Training in Wideband Tympanometry

Wideband tympanometry vs 226 Hz tympanometry in adults and children

10 mins
07 February 2022


Summary of: Keefe, D. H., & Simmons, J. L. (2003). Energy transmittance predicts conductive hearing loss in older children and adultsThe Journal of the Acoustical Society of America114(6 Pt 1), 3217–3238.

Wideband absorbance and acoustic admittance are useful tools in the study of middle-ear function in neonates, infants, older children and adults. Ambient-pressure wideband measures such as reflectance (or absorbance) are better indicators of conductive hearing loss and middle-ear dysfunction relative to standard 226-Hz tympanometry. As such, the use of a single frequency as in conventional tympanometry is not optimal for studying middle-ear function at all the frequencies that are important for human auditory communication. Further, wideband measures of middle-ear function are sensitive to otitis media, otosclerosis, ossicular discontinuity, and tympanic membrane perforation. Finally, wideband tympanometry (absorbance over a range of pressure) contains information that is absent in ambient pressure absorbance. This study compares the performance of 226-Hz tympanometry, wideband tympanometry (WBT), and ambient-pressure absorbance (WBA) in the prediction of conductive hearing loss in 42 normal-hearing ears and 18 ears with a conductive hearing loss across a group comprised of adults and older children above the age of 10 years. Using a fixed specificity of 90%, WBT is most sensitive (94%) followed by WBA (72%) and finally peak compensated 226-Hz tympanometry (28%). The area under the receiver operating characteristic (ROC) curve (where 0.5 represents chance and 1.0 is perfect performance), WBT achieves a 0.95 and WBA a 0.9, which indicates that wideband measures of absorbance both pressurized and ambient are better predictors of conductive hearing loss relative to conventional tympanometry. These results suggest that wideband measures of middle-ear function, as is possible via the Titan, improve clinical diagnostics related to conductive hearing loss over conventional tympanometry.


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