Abstract
Objective(s) The purpose of this study was to explore the effectiveness of wideband acoustic immittance (WAI) in the diagnosis of otosclerosis by comparing the differences in the energy reflectance (ER) of WAI between patients with otosclerosis and age- and gender-matched normal hearing controls in the Chinese population. Methods Twenty surgically confirmed otosclerotic ears were included in the otosclerotic group. The ER of WAI at ambient and peak pressures, resonance frequency, and 226-Hz tympanogram were collected prior to surgery using a Titan hearing test platform (Interacoustics A/S, Middelfart, Denmark). All diagnoses of otosclerosis in the tested ear were confirmed by surgery after the measurements. Thirteen normal adults (26 ears) who were age- and gender-matched with the otosclerotic patients were included as the control group. Results At peak pressure, the ERs of otosclerotic patients were higher than those of the control group for frequencies less than 4,000Hz and were lower for frequencies greater than 4,000Hz. In addition, within the analyzed frequencies, the differences observed at 2,520Hz was statistically significant (p<0.05/16=0.003, Bonferroni corrected). At ambient pressure, the differences observed at 1,260 and 6,350Hz were statistically significant (p<0.05/16=0.003, Bonferroni corrected). Although the differences between the otosclerotic and control groups exhibited similar trends to those in studies implemented in Caucasian populations, the norms in the present study in the control group were different from those in the Caucasian populations, suggesting racial differences in WAI test results. Regarding the middle ear resonance frequency, no significant difference was observed between the two groups (P>0.05). Conclusion WAI can provide valuable information for the diagnosis of otosclerosis in the Chinese population. Norms and diagnostic criteria corresponding to the patient's racial group are necessary to improve the efficiency of WAI in the diagnosis of otosclerosis.
Highlights
Otosclerosis is a lesion occurring in the middle ear and bony labyrinth, and its main clinical manifestations are progressive conductive or mixed hearing losses with a normal eardrum
Traditional single-frequency and multifrequency tympanometry have revealed that the immittance characteristics in typical cases of otosclerosis include an increase in low-frequency acoustic stiffness and a decrease in static immittance amplitude [2, 3]
Muchink et al [4] employed 220- and 660-Hz probe tones for measurements in otosclerotic patients, and only one-third of otosclerotic patients had immittance values below the normal range, while all other patients showed immittance values within or beyond the normal range. These results indicate that there is a large overlap between the static immittance of otosclerotic and normal ears, which suggests that the effectiveness of the traditional tympanogram (226Hz) in the diagnosis of otosclerosis is low [3,4,5]
Summary
Otosclerosis is a lesion occurring in the middle ear and bony labyrinth, and its main clinical manifestations are progressive conductive or mixed hearing losses with a normal eardrum. Muchink et al [4] employed 220- and 660-Hz probe tones for measurements in otosclerotic patients, and only one-third of otosclerotic patients had immittance values below the normal range, while all other patients showed immittance values within or beyond the normal range. These results indicate that there is a large overlap between the static immittance of otosclerotic and normal ears, which suggests that the effectiveness of the traditional tympanogram (226Hz) in the diagnosis of otosclerosis is low [3,4,5]. A middle ear test method with higher sensitivity is needed to detect subtle changes in BioMed Research International sound conductance characteristics in patients with ossicularchain disorders
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