Tympanometric Measures Research Articles

Development and Application of a Reference-Interval Approach to Tympanometric Norms Using U.S. Population Data for Ages 6-80+ Years.

United States national data for tympanometric measures from 16,614 ears included in the National Health and Nutrition Examination Survey for 2015-2016 and 2017-2020 were analyzed and described. Analyses were primarily descriptive and relied on distribution-free medians and cumulative distribution functions (CDFs). Differences between CDFs were examined using Cohen's h effect size. Results are presented for the age range 6-80+ years. A reference interval (RI) approach was pursued in which the interval from the 2.5th to the 95th percentile for healthy ears was specified for peak-compensated static admittance (Ytm+), tympanometric peak pressure, tympanometric width, and equivalent acoustic ear-canal volume (Vea+). Separate RIs were required for 6- to 13-year-olds compared to those 14-80+ years of age for all four tympanometric measures. For both age groups, a separate RI was warranted for each sex for Ytm+ and Vea+. For those 14-80+ years of age, a separate RI was also needed for non-Hispanic Asians for Ytm+. When these RIs were applied to the full data set, about 5%-10% of ears were found to be either below the lower limit or above the upper limit of the RI. Those ears outside the RI limits had about 5 dB higher low-frequency hearing thresholds than those within RI limits. Both Ytm+ and Vea+ were found to depend on body size. RIs for tympanometric measures from individuals with healthy ears were established, and when applied to the general U.S. population 6-80+ years of age, 5%-10% of ears fell outside the RIs depending on the measure.

High frequency (1000 Hz) tympanometry in six-month-old infants

ObjectivesHigh frequency tympanometry (HFT) using a 1000 Hz probe tone is recommended for infants from birth to six months of age. However, there is limited normative HFT data outside the newborn period. The objective of this study was to describe HFT data in healthy six-month-old infants. MethodsHFT and distortion product otoacoustic emission (DPOAE) tests were performed on 168 six-month-old full-term healthy infants. Ears that passed DPOAEs and had a single-peaked tympanogram were included for analysis. The tympanometric measures included in the normative HFT data were tympanometric peak pressure (TPP), peak compensated static admittance (Ytm) and tympanometric width (TW). ResultsA total of 118 ears from 118 infants who passed DPOAE and had single-peaked tympanograms were included in the analysis. Normative data were presented for TPP, Ytm and TW. A comparison of the present study with studies on neonates and younger infants revealed significantly higher mean Ytm and lower mean TPP for six-month-old-infants. ConclusionSignificant differences in HFT findings between neonates and six-month-old infants suggest a developmental trend and confirm the need for separate age-appropriate norms for the tympanometric measures. Normative HFT data described in the present study may provide useful information for optimizing the diagnosis of conductive conditions in six-month-old infants.

An Examination of Asymmetry in Adult Tympanometric Measures.

During audiologic evaluations, an examination of interaural asymmetry is commonly evaluated. To date, however, interaural differences for tympanometric indices have not been reported for adults. Without documented tympanometric right-left differences, one cannot determine if asymmetries are normal or are indicative of significant clinical asymmetries. The purpose of this study was to investigate interaural asymmetries in peak compensated static acoustic admittance (Ytm), equivalent ear canal volume (Vea), tympanometric peak pressure (TPP), and tympanometric width (TW) in normal adults. Descriptive, correlational, and inferential measures designs were employed. Participants were 188 otologically normal Caucasian young adults (i.e., 77 females and 111 males; M = 23.0 years, standard deviation [SD] = 2.7, range = 18-30 years). Ytm, Vea, TPP, and TW measures were obtained bilaterally from an admittance tympanogram using a 226 Hz probe tone. Separate two-factor mixed measures analysis of variance examined the effect of ear and sex for each tympanometric index. Correlation analyses examined the association between right and left ear indices. Interaural differences in tympanometric indices were examined with independent t-tests. Critical differences, for deciding if two tympanometric indices are different between ears, were computed from the standard deviations of the right-left ear difference for statistical confidence levels of 85, 90, 95, and 99%. The effect of ear was not statistically significant (p > 0.05) on any tympanometric index. Females had significantly lower Ytm and smaller Vea measures than males (p < 0.05). Correlations between all right and left tympanometric indices were positive and statistically significant (p < 0.05). There were no statistically significant differences in interaural differences for any of the tympanometric indices as a function of sex (p > 0.05). Critical differences, for confidence levels for 85% to 99% confidence ranged from ± 0.20-0.36 mmhos for Ytm, ± 0.23-0.41 cm3 for Vea, ± 11.1-19.8 daPa for TPP, and ± 27.2-48.7 daPa for TW. A clinician can use these critical differences to determine if tympanometric index interaural differences in ears of young normal Caucasian adults are statistically significant.

The P.E.A.N.U.T. Method: Update on an Integrative System Approach for the Treatment of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children

Background and objectives: Based on our previous single-center study on optimization of treatment of chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) in children using a noninvasive system approach to lower the necessity of antibiotics, analgesic use, and surgical interventions, we proceeded to perform a multicenter investigation in an outpatient setting. The purpose of the previous prospective study in 2013–2015 was to compare outcomes in the treatment of COME and AH using the noninvasive multimodal integrative method (IM) versus conventional treatment practice (COM). Materials and Methods: In this paper, we retrospectively analyze the data of patients treated with the integrative method between 2017 and 2020 in a multicenter setting and compared the outcomes with data from 2013–2015 in order to evaluate generalizability. In both periods, all eligible and willing participants were included and treated with the IM protocol under real-life conditions. The treatment involved pneumatization exercises, education, an antiallergic diet, nasal hygiene, useful constitutional therapy, and thermal interventions (P.E.A.N.U.T.). A total of 48 versus 28 patients, aged 1–8, were assessed, presenting with COME and AH, with moderate to severe hearing impairment at entry. Results: The significant improvement found in both audiometric measures (intact hearing) and tympanometric measures (normal A-type curve) was similar in both datasets with respect to conventional treatment. The new data confirms that the P.E.A.N.U.T. method results in a significant reduction of antibiotics, analgesic use, and surgical interventions. Conclusion: In this multicenter trial, we confirm the effectiveness of the noninvasive system approach for the treatment of COME in lowering the need for antibiotics and analgesic use and elective surgery. This could be especially important with respect to a generally observed increase in antibiotic resistance. The method is easy to perform in different clinical settings and is effective, safe, and well-tolerated.

Standard and multiple-frequency tympanometric norms in Chinese young and older adults

ABSTRACT The normative data of standard and multiple-frequency tympanometry should be established depending on gender, age, race and specific recording parameters. However, the lack of normative data of standard and multiple-frequency tympanometry was documented in Chinese older adults. Previous studies which conducted the normative data from Southern Chinese young adults may not represent the Chinese young and older adults in Taiwan. The purpose of this study is to establish the norms of standard and multiple-frequency tympanometry in Chinese young and older adults. The effects of age and gender are investigated for understanding the characteristics of normative data of tympanometry. A total of 100 young adults and 100 older adults with normal middle ear status were recruited from the community in Taiwan. The data of peak Ytm, Vea and TW were obtained by a 226 Hz probe tone. Multiple-frequency tympanometry was recorded by 226, 678 and 1000 Hz probe tones and categorized by the Vanhuyse model. The resonance frequency was obtained by the method of sweep-pressure. The two-way independent ANOVA was used separately to examine the effects of age and gender on each of the tympanometric measures. The effect of gender was found in Ytm, Vea and TW, while the effect of age was only found in Vea. Older adults have more complex patterns of multiple-frequency tympanometry and have significantly lower resonance frequency than young adults do. Results suggest that the middle ear system status changes with aging. The norms, especially gender-specific norms, are needed for Chinese older adults for interpretation.

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

Background: Chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) are common entities in the pediatric population. The conventional treatment approach (conventional medicine; COM) involved mainly surgery after a period of close observation. In this study, we aimed to introduce an integrative, non-invasive approach (integrative medicine; IM) for COME, AH, and associated episodes of recurrent acute otitis media, and compared outcomes with conventional treatment. Methods: We conducted a prospective, non-randomized study in an integrative primary care pediatric practice and a conventional pediatric otolaryngological clinic, where treatment modality was determined by patient preference. Out of a total 101 patients aged 1-8 years, integrative therapy was chosen by 46, and conventional treatment by 55. All patients had COME and AH diagnosed by an otolaryngologist and had moderate to severe hearing impairment. COM treatment was based on close observation over time, nasal decongestants and surgical intervention. In contrast, the IM involved a complex personalized approach with non-invasive interventions, non-allopathic medications, diet and patient education. Results: The number of surgical interventions (adenoidectomy, pressure-equalization tube insertion, myringotomy) was significantly less in the IM cohort (1 of 28 vs. 15 of 35 in the COM group, p < 0.001). The frequency of antibiotic use was significantly less in the IM group (p < 0.001). The frequency of analgesic use was also significantly less in the IM group (p = 0.029). Improvement in tympanometric measures (normal A-type curve) was higher in IM patients compared to expected spontaneous remission during the observation period. Improvement in audiometric measures (intact hearing) of IM patients was also higher than expected compared to spontaneous remission during the observation period. Conclusion: Compared to conventional treatment, integrative treatment of patients with COME and AH showed significantly lower invasive surgical intervention rates and significantly decreased antibiotic and analgesic use. The integrative treatment was effective, safe and well tolerated.

A Preliminary Attempt to Profile Tympanometric Measures in Infants Using High Frequency Probe Tones.

There is dearth of published data on high frequency tympanometric measures for infants in Indian context. Aim of present study was to profile Peak compensated static acoustic admittance (Ytm), Tympanometric peak pressure (TPP), Tympanometric width (TW) and Equivalent ear canal volume (Vea) in infants. Cross-sectional study on 50 infants with present TEOAEs and with risk indicators for hearing loss. Tympanometry was performed using GSI-Tympstar for 678 and 1000Hz probe tones. Descriptive statistics were used to determine mean, SD and minimum and maximum for both genders. Using 678Hz, Ytm ranged from 0.09 to 1. 48mmho (males) and 0.11 to 1.14mmho (females), while with 1000Hz ranged from 0.15 to 1.49 (males) and 0.13-1.61mmho (females). Using 678Hz, TPP ranged from -95 to 70daPa (males) and -155 to 80daPa (females), while with 1000Hz ranged from -75 to 95daPa (males) and -145 to 50daPa (females). Using 678Hz, TW ranged from 30 to 190daPa (males) and 40-23daPa (females), while with 1000Hz ranged from 60 to 210daPa (males) and 40-183daPa (females). Using 678Hz, Vea ranged from 0.11 to 1.7mmho (males) and 0.14-2.5mmho (females), while with 1000Hz ranged from 0.14 to 2.0mmho (males) and 0.14-3.6mmho (males). This study was a preliminary attempt to profile the tympanic measures. Ytm values were lesser or similar to other studies, TPP and Vea values had lower and narrow range, while TW were more than previous studies.

Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional study

ObjectiveThe aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. MethodsCross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. ResultsChildren presented in left ear (LE) a mean peak pressure (PP) of −156.53daPa and a mean compliance of 0.16cm3. Right ear (RE) revealed a PP of −145.61daPa and a compliance of 0.19cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p=0.016; RE: p=0.013) and between the presence of rhinorrhea and PP (LE: p=0.002; RE: p<0.05). Abnormal tympanograms were more frequent in Spring (RE: p=0.009), in younger children (LE: p=0.03) and in children that had rhinorrhea (LE: p=0.002; RE: p=0.044).Healthy children had a mean PP of −125.19daPa and a mean compliance of 0.21cm3 in LE and a mean PP of −144.27daPa and a mean compliance of 0.22cm3 in RE. ConclusionTympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.

Sixteen-Year Change in Acoustic-Admittance Measures Among Older Adults: Data From a Population-Based Study

The primary purpose of this study was to measure the 16-year change in peak compensated static acoustic admittance (Peak Y(tm)) in a population-based cohort of older adults, and to determine whether age was associated with any observed change in Peak Y(tm). Other tympanometric measures also were taken and analyzed. Data from two examinations (1993-1995 and 2009-2010) of the population-based Epidemiology of Hearing Loss Study (n = 1,439 with data at both examinations, ages 48-84 years at baseline) were utilized to assess 16-year change. Tympanometric measures were taken using a 226-Hz probe tone, a positive-to-negative direction of pressure change, and a measured pump speed of 600/200 daPa/s. During the 16-year period, Peak Y(tm) declined an average of 0.009 mmho/year (0.009/year for women, 0.007/year for men). Among women, older baseline age was associated with greater decline in Peak Y(tm). Among men, baseline age was associated with change in Peak Y(tm), but in a nonlinear pattern. Other tympanometric measures demonstrated little change after 16 years. These results demonstrate a small degree of middle-ear stiffening after 16 years among these older adults, but not enough to affect function in a manner that would influence clinical decisions.

A Novel Animal Model for Chronic Tympanic Membrane Perforation

Objectives: In order to assess and treat chronic tympanic membrane perforations it is necessary to have a reliable and reproducible animal model. After a literature review, different surgical techniques and rates of patency of tympanic membrane perforation were encountered. We report an inexpensive, readily available, and easy to create animal model. Methods: We performed an anatomic study of the guinea pig ear using endoscopic, computed tomography, and tympanometric measures. Bilateral microinstrumental endoscopic perforations were performed in 17 guinea pigs (34 ears). Three subjects served as controls using perforation without flaps in the anterior quadrants of the tympanic membrane. In 14 subjects, local microflaps combined with infolding technique and local application of glutaraldehyde in anterior quadrants were performed. Endoscopic follow up at 7, 14, 30 and 60 days was performed, and after that histological analysis was conducted. Results: All control subjects healed within 2 weeks. Of the 14 guinea pigs, patent perforations were achieved in almost all subjects. Our results are comparable with the studies reported by Amoils and Kaftan. Conclusions: Our procedure is a feasible method and may be useful in further investigations to assess and treat tympanic membrane perforations.

Tympanometric measures in ears with negative middle ear pressure, and tests of some common assumptions

Objective: To test the assumptions concerning the compensation of middle ear pressure (MEP) in using peak Ytm and the tympanogram asymmetry phenomenon, and to address the variability and reliability of 226 Hz tympanometry under negative MEP. Design: (1) Repeated measures in normal ears with experimentally-induced negative MEP; (2) Retrospective analysis of clinical data from ears with negative MEP. Study sample: Experimental data: 57 adult ears. Clinical data: 200 adult ears. Results: Mean peak Ytm significantly increased (˜ 0.10 mmhos) under negative MEPs (> − 190 daPa). TW increased, up to ˜50 daPa, for MEP ≤ − 130 daPa. Vea decreased when MEP ≤ − 190 daPa. With increasing negative MEP, peak Ytm and tympanogram gradient tended to decrease. The within-subject variation of all measures and difference between normal and negative MEP were small. Conclusions: The tympanometry procedure increases peak Ytm in ears with low to moderate negative MEP, and decreases gradient and Vea with high negative MEP. This is referred to as hypercorrection of the admittance and should be accounted for in clinical norms. Results imply that tympanogram asymmetry is due to divergent effects of air pressure on the middle ear. The variability of tympanometry does not increase and reliability not decrease under negative MEP.

Vitamin A supplementation in preschool children and risk of hearing loss as adolescents and young adults in rural Nepal: randomised trial cohort follow-up study

Objective To determine whether vitamin A supplementation administered in the preschool years can lower the risk of hearing loss in adolescence and adulthood.Design Follow-up study of adolescents and young adults...

Tympanometry with 226 and 1000 Hertz tone probes in infants

This study aimed at describing and analyzing tympanometric results obtained with 226Hz and 1000Hz probe tones; checking for correlations between tympanometry, otoacoustic emissions and otoscopic examination; describing abnormal results found in the evaluation procedures. MethodsDouble-blind and prospective study. Our sample included 70 babies, between 7 days and one month and 13 days of age, without risk indicators for hearing loss, evaluated in the State Neonatal Hearing Screening Program. Transient evoked otoacoustic emissions, otoscopic examination and tympanometry with 226Hz and 1000Hz probe tones were used as assessment tools. The study was approved by the Ethics Committee from the institution. ResultsStatistically significant differences were observed (p<0.05) in the tympanometric measures correlation and also between transient evoked otoacoustic emissions and compliance obtained with both probe tones. Most test results were within the normal range (94.28%). Three children (4.28%) were referred to diagnostic follow-up and one (1.42%) had middle ear dysfunction confirmed by otoscopy and 1000Hz tympanometry. Conclusions1000Hz tympanometry is the most reliable probe tone used to evaluate children under three months of age. More studies focusing on middle ear acoustics and mechanics are necessary to provide reliable and precise interpretation in the evaluation of middle ear functions in babies.

Relationships among Standard and Wideband Measures of Middle Ear Function and Distortion Product Otoacoustic Emissions

The overall goal of the current study was to examine the relationships among uncompensated admittance (Ya) at ambient pressure extracted from tympanograms, energy reflectance (ER) measures at ambient pressure from wideband acoustic transfer functions (WATF), and distortion product otoacoustic emissions (DPOAEs). If WATF measures of Ya are comparable to tympanometric measures of Ya at ambient pressure, it would be further evidence that the two systems provide comparable information at ambient pressure. Such a relationship could be used as a cross-check or validation for WATF measures and support the use of WATFs in lieu of tympanograms in some applications. Finally, if WATF measures of Ya and/or ER at DPOAE stimulus frequencies can account for some of the variability observed in DPOAE levels and/or signal-to-noise ratios (SNRs) in ears with normal hearing, the relationships could be used to improve hearing screening procedures. The hypotheses were as follows: (1) measures of Ya at ambient pressure are significantly correlated as measured with tympanometric and WATF procedures and (2) measures of Ya and ER at DPOAE stimulus frequencies are significantly correlated with DPOAE level and SNR. Repeated measures in human adults. Forty ears of 20 adults with normal hearing and middle ear function were included in the final sample. Tympanograms were obtained using probe frequencies of 226, 678, and 1000 Hz; WATFs were obtained using a click probe, and DPOAEs were elicited with f2's of 1000, 2000, and 4000 Hz. A repeated measures analysis of variance (RM-ANOVA) was completed to identify significant differences between ears and among probe frequencies for Ya measured at ambient pressure from the Tympstar and for Ya measured at the three closest frequencies on the WATFs. Lines were fit to the comparison of Ya from the Tympstar and WATF, and percent variance accounted for (r2) was calculated. Ya and ER were extracted at all stimulus frequencies that were used to elicit DPOAEs and were compared to DPOAE levels and SNRs. RM-ANOVAs were completed to identify any significant differences in DPOAE level and SNR between ears and among f2 conditions. Lines were fit to the comparison of Ya and ER measures at f1 and f2 with the DPOAE levels and SNRs. The relationship between behavioral air conduction threshold at each f2 and DPOAE level (and SNR) was examined with regression analysis. Ya was significantly correlated between the tympanometric and WATF measures at all three probe-tone frequencies. Ya and ER at f1 and f2 were significantly correlated with DPOAE level for f2 = 4000 Hz. The implications are as follows: (1) WATFs, which can be obtained with the same probe microphone system as DPOAEs, could be used as a supplement to tympanometry in a diagnostic test battery, and the relationship between Ya measured on the two systems could be used for verification, and (2) Ya and ER measures from WATFs at both DPOAE stimulus frequencies account for some of the variability observed in DPOAE levels at f2 = 4000 Hz in normal ears.

Tympanometry in infants with middle ear effusion having been identified using spiral computerized tomography

Purpose This study was carried out to evaluate the diagnostic value of 226 and 1000 Hz probe-tone tympanometry in infants with effusion in the middle ear. Methods For this study, we recruited 52 infants with ages 42 days to 6 months as clinical subjects in a hearing-ability screening program. After a spiral computerized tomography (CT) scan of the patients, we tested their hearing using tympanometry of 2 probe-tone frequencies: 226 and 1000 Hz. The patients were divided into 2 groups according to the results of the CT scan: group 1 patients had normal middle ears without fluid, and group 2 patients had ears with fluid. We recorded the tympanograms and their percentage of every type and compared the tympanometric results with CT to get the concordance rate between tympanometry and CT diagnose while obtaining the normal values of 1000 Hz tympanometric measures. Results The 226 Hz probe-tone tympanograms of middle ears with fluid differed greatly from those without. At 226 Hz, their tympanograms were single-peaked tympanograms (51.06%), double-peaked tympanograms (44.68%), flat tympanograms (2.13%), and negative-pressure tympanograms (2.13%) for the group with normal middle ears, but single-peaked tympanograms (77.19%), double-peaked tympanograms (19.30%), and flat tympanograms (3.51%) for the group with middle ear effusion. The 1000 Hz probe-tone tympanograms included single-peaked or flat-type tympanograms in both the normal middle ear group and the group with middle ear effusion. The group with normal middle ears was identified by spiral CT, and its tympanograms mostly had a single peak (97.87%) during 1000 Hz tympanometry. Tympanograms of the middle ear effusion group mostly had a flat curve (98.25%). When the Liden/Jerger classification system was used to evaluate the tympanograms, normal tympanograms were single-peaked, and flat tympanograms indicated middle ear effusion. According to this standard, the concordance rate between the 1000 Hz tympanometry (98.08%) and CT diagnosis was higher than when 226 Hz tympanometry (25%) ( P < .05) was performed, and the value of κ was equal to 0.961 between 1000 Hz tympanometry and CT diagnosis. Conclusions In clinical practice, 1000 Hz tympanometry, not 226 Hz, is recommended to determine the presence of middle ear fluid in infants younger than 6 months.

Racial Heritage/Melanin and Otoacoustic Emission Measures of Cochlear Function

Researchers have hypothesized that races with high levels of melanin may possess superior cochlear robusticity. This study aimed to examine the relationship between cochlear function and racial heritage, by determining if a significant difference existed in otoacoustic emission (OAE) characteristics and hearing sensitivity between differing groups. OAEs, puretone thresholds, and tympanometric measures were obtained from 18 Caucasians and 19 Africans. Seven albino Caucasians, a group with defective melanin production/distribution, were included for comparative purposes. An analysis of variance with repeated measures was applied to the data, to establish the group interactions of significance. Africans were found to display significantly stronger OAEs than Caucasians. However, the OAEs of albino Caucasians did not significantly differ from those of the other groups. Results did show significantly poorer hearing thresholds for the albino Caucasian group than for the Caucasians. These findings suggest that the robust cochlear function observed in Africans could be due to factors other than enhanced melanin levels.

Audiologic results in patients with Moebiüs sequence

Moebiüs sequence is a pathology not very well understood regarding to the hearing status. The main goal of this study was to describe the audiologic findings in children and adolescent who carry Moebiüs sequence. Participated in this study 17 children and adolescent, with age ranging from 3 to 13 years old. Prior to the testing, the family answered an interview. It was realized external auditory canal inspection, and the hearing testing (auditory instrumentation, pure tone audiometry, speech audiometry, immittanciometric measures, and otoacoustic emissions) on the participants. The auditory instrumentation evaluation (n=6) was present in all participants. The pure tone audiometry presented normal hearing levels in 75.0% of the tested ears, one ear with conductive hearing loss, two ears with sensory neural hearing loss, and one ear with mixed hearing loss. The tympanometric measures showed Type A tympanograms in 63.0% of the ears, Type B in 11.1%, Type C in 18.5%, and Type As in 7.4%. T the acoustic reflexes measure showed contralateral acoustic reflexes present in 50.0% of the ears, and ipsilateral acoustic reflexes present in 34.6% ears. The OAE results showed presence in 73.0%, for the TOAE, and 76.9% for the DPOAE. These results support the idea that there is no audiologic pattern for conductive hearing loss. The majority of the participants presented hearing in the normal range. Care should be taken in drawing conclusions regarding to auditory status of the individual with Moebiüs sequence, but what can be said is that not always those individuals present hearing loss.

R170: Age and Sex Variations of Tympanometric Measures in Adults

R170: Age and Sex Variations of Tympanometric Measures in Adults

Five-Year Changes in Middle Ear Function for Older Adults

Longitudinal changes in tympanometric measures of middle ear function over five years were reported for a large population of older adults. Findings were similar for men and women, for right and left ears, and across age groups from 48 to 92 years. Although some of the mean changes reached statistical significance, the vast majority of observed changes were small in magnitude relative to the observed variability and the tolerances of the measuring instrument. Observed mean changes in Peak Ytm for older adults were quite small and were in the positive direction. This is counter to changes that would be predicted on the basis of increases in the stiffness of the middle ear transmission system with advancing age suggested in earlier reports. Overall, the findings suggest little in the way of functional change in middle ear mechanics over a span of five years in older adults.

The aging ear: an otomicroscopic and tympanometric study

ObjectiveTo analyze changes in tympanometric measures with age and to study some otitis-related issues in the elderly (≥ 60 years) population.Material and MethodsThe study was designed as a combination of a cross-sectional survey and a controlled study. We studied a random sample of 232 elderly subjects using an extended battery of audiological tests, including pure-tone audiometry. tympanometry with a probe frequency of 226 Hz, otomicroscopy and a standardized questionnaire. A sample of 60 otologically normal subjects were selected for comparative analysis with young healthy controls, and for description of age-related changes and gender differences.ResultsUsing linear regression analyses of ear canal volume, middle ear pressure and tympanic membrane compliance on age, no consistently significant change in these parameters with age was found. When these measures were compared between the elderly and the controls, using parametric and non-parametric statistical tests, no significant differences were found for either gender. The only significant gender difference was found for ear canal volume, which was greater for elderly males than for elderly females In the unscreened elderly sample, the adjusted prevalence for reported previous or current otitis media was 15–27% of the population (95% CI). The adjusted prevalence for reported previous or current chronic otitis media (COM) or sequelae thereof was 1–7% (95% CI). With the exception of cerumen obstruction, the prevalence of outer ear canal-related complaints was 1–7% (95% CI). There were some discrepancies between these reported complaints and the findings at otomicroscopy. Although elderly subjects with COM were found to have poorer hearing at speech frequencies than normal elderly subjects. no such effect was found in subjects with scarring or atrophy of the tympanic membrane. The effect of pathological findings at otomicroscopy on tympanometric measures in the elderly sample was highly variable and no consistent association was found.ConclusionsNo change in middle ear sound transmission, as assessed by tympanometry, occurs with normal aging. Ear canal volume is smaller in elderly females than elderly males, which is potentially relevant to the study of otoacoustic emissions in the elderly. The estimated prevalence of ear canal-related problems, excluding cerumen obstruction, is of such a magnitude that the introduction of partially implanted hearing aids may be warranted in our elderly population.