interaction of age and hearing loss. The Inuit appear to be at higher risk for conductive hearing impairment than the other ethnic groups. Conductive hearing loss also appears to increase as age increases through the teenage years for all the patients regardless of ethnic group membership. Preschoolers were at the lowest risk for conductive hearing loss. The trend for the amount of hearing impairment to increase throughout childhood suggests that children living in the Arctic may manifest a unique and more serious form of the disease not often observed in audiology patients who are Caucasian in southern Canada or the United States or that they may be exposed to additional risk factors.

Multiple-frequency tympanometry in children with acute otitis media

Multiple-frequency tympanometry (MFT) is a sweep-frequency method of acoustic immittance measurement, recently introduced in clinical practice. It provides values for the resonant frequency of the middle ear system. The purpose of this study was to use MFT to collect information about the mechanoacoustical changes occurring to the middle ear system after acute otitis media and to compare it with the results of conventional, low probe-tone tympanometry. Children with acute otitis media were followed up with both methods for 1 month after an episode of acute infection. Also, children with normal hearing were studied to establish normative data. Resonant frequency of the middle ear was found to be lower than normal even 1 month past the initial episode, for all types of 226-Hz tympanograms. MFT seemed to record changes in the middle ear after acute otitis media that 226-Hz tympanometry was unable to detect, implying persistence of pathology. More extended research will illuminate the clinical value of this method in the follow-up of acute otitis media.

Current opinion in the management in acute otitis media

The management of Acute otitis media has been a subject of controversy. This paper discusses the the current opinion on the subject including a review of recent literature. The use and choice of antibiotics reflects the wide variation in opinion for both first line and second-line therapy. The role of tympanocentesis and prophylactic treatment is discussed. The introduction of vaccines holds new promise on the prevention of Acute otitis media. Factors affecting outcome influence the management plan especially in recurrent cases, high risk groups and treatment failures.

Tympanometric evaluation of middle ear function in children with otitis media

Current tympanometry instruments allow a quantitative approach to the evaluation of middle ear function in children with otitis media. Conventional 226-Hz tympanograms can be characterized by static admittance, tympanometric width (gradient), tympanometric peak pressure, and equivalent volume. Multifrequency tympanograms obtained with probe frequencies ranging from 226 to 2,000 Hz appear to be sensitive to sequelae of otitis media that are not detected by conventional tympanometry or audiometry.