A Comparison of Audiometry and Audiometry With Tympanometry to Determine Middle Ear Status in School-Age Children

2002 ◽  
Vol 18 (5) ◽  
pp. 287-292 ◽  
Author(s):  
Norma J. Yockel
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
School Age Children ◽  
Elementary Children ◽  
School Age ◽  
Fluctuating Hearing Loss

Otitis media with effusion is the most common cause of fluctuating hearing loss in children. Pure-tone audiometry is the current mandated standard to determine hearing loss in public-school children in most states. Students who fail pure tone audiometry are at risk for otitis media with effusion because it is asymptomatic. Tympanometry, which assesses middle ear status, is used to detect hidden otitis media with effusion. This longitudinal study evaluated pure tone audiometry and tympanometry in preschool and elementary children ( n = 141). Results found 12 children (23 ears) who failed either a second threshold or tympanometry. The study also showed that a greater number of ears were identified with otitis media with effusion ( n = 19) by using pure tone audiometry and tympanometry than by using pure tone audiometry alone ( n = 4).

Auditory Brainstem Responses in Children with Otitis Media with Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 200-206 ◽  
Author(s):  
Thomas J. Fria ◽  
Diane L. Sabo
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
School Age Children ◽  
School Age ◽  
Conductive Hearing

Auditory brainstem responses (ABR) were recorded in 14 infants and toddlers and 12 school-age children with a previous history of recurrent otitis media with effusion (OME), or otoscopic and tympanometric evidence of persistent OME, or both. ABR tests were performed immediately before and after myringotomy and tympanostomy tube insertion in the younger subjects. For the school-age children, ABR tests were performed following otoscopy, tympanometry, and pure tone audiometry. The results demonstrate that the latency of both wave I and wave V of the ABR was sensitive (82% and 100%, respectively) to the presence of OME. Wave I also identified the absence of OME (specificity = 100%) whereas wave V did not (specificity = 25%). ABR latency was significantly decreased postoperatively in ears found to have OME, but not in ears found to have no OME. In the school-age subjects the ABR was used to predict the conductive hearing loss at 4000 Hz with less than a 20 dB error in virtually all subjects. The ABR latency delay was also found to be related to conductive hearing impairment at lower pure tone frequencies and to the average conductive loss at a variety of pure tone frequencies. Predictions of the presence of a conductive hearing loss from these relationships promise to be impressively accurate. The results suggest that the ABR can be a valuable tool for detecting the presence of conductive hearing impairment in infants and young children suspected to have OME and perhaps as an estimate of the degree of impairment.

scholarly journals A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Operative Findings

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

2006 ◽  
Vol 121 (3) ◽  
pp. 219-221 ◽  
Author(s):  
H Yasan
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Stapes Footplate ◽  
Predictive Role ◽  
Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

Impedance Bridge (Tympanometer) As a Screening Device in Schools

PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 472-472
Author(s):  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Pure Tone ◽  
School Health ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Middle Ear Effusion ◽  
Screening Programs ◽  
Ear Effusion ◽  
Impedance Bridge

STATEMENT OF PROBLEM There is confusion in schools about the proper use of the impedance bridge. Some groups recommend its use as a substitute for audiometry and suggest physician referral on the basis of an abnormal tympanogram. In our opinion this is inappropriate. BACKGROUND The impedance bridge primarily detects asymptomatic middle ear effusion. This effusion may cause a conductive hearing loss (rarely greater than 20 to 30 dB). There is no consensus as to the advisability of treating this effusion, because it usually remits spontaneously within 2 to 3 months. RECOMMENDATIONS The Committee on School Health recommends that (1) the impedance bridge should not be used in mass screening programs for the detection of hearing loss or middle ear effusion; (2) the impedance bridge may be used in the school setting only as an aid in the diagnosis of individual children who are at high risk for, or who are suspected of having, otitis media with effusion; (3) hearing screening by pure-tone audiometry be used as the primary method of detection of hearing loss in school children; (4) the impedance bridge not be used as a replacement for audiometric screening, because it will not detect sensory neural hearing loss and may lead to overreferral of children with asymptomatic middle ear effusion; (5) any persistent abnormality detected by either the impedance bridge or pure-tone audiometry should result in a prompt referral to the child's pediatrician.

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

scholarly journals Impact of adenotonsillectomy on hearing profile of children with chronic middle ear effusion

2018 ◽  
Vol 5 (4) ◽  
pp. 1377
Author(s):  
Febin James ◽  
Josmy George ◽  
Regina M.
Keyword(s):  
Hearing Loss ◽  
Standard Deviation ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Age Group ◽  
Middle Ear Effusion ◽  
Adenotonsillar Hypertrophy ◽  
Ear Effusion

Background: Chronic middle ear effusion (CME) also known as otitis media with effusion (OME)/glue ear/secretory otitis media is the commonest cause of hearing loss in children, characterized by presence of sterile serous fluid within the middle ear, causing temporary and reversible hearing loss. The aim of present investigation was to determine the effect of adenotonsillectomy on hearing profile of children with persistent OME.Methods: This prospective study was conducted in the Department of ENT, Aarupadai Veedu Medical College, Pondicherry during the period of June 2014 to February 2016. 50 children, between the age group of 3-12 years, with features suggestive of OME, and adenotonsillar hypertrophy that underwent adenotonsillectomy during the study period was included in this study. Demographic details and clinical features were collected from the participants. Hearing evaluation was performed by pure tone audiometry (PTA) and tympanometry preoperatively at time of diagnosis and postoperatively at 6 weeks and 3 months after adenotonsillectomy. Data collected was plotted into master chart and analysed using paired t-test and chi square test to determine the improvement in hearing after 6 weeks and 3 months following surgery.Results: 46 children aged between 3 and 12 years with a mean age of 5.3 and standard deviation of 2.2 years. OME was most prevalent in age group was 5-7 years (34.78%) followed by 7-9 years (30.43%). There were 26 (56.52%) males and 20 (43.47%) females. Pre-operatively most of the subjects were having moderate conductive hearing loss (between 26dB to 40dB) with a mean hearing loss of 34.2dB and a standard deviation of 12.2dB. At 6 weeks postoperatively, hearing loss of children were within 16-25dB with a mean loss of 21.6dB and a standard deviation of 6.4dB. At 3 months postoperatively, 30 children were having only minimal hearing loss and 8 were having mild hearing loss.Conclusions: CME is a common cause of childhood hearing loss having a long-term sequel affecting the language development of the child. Adenoidectomy can improve the middle ear function and the hearing profile of child and can be considered as a practical management option in children with chronic adenotonsillar hypertrophy with established otitis media with effusion.

scholarly journals Otological and audiological manifestations in cleft lip and cleft palate children: a clinical study

2015 ◽  
Vol 1 (1) ◽  
pp. 7 ◽  
Author(s):  
Vijayalakshmi Subramaniam ◽  
Manuprasad S ◽  
Hebin H. Kallikkadan ◽  
Vijay Kumar K
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Cleft Lip ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
College Hospital ◽  
Orofacial Region

<p class="abstract"><strong>Background:</strong> Cleft lip and cleft palate are the commonest congenital anomalies of the orofacial region. The<strong> </strong>incidence of middle ear problems and hearing loss is reported to be higher in children with cleft palate &amp;/or cleft lip.</p><p class="abstract"><strong>Methods:</strong> A prospective, observational case-control study comprising 80 subjects (40 cases and 40 controls) was undertaken at Yenepoya Medical College Hospital, Mangalore, Karnataka, India. All subjects enrolled were subjected to detailed ENT examination including otoscopy, pure tone audiometry and impedance audiometry.  </p><p class="abstract"><strong>Results:</strong> Retracted tympanic membrane suggestive of Otitis Media with Effusion (OME) and conductive hearing loss was observed in more than 50% of patients with cleft palate &amp;/or cleft lip. Tympanogram of B type suggesting OME was observed in 27% of cases. Chronic otitis media was observed in 32.5% of cases.</p><strong>Conclusions:</strong> The prevalence of OME, Chronic otitis media and hearing loss was observed to be higher among children with cleft palate &amp;/or cleft lip. Otological and audiometric assessment should be performed for all patients having cleft palate &amp;/or cleft lip atleast before surgery in order to facilitate early identification and intervention for middle ear problems particularly middle ear effusion.

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

Effects of Platelet Activating Factor on the Tubotympanic Mucosa and Inner Ear in the Guinea Pig

1998 ◽  
Vol 107 (10) ◽  
pp. 876-884 ◽  
Author(s):  
Yoshiharu Ohno ◽  
Yoshihiro Ohashi ◽  
Hideki Okamoto ◽  
Yoshikazu Sugiura ◽  
Yoshiaki Nakai
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Platelet Activating Factor ◽  
Sensorineural Hearing ◽  
Ciliary Activity ◽  
Middle Ear Mucosa

The effect of platelet activating factor (PAF) was studied to elucidate its role in the pathogenesis of otitis media and sensorineural hearing loss. The PAF alone did not induce a reduction of ciliary activity of the cultured middle ear mucosa. However, a dose-dependent decrease in ciliary activity was observed in the presence of the medium containing both PAF and macrophages. Intravenous injection of PAF did not induce dysfunction of the mucociliary system or morphologic changes of epithelium in the tubotympanum, but cytoplasmic vacuolization and ballooning were observed in the inner ear within 1 hour after injection of PAF. In contrast, intratympanic injection of PAF induced mucociliary dysfunction and some pathologic changes in the tubotympanum. Intratympanic inoculation of PAF induced no pathologic findings in the inner ear. These results suggest that PAF is at least partially involved in the pathogenesis of certain middle ear diseases such as otitis media with effusion. Additionally, PAF might be involved in the pathogenesis of some types of unexplained sensorineural hearing loss.

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