Can Wideband Absorbance Be Used in the Detection of Ossicular Chain Defects

Document Type : Original

Authors

1 Department of Otorhinolaryngology-Head and Neck Surgery, Arnavutkoy State Hospital, Istanbul, Turkey.

2 Department of Otorhinolaryngology-Head and Neck Surgery, University of Health Sciences Istanbul Training and Research Hospital, Istanbul, Turkey.

Abstract

Introduction:
We aimed to compare the effectiveness of wideband absorbance in detecting ossicular chain discontinuity with intraoperative findings.
Materials and Methods:
In this study, 58 ears from 38 patients with chronic otitis media (COM) were included. Twenty-six ears with perforation and intact ossicular chain were determined as Group 1, 12 ears with perforation and ossicular chain defects were determined as Group 2, and 20 ears with normal hearing and intact tympanic membrane were determined as Group 3. The comparison of the groups was made considering the static (non-pressure) absorbance analysis performed using wideband tympanometry.
Results:
When perforation sites were evaluated in Group 1 and Group 2; there were 12 anterior perforations, 7 posterior perforations, and 19 subtotal perforations. Air conduction thresholds in Group 2 were significantly (P<0.05) higher than in Group 1, as expected in pure tone audiometry. When wideband absorbance (WBA) measurements were evaluated in all 3 groups, no significant difference (P>0.05) was found between the frequencies 226 to 1000 Hz. WBA measurements at 8 frequencies between 1888-2311 Hz in Group 1 were significantly lower than Group 3 (P<0.05). WBA measurements at 4 frequencies between 3462-3886 Hz frequencies in Group 2 were significantly lower than Group 1 (P<0.05).
Conclusions:
Our findings concluded that a significant decrease in absorbance values in the narrow frequency range may be valuable in predicting ossicular chain defects.

Keywords

Main Subjects

References

  1. Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: a systematic review and global estimates. PLoS One. 2012;7(4):e36226.
  2. Sarmento KMA Jr, de Olivieira CACP, Sampaio ALL, Sales AF. Erosion of the long process of the incus with incomplete ossicular discontinutiy in simple chronic otitis media: Should we reconstruct or leave it be? Clin Otolaryngol. 2018;43(1):300-305.
  3. Sheikh R, Haidar H, Abdulkarim H, Aslam W, Larem A, Alsaadi A, et al. Preoperative Predictors in Chronic Suppurative Otitis Media for Ossicular Chain Discontinuity: A Cross-Sectional Study. Audiol Neurotol. 2016;21(4):231-236.
  4. Gül A, Akdağ M, Kiniş V, Yilmaz B, Şengül E, Teke M, et al. Radiologic and surgical findings in chronic suppurative otitis media. J Craniofac Surg. 2014; 25(6):2027-9.
  5. Jeng FC, Tsai MH, Brown CJ. Relationship of preoperative findings and ossicular discontinuity in chronic otitis media. Otol Neurotol. 2003;24(1):29-32.
  6. Vaidya S, Sharma JK, Singh G. Study of the outcome of tympanoplasties in relation to size and site of tympanic membrane perforation. Indian J Otolaryngol Head Neck Surg. 2014;66(3):341-346.
  7. Terkildsen K, Thomsen KA. The influence of pressure variations on the impedance of the human ear drum. J Laryngol and Otol. 1959;73:409-418.
  8. Shanks JE. Tympanometry. Ear Hear. 1984; 5(5):268-280.
  9. Margolis RH, Van Camp KJ, Wilso RH, Creten WL. Multifrequency tympanometry in normal ears. J Audiology. 1985;24(1):44-53.
  10. Kei J, Sanford CA, Prieve BA, Hunter LL. Wideband acoustic immittance Measures: developmental characteristics (0 to 12 months). Ear Hear. 2013;34(1):17-26.
  11. Shahnaz N, Polka L. Standard and multifrequency tympanometry in normal and otosclerotic ears. Ear Hear. 1997;18(4):326-341.
  12. Burdiek LM, Sun XM. Effects of consecutive wideband tympanometry trials on energy absorbance measures of the middle ear. J Speech Lang Hear Res. 2014;57(5):1997-2004.
  13. Feeney MP, Grant IL, Marryott LP. Wideband energy reflectance measurements in adults with middle-ear disorders. Speech Lang Hear Res. 2003; 46(4):901-911
  14. Sanford CA, Feeney MP. Effects of maturation on tympanometric wideband acoustic transfer functions in human infants. J Acoust Soc Am. 2008; 124(4):2106–2122.
  15. Voss SE, Allen JB. Measurement of acoustic impedance and reflectance in the human ear canal. J Acoust Soc Am. 1994;95(1):372–384.
  16. Keefe DH, Levi E. Maturation of the middle and external ears: acoustic power-based responses and reflectance tympanometry. Ear Hear. 1996;17(5): 361-373.
  17. Liu YW, Sanford CA, Ellison JC, Fitzpatrick DF, Gorga MP, Keefe DH. Wideband absorbance tympanometry using pressure sweeps: System development and results on adults with normal hearing. J Acoust Soc Am. 2008;124(6);3708–3719.
  18. Sanford CA, Hunter LL, Feeney MP, Nakajima HH. Wideband acoustic immittance: tympanometric measures. Ear Hear. 2013;34(1):65-71.
  19. Santosh UP, Prashanth KB, Rao MS. Study of myringoplasty in wet and dry ears in mucosal type of chronic otitis media. J Clin Diagn Res. 2016; 10(9):MC01-MC03.
  20. O’Reilly BJ, Cheverton EB, Wylie I, Thakkar C, Butler P, Sathanathan N, et al. The value of CT scanning in chronic suppurative otitis media. J Laryngol Oto. 1991;105(12):990-994.
  21. Thukral CL, Singh A, Singh S, Sood AS, Singh K. Role of high resolution computed tomography in evaluation of pathologies of temporal bone. J Clin Diagn Res. 2015;9(9):TC07-10.
  22. Karki S, Pokharel M, Suwal S, Poudel R. Correlation between preoperative high resolution CT findings with surgical findings in chronic otitis media squamosal type. Kathmandu Univ Med J. 2017; 15(57):84-87.
  23. Feeney MP, Grant IL, Mills DM. Wideband energy reflectance measurements of ossicular chain discontinuity and repair in human temporal bone. Ear Hear. 2009;30(4):391-400.
  24. Voss SE, Horton NJ, Woodbury RR, Sheffield KN. Sources of variability in reflectance measurements on normal cadaver ears. Ear Hear. 2008; 29(4):651-65.
  25. Voss SE, Merchant GR, Horton NJ. Effects of middle-ear disorders on power reflectance measured in cadaveric ear canals. Ear Hear. 2012;33(2):195-208.
  26. Voss SE, Rosowski JJ, Merchant SN, Peake WT. Middle-ear function with tympanic-membrane perforations. I. Measurements and mechanisms. J Acoust Soc Am. 2001;110(3):1432-44.
  27. Voss SE, Rosowski JJ, Merchant SN, Peake WT. How do tympanic-membrane perforations affect human middle-ear sound transmission? Acta Otolaryngol. 2001;121(2):169-73.
  28. Shahnaz N, Bork K. Wideband reflectance norms for Caucasian and Chinese young adults. Ear Hear. 2006;27(6):774-788.
Iranian Journal of Otorhinolaryngology
Volume 34, Issue 5
September and October 2022
Pages 225-232

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