광대역 고막 흡수도 검사의 정상치 및 중이 질환에서의 측정값 비교 = Wideband Absorbance Measurements: Norms and Middle Ear Disorders

다국어 초록 (Multilingual Abstract)

Background and Objectives To evaluate the usefulness of wideband tympanometry in predicting middle ear disorders by comparing the absorbance measurements of the disorder and the norm.
Subjects and Method Wideband tympanometry, pure tone audiometry, and endoscopic examination were performed on 284 ears of 190 subjects. Wideband absorbance (WBA) was measured from normal ears (adults: 128 ears, children: 32 ears), disorders of middle ear included effusion (adults: 24 ears, children: 21 ears), tympanic membrane (TM) retraction (adults: 26 ears, children: 6 ears) and perforation (47 adult ears).
Results The normative data of WBA were similar to previous reports from other countries.
WBA of the 17-29 age group showed higher values than other age groups at 1600-3150 Hz. Men had higher absorbance at low frequencies whereas women had higher absorbance at high frequencies. There was a significant gender difference at 4000 Hz. Adults showed higher absorbance at 1000, 1250, and 1600 Hz and lower absorbance at 2500, 3150, and 4000 Hz than children did at those respective frequencies. Compared to the normal group, WBA was decreased at all frequencies by more than 500 Hz in ears with middle ear effusion and at most frequencies by less than 2000 Hz in ear with TM retraction. TM perforation showed higher absorbance in low frequencies; the absorbance decreased as the size of perforation increased.
Conclusion The present study established normative WBA data and the results showed comparable statistics to former studies in age and gender difference. WBA provided a high reliability in discrimination of middle ear effusion and TM retraction. WBA is a simple, non-invasive and useful diagnostic tool for middle ear disease.
Korean J Otorhinolaryngol-Head Neck Surg 2017;60(2):55-62

참고문헌 (Reference)

1 Margolis RH, "Wideband reflectance tympanometry in normal adults" 106 (106): 265-280, 1999

2 Shahnaz N, "Wideband reflectance norms for Caucasian and Chinese young adults" 27 (27): 774-788, 2006

3 Beers AN, "Wideband reflectance in normal Caucasian and Chinese school-aged children and in children with otitis media with effusion" 31 (31): 221-233, 2010

4 Hunter LL, "Wideband reflectance in newborns: normative regions and relationship to hearing-screening results" 31 (31): 599-610, 2010

5 Feeney MP, "Wideband energy reflectance measurements in adults with middle-ear disorders" 46 (46): 901-911, 2003

6 Ellison JC, "Wideband acoustic transfer functions predict middle-ear effusion" 122 (122): 887-894, 2012

7 Liu YW, "Wideband absorbance tympanometry using pressure sweeps:system development and results on adults with normal hearing" 124 (124): 3708-3719, 2008

8 Cho YS, "Video pneumatic otoscopy for the diagnosis of otitis media with effusion: a quantitative approach" 266 (266): 967-973, 2009

9 Margolis RH, "Tympanometric evaluation of middle ear function in children with otitis media" 163 : 34-38, 1994

10 Paradise JL, "Tympanometric detection of middle ear effusion in infants and young children" 58 (58): 198-210, 1976

11 Vander Werff KR, "Test-retest reliability of wideband reflectance measures in infants under screening and diagnostic test conditions" 28 (28): 669-681, 2007

12 Shahnaz N, "Standard and multifrequency tympanometry in normal and otosclerotic ears" 18 (18): 326-341, 1997

13 Sanford CA, "Sound-conduction effects on distortion-product otoacoustic emission screening outcomes in newborn infants: test performance of wideband acoustic transfer functions and 1-kHz tympanometry" 30 (30): 635-652, 2009

14 Jaisinghani VJ, "Residual mesenchyme persisting into adulthood" 20 (20): 363-370, 1999

15 Kim JG, "Prevalence of otitis media with effusion in kindergarten children in Taegu area" 38 : 1695-1703, 1995

16 Kim CS, "Prevalence of otitis media and allied diseases in Korea--results of a nation-wide survey, 1991" 8 (8): 34-40, 1993

17 Margolis RH, "Multifrequency tympanometry in normal adults" 14 (14): 408-413, 1993

18 Keefe DH, "Method to measure acoustic impedance and reflection coefficient" 91 (91): 470-485, 1992

19 Voss SE, "Measurement of acoustic impedance and reflectance in the human ear canal" 95 (95): 372-384, 1994

20 Miura T, "Marrow-tympanum connections in fetuses and infants" 111 (111): 14-20, 2008

21 이효정, "Korean Clinical Practice Guidelines: Otitis Media in Children" 대한의학회 27 (27): 835-848, 2012

22 Keefe DH, "Identification of neonatal hearing impairment: ear-canal measurements of acoustic admittance and reflectance in neonates" 21 (21): 443-461, 2000

23 Prieve BA, "Identification of conductive hearing loss in young infants using tympanometry and wideband reflectance" 34 (34): 168-178, 2013

24 Werner YL, "How body size affects middle-ear structure and function and auditory sensitivity in gekkonoid lizards" 201 (201): 487-502, 1998

25 Doan DE, "Functional changes in the aging mouse middle ear" 97 (97): 174-177, 1996

26 Colin Bell A, "Ethnic differences in the association between body mass index and hypertension" 155 (155): 346-353, 2002

27 Keefe DH, "Energy transmittance predicts conductive hearing loss in older children and adults" 114 (114): 3217-3238, 2003

28 Keefe DH, "Ear-canal impedance and reflection coefficient in human infants and adults" 94 (94): 2617-2638, 1993

29 Keefe DH, "Ear-canal acoustic admittance and reflectance effects in human neonates. I. Predictions of otoacoustic emission and auditory brainstem responses" 113 (113): 389-406, 2003

30 Holte L, "Developmental changes in multifrequency tympanograms" 30 (30): 1-24, 1991

31 Jerger J, "Clinical experience with impedance audiometry" 92 (92): 311-324, 1970

32 Feeney MP, "Age effects in the human middle ear:wideband acoustical measures" 116 (116): 3546-3558, 2004

33 Ovesen T, "Accuracy of an automatic impedance apparatus in a population with secretory otitis media: principles in the evaluation of tympanometrical findings" 14 (14): 100-104, 1993

34 Cumming G, "A primer on the understanding, use, and calculation of confidence intervals that are based on central and noncentral distributions" 61 (61): 532-574, 2001