Abstract
Background: Tympanometry is a routine clinical test ordered at the Department of Otolaryngology, Ear, Nose and Throat (ENT) at Changi General Hospital (CGH). In combination with the pure tone audiogram, tympanograms aid in the diagnostic value of various middle ear disorders. However, its diagnostic value depends on the physician and audiologist’s accuracy of classifying and interpreting the tympanograms. Presently, Caucasian normative values are used in the classification of tympanograms, which could be inaccurate without population specific norms. Therefore, there is a need to understand ethnic differences in tympanometry parameters in order to usefully interpret the tympanogram. Thus far, there are no local studies on the differences in tympanometric parameters among multiethnic groups. Previous studies also had conflicting results on the effects of ethnicity with direct or indirect comparison only between two ethnic groups. To our knowledge, this is the first preliminary investigation on the effects of demographic and anthropometric measurements on tympanometric parameters. Materials and Methods: 90 patients’ medical charts were randomly selected and reviewed to extract demographic, anthropometric and clinical information. Tympanogram characteristics among ethnic groups were investigated using univariate and multivariate analyses. The mean ages of males and females in the study were 41.9 years ± 17.4 and 46.1 ± 19.2, respectively. Results: Gender significantly influenced ear canal volume (ECV). Chinese had marginally significant lower static admittance (SA) as compared to non-Chinese. There were, however, no effects of age or anthropometric measurements on tympanometric results. Conclusion: Further prospective large cohort analyses are warranted to expand this investigation to better elucidate differences observed in tympanometric parameters and establish population specific norms for appropriate and accurate tympanogram classifications.
Highlights
Tympanometry is a quick, noninvasive, and objective procedure to assess the function of the middle ear
There are, no population-specific norms for our local multiethnic population yet. This is the first preliminary analysis of tympanometric parametersin a multiethnic population, which examined the effect of ethnicity and gender on immittance measurements such as static admittance (SA), tympanic peak pressure (TPP), tympanic width (TW) and ear canal volume (ECV)
When we looked at the distribution of different ethnic groups in non-Chinese (Malay, Indian and others) and compared it with the main Chinese group, the effect was only less significant (p = 0.065) for SA but still highly significant for ECV (p = 0.006)
Summary
Tympanometry is a quick, noninvasive, and objective procedure to assess the function of the middle ear. An audiologist using developed specific norms for the Caucasian population usually interprets the tympanometric parameters [2,3,4] This is a concern, as past studies have shown us that there are age [5], ethnic [6] and gender [7] effects on tympanometric parameters. If the interpretation of quantitative tympanogram has significant clinical values in the diagnosis of middle ear problems [8], applying the Caucasian norms may not be appropriate, especially for a multiethnic population in Singapore. Previous studies had conflicting results on the effects of ethnicity with direct or indirect comparison only between two ethnic groups To our knowledge, this is the first preliminary investigation on the effects of demographic and anthropometric measurements on tympanometric parameters. Conclusion: Further prospective large cohort analyses are warranted to expand this investigation to better elucidate differences observed in tympanometric parameters and establish population specific norms for appropriate and accurate tympanogram classifications
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