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Abstract
Objective: This study tested the hypothesis that wideband aural absorbance predicts conductive hearing loss (CHL) in children medically classified as having otitis media with effusion. Design: Absorbance was measured in the ear canal over frequencies from 0.25 to 8 kHz at ambient pressure or as a swept tympanogram. CHL was defined using criterion air-bone gaps of 20, 25, and 30 dB at octaves from 0.25 to 4 kHz. A likelihood-ratio predictor of CHL was constructed across frequency for ambient absorbance, and across frequency and pressure for absorbance tympanometry. Performance was evaluated at individual frequencies and for any frequency at which a CHL was present. Study sample: Absorbance and conventional 0.226-kHz tympanograms were measured in children of age three to eight years with CHL and with normal hearing. Results: Absorbance was smaller at frequencies above 0.7 kHz in the CHL group than the control group. Based on the area under the receiver operating characteristic curve, wideband absorbance in ambient and tympanometric tests were significantly better predictors of CHL than tympanometric width, the best 0.226-kHz predictor. Accuracies of ambient and tympanometric wideband absorbance did not differ. Conclusions: Absorbance accurately predicted CHL in children and was more accurate than conventional 0.226-kHz tympanometry.
Acknowledgements
The authors are grateful for the assistance of Yi-Wen Liu in software development and analysis. The authors thank the audiology staff of BTNRH for help in recruiting subjects and collecting data. Preliminary results were presented at the American Auditory Society Annual Meeting, March 2010, Scottsdale, USA (C.A. Sanford, D.H. Keefe, J.C. Ellison, D.F. Fitzpatrick, and M.P. Gorga, ‘Wideband acoustic transfer functions predict conductive hearing loss in children’).
Declaration of interest: This research was supported by the National Institute on Deafness and Other Communication Disorders (NIDCD grants DC006607, DC000013, DC004662). Douglas H. Keefe is president of Sonicom, Inc., which is a small business aiming to commercialize medical devices, including those used for wideband aural acoustic transfer function testing. The NIDCD grant R42 DC006607 was awarded to Sonicom, Inc. as Application Organization, with BTNRH as Research Institution. The present address of Chris A. Sanford is Department of Communication Sciences & Disorders, Idaho State University, Pocatello, USA. The present address of John C. Ellison is Research and Development, Starkey Laboratories, Eden Prairie, USA.