Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power
| Autor: | Angela C. Garinis, Daniel B. Putterman, M. Patrick Feeney, Denis F. Fitzpatrick, Douglas H. Keefe, Lisa L. Hunter |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Middle ear disorder Hearing Loss Sensorineural Ear Middle Audiology 01 natural sciences Article Absorbance 03 medical and health sciences Speech and Hearing 0302 clinical medicine Audiometry Absorbed power 0103 physical sciences medicine Humans Wideband 030223 otorhinolaryngology 010301 acoustics Receiver operating characteristic business.industry Middle Aged medicine.disease Otosclerosis Otorhinolaryngology Acoustic Impedance Tests Sensorineural hearing loss Analysis of variance sense organs business |
| Zdroj: | Ear Hear |
| ISSN: | 1538-4667 |
| Popis: | OBJECTIVE: Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing, (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate pre-operative and post-operative test results. DESIGN: Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare pre- and post-operative results at 3 and 6 months. RESULTS: There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance (SAA) at 226-Hz was near chance performance, which is consistent with previous findings. There was good agreement between the present study and Keefe et al. (2017b) for absorbance peak-to-tail differences with high AUCs for both studies at 2.83 kHz for the peak-to-positive tail condition and at 4 kHz for the peak-to-negative tail condition. There were significant mean differences between pre- and post-operative tests for absorbance and absorbed power. CONCLUSIONS: Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than SAA at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis. |
| Databáze: | OpenAIRE |
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