Abstract
The purpose of this study was to investigate the effectiveness of wideband energy absorbance in diagnosing otosclerosis by comparing the differences in acoustic absorbance between otosclerotic and normal ears. Exactly 90 surgically confirmed otosclerotic ears were included in the test group. The control group consisted of 126 matched normal-hearing subjects. The Titan hearing test platform (Interacoustics) was used for absorbance and acoustic immittance tests. Energy absorbance, measured at tympanometric peak pressure, was analyzed in the range 226–8000 Hz. Differences between normal and otosclerotic ears were analyzed in quarter-octave bands. Wideband absorbance, i.e., absorbance averaged over the 226–2000 Hz band, and resonance frequency were calculated and compared between normal and otosclerotic ears. Significant differences between the absorbance of normal and otosclerotic ears were found, especially at low and middle frequencies. No significant effect of ear side or gender was observed. For average wideband absorbance and resonance frequency, less pronounced (although significant) differences were found between normal and otosclerotic ears. Measurement of peak-pressure energy absorbance, averaged over a frequency band around 650 Hz, provides a valid criterion in testing for otosclerosis. The test is highly effective, with a sensitivity and specificity of over 85% and area under receiver operating characteristic curve above 0.9. Average wideband absorbance can also be used, but its effectiveness is lower. Other immittance-related measures are considerably less effective.
Highlights
Otosclerosis manifests in abnormal growth of the ossicular bones and bony fixation of the anterior stapes plate leading to stiffening of the chain
All patients were thoroughly examined before surgery, and otosclerosis was diagnosed based on clinical criteria: progressive conductive hearing loss, absence or abnormally high acoustic stapedial reflex thresholds (ASRT), absent otoacoustic emissions, and the results of otoscopic examination
It is generally agreed that testing energy absorbance of the middle ear can provide useful information about its status and facilitate detection of ear pathology
Summary
Otosclerosis manifests in abnormal growth of the ossicular bones and bony fixation of the anterior stapes plate leading to stiffening of the chain. A comprehensive description of cases of otosclerosis, its symptoms, development and consequences, and methods of surgical treatment can be found in [2]. The gold standard for diagnosis of otosclerosis is intraoperative examination of the stapes and the ossicular chain. Noninvasive methods of middle ear examination, such as imaging by high-definition computerized tomography (CT) or magnetic resonance imaging, still have insufficient resolution in detecting otosclerotic changes [3]. Other noninvasive and easy test methods that could help qualify patients suspected of otosclerosis for stapedotomy (or other reconstructive ear operations) would be very useful
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