Clinical diagnosis of middle ear disorders using wideband energy reflectance in adults

Abstract

Accurate diagnosis of middle ear disorders in adults is a challenging task because of the complexity of disorders. The wideband energy reflectance (WBER) technique provides simplicity and accuracy in diagnosing middle ear disorders across a wide frequency range. This research is expanding the studies of WBER to investigate the middle ear function in normal and pathological conditions of the middle ear in adults. Several specific WBER patterns were established in a variety of middle ear disorders among adults that should help in early diagnosis of such pathologies. The energy reflectance (ER) pattern included significantly higher ER in the control group of children than the control group of adults at 0.5 and 1 kHz, abnormally high or shallower ER in otosclerotic ears with a characteristic Carhart notch at 2 kHz, abnormally low ER in ears with tympanic membrane (TM) perforation, and abnormally low ER with a deep notch in ears with hypermobile TM. In the presence of negative middle ear pressure, elevated ER at ambient pressure was also observed. Results also showed that standard tympanometry was less sensitive in diagnosing middle ear disorders compared with WBER, especially in otosclerotic cases. Further studies are still required to validate the clinical use of ER in larger numbers of individuals with confirmed middle ear disorders.