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J Am Acad Audiol 2024; 35(07/08): 193-203
DOI: 10.1055/s-0044-1791213
Research Article

Predictive Accuracy of Wideband Absorbance under Various Pressure Conditions in Identifying Infants with a Conductive Hearing Loss

Sreedevi Aithal
1   Department of Audiology, Townsville University Hospital, Townsville, Queensland, Australia
2   Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
3   Department of Speech Pathology, School of Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
,
Venkatesh Aithal
1   Department of Audiology, Townsville University Hospital, Townsville, Queensland, Australia
2   Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
,
Joseph Kei
2   Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
,
Matthew Wilson
4   Department of Audiology, Monash Health Melbourne, Victoria, Australia
› Institutsangaben Funding This study was supported by Queensland Health New Technology Funding and Evaluation program (NTFEP 2014/15-HQ000249).
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Abstract

Objective The objectives of the study were to (i) evaluate the effectiveness of wideband absorbance (WBA) at ambient pressure (WBAamb), tympanic peak pressure (WBATPP), and 0 daPa (WBA0) to identify conductive hearing loss (CHL) in infants and (ii) compare the sensitivity and specificity of the three WBA tests with that of high-frequency tympanometry (HFT) and transient-evoked otoacoustic emissions (TEOAE).

Method A total of 31 ears with hearing thresholds no greater than 20 dB HL (reference group from 20 infants [mean age: 3.1 weeks]) and 47 ears with CHL from 31 infants (mean age: 3.4 weeks) were included in the study. Hearing threshold was determined using air-conduction tone-burst auditory brainstem response (TB-ABR) test, whereas CHL was determined using both air- and bone-conduction TB-ABR tests. HFT with a 1000-Hz probe tone, TEOAE, and WBA tests were conducted on all participants.

Results WBAamb, WBATPP, and WBA0 of the CHL group were significantly lower than that of the reference group across a wide frequency range. Area under the receiver operating characteristic (AROC) curve for detecting CHL varied from 0.51 to 0.9 depending on the frequency. The highest AROC was obtained at 1.25 kHz for WBAamb (0.79), at 1.5 kHz for WBATPP (0.9) and at 1 kHz for WBA0 (0.80). The sensitivity and specificity were 0.98 and 0.45, respectively for HFT, and 1.0 and 0.6, respectively for TEOAE. In comparison, the WBA test had slightly lower sensitivity but higher specificity than the HFT and TEOAE tests.

Conclusion WBATPP at 1.5 kHz can identify CHL in infants as good as, if not more accurately than, WBAamb or WBA0. WBATPP test had good balance of high sensitivity and specificity compared with HFT and TEOAE. The three WBA tests are useful tools for identifying CHL in infants under 6 weeks of age.

Keywords

diagnostic techniques - conductive hearing loss - infants - wideband absorbance

Previous Presentation

Portions of this study were presented at the Audiology Australia 2023 Conference, Gold Coast, May 7–10.




Publikationsverlauf

Eingereicht: 06. September 2022

Angenommen: 04. April 2024

Artikel online veröffentlicht:
18. Dezember 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Kei J, Allison-Levick J, Dockray J. et al. High-frequency (1000 Hz) tympanometry in normal neonates. J Am Acad Audiol 2003; 14 (01) 20-28
    Thieme ConnectPubMedSuche in Google Scholar
  • 2 Margolis RH, Bass-Ringdahl S, Hanks WD, Holte L, Zapala DA. Tympanometry in newborn infants–1 kHz norms. J Am Acad Audiol 2003; 14 (07) 383-392
    Thieme ConnectPubMedSuche in Google Scholar
  • 3 Shahnaz N, Miranda T, Polka L. Multifrequency tympanometry in neonatal intensive care unit and well babies. J Am Acad Audiol 2008; 19 (05) 392-418
    Thieme ConnectPubMedSuche in Google Scholar
  • 4 Mazlan R, Kei J, Hickson L. et al. High frequency immittance findings: newborn versus six-week-old infants. Int J Audiol 2007; 46 (11) 711-717
    CrossrefPubMedSuche in Google Scholar
  • 5 Hunter LL, Feeney MP, Lapsley Miller JA, Jeng PS, Bohning S. Wideband reflectance in newborns: normative regions and relationship to hearing-screening results. Ear Hear 2010; 31 (05) 599-610
    CrossrefPubMedSuche in Google Scholar
  • 6 Sanford CA, Keefe DH, Liu Y-W. et al. Sound-conduction effects on distortion-product otoacoustic emission screening outcomes in newborn infants: test performance of wideband acoustic transfer functions and 1-kHz tympanometry. Ear Hear 2009; 30 (06) 635-652
    CrossrefPubMedSuche in Google Scholar
  • 7 Aithal S, Kei J, Driscoll C, Khan A, Swanston A. Wideband absorbance outcomes in newborns: a comparison with high-frequency tympanometry, automated brainstem response, and transient evoked and distortion product otoacoustic emissions. Ear Hear 2015; 36 (05) e237-e250
    CrossrefPubMedSuche in Google Scholar
  • 8 Aithal S, Kei J, Aithal V. High frequency (1000 Hz) tympanometry in six-month-old infants. Int J Pediatr Otorhinolaryngol 2022; 160: 111223
    CrossrefPubMedSuche in Google Scholar
  • 9 Aithal S, Kei J, Driscoll C, Khan A. Normative wideband reflectance measures in healthy neonates. Int J Pediatr Otorhinolaryngol 2013; 77 (01) 29-35
    CrossrefPubMedSuche in Google Scholar
  • 10 Merchant GR, Horton NJ, Voss SE. Normative reflectance and transmittance measurements on healthy newborn and 1-month-old infants. Ear Hear 2010; 31 (06) 746-754
    CrossrefPubMedSuche in Google Scholar
  • 11 Baldwin M. Choice of probe tone and classification of trace patterns in tympanometry undertaken in early infancy. Int J Audiol 2006; 45 (07) 417-427
    CrossrefPubMedSuche in Google Scholar
  • 12 Prieve BA, Feeney MP, Stenfelt S, Shahnaz N. Prediction of conductive hearing loss using wideband acoustic immittance. Ear Hear 2013; 34 (Suppl. 01) 54S-59S
    CrossrefPubMedSuche in Google Scholar
  • 13 Prieve BA, Vander Werff KR, Preston JL, Georgantas L. Identification of conductive hearing loss in young infants using tympanometry and wideband reflectance. Ear Hear 2013; 34 (02) 168-178
    CrossrefPubMedSuche in Google Scholar
  • 14 Keefe DH, Folsom RC, Gorga MP, Vohr BR, Bulen JC, Norton SJ. Identification of neonatal hearing impairment: ear-canal measurements of acoustic admittance and reflectance in neonates. Ear Hear 2000; 21 (05) 443-461
    CrossrefPubMedSuche in Google Scholar
  • 15 Aithal S, Aithal V, Kei J, Wilson M. Wideband tympanometry findings in healthy neonates. J Am Acad Audiol 2022; 33 (07–08): 381-389
    Thieme ConnectPubMedSuche in Google Scholar
  • 16 Keogh T, Beahan N. eds. Healthy Hearing Program Diagnostic Assessment Protocols for Audiological Practice, Version 1.0. Brisbane: Healthy Hearing; 2009
    Suche in Google Scholar
  • 17 Mazlan R, Kei J, Hickson L, Khan A, Gavranich J, Linning R. High frequency immittance (1000 Hz) tympanometry findings in newborns: normative data using a component compensated admittance approach. Aust N Z J Audiol 2009; 31: 15-24
    CrossrefSuche in Google Scholar
  • 18 Interacoustics. Titan: Technical specifications. 2015 Accessed August 22, 2017 at: http://www.interacousticcs.us/titan/support
  • 19 Liu Y-W, 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 (06) 3708-3719
    CrossrefPubMedSuche in Google Scholar
  • 20 Kemp DT, Ryan S, Bray P. A guide to the effective use of otoacoustic emissions. Ear Hear 1990; 11 (02) 93-105
    CrossrefPubMedSuche in Google Scholar
  • 21 Amedee RG. The effects of chronic otitis media with effusion on the measurement of transiently evoked otoacoustic emissions. Laryngoscope 1995; 105 (06) 589-595
    CrossrefPubMedSuche in Google Scholar
  • 22 Yang EY, Stuart A. A method of auditory brainstem response testing of infants using bone-conducted clicks. J Speech Lang Pathol Audiol 1990; 14: 69-76
    Suche in Google Scholar
  • 23 Stuart A, Yang EY, Stenstrom R. Effect of temporal area bone vibrator placement on auditory brain stem response in newborn infants. Ear Hear 1990; 11 (05) 363-369
    CrossrefPubMedSuche in Google Scholar
  • 24 Cone-Wesson B. Bone-conduction ABR. Am J Audiol 1995; 4: 14-19
    CrossrefSuche in Google Scholar
  • 25 Greenhouse SW, Geisser S. On the methods in the analysis of provide data. Psychometrika 1959; 9: 95-112
    CrossrefSuche in Google Scholar
  • 26 Vassarstats. Significance of the difference between the areas under two independent ROC curves. Accessed August 1, 2023 at: http://vassarstats.net/roc_comp.html
  • 27 Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000; 45 (1-2): 23-41
    CrossrefPubMedSuche in Google Scholar
  • 28 Aithal S, Aithal V, Kei J, Anderson S. Wideband absorbance in ears with retraction pockets and cholesteatomas: a preliminary study. J Am Acad Audiol 2020; 31 (10) 708-718
    Thieme ConnectPubMedSuche in Google Scholar
  • 29 Aithal V, Aithal S, Kei J, Anderson S, Wright D. Predictive accuracy of wideband absorbance under ambient and tympanometric peak pressure conditions in identifying children with surgically confirmed otitis media with effusion. J Am Acad Audiol 2020; 31 (07) 471-484
    PubMedSuche in Google Scholar
  • 30 Aithal V, Kei J, Driscoll C, Murakoshi M, Wada H. Effects of ear canal static pressure on the dynamic behaviour of outer and middle ear in newborns. Int J Pediatr Otorhinolaryngol 2016; 82: 64-72
    CrossrefPubMedSuche in Google Scholar
  • 31 Sangster L. Critical review: can wideband energy reflectance be used in newborn hearing screening to detect transient middle ear dysfunction and to interpret screening results?. University of Western Ontario; 2012
    Suche in Google Scholar
  • 32 Vander Werff KR, Prieve BA, Georgantas LM. Test-retest reliability of wideband reflectance measures in infants under screening and diagnostic test conditions. Ear Hear 2007; 28 (05) 669-681
    CrossrefPubMedSuche in Google Scholar
  • 33 Hunter LL, Tubaugh L, Jackson A, Propes S. Wideband middle ear power measurement in infants and children. J Am Acad Audiol 2008; 19 (04) 309-324
    Thieme ConnectPubMedSuche in Google Scholar
  • 34 Aithal V, Aithal S, Kei J, Anderson S, Wright D. Predictive accuracy of wideband absorbance at ambient and tymppanometric peak pressure conditions in identifying children with surgically confirmed otitis media with effusion. J Am Acad Audiol 2020; 31 (07) 471-484
    PubMedSuche in Google Scholar
  • 35 AlMakadma H, Aithal S, Aithal V, Kei J. Use of wideband acoustic immittance in neonates and infants. Semin Hear 2023; 44 (01) 29-45
    Thieme ConnectPubMedSuche in Google Scholar
  • 36 Clinical Guidance Document Assessment of Hearing in Infants and Young Children. American Academy of Audiology Assessment of Hearing in Infant and Young Children 2020. Accessed January 2, 2024 at: https://www.audiology.org/wp-content/uploads/2021/05/Clin-Guid-Doc_Assess_Hear_Infants_Children_1.23.20.pdf
  • 37 Turner RG, Nielsen DW. Application of clinical decision analysis to audiological tests. Ear Hear 1984; 5 (03) 125-133
    CrossrefPubMedSuche in Google Scholar
  • 38 Aithal S, Aithal V, Kei J, Driscoll C. Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia. J Am Acad Audiol 2012; 23 (09) 673-685
    Thieme ConnectPubMedSuche in Google Scholar