No abstract available.
Acoustic Impedance Tests*

Background: The Philippine National Ear Institute (PNEI) was created to promote health of hearing and balance among Filipinos. Over the years, it has provided audiologic services to thousands of patients annually and has published relevant hearing and balance research. Objective: To describe the patients served by the PNEI in terms of age, region of origin, occupation, pretest diagnosis, and audiologic results. Methods: Study Design - Cross-sectional study Setting - National tertiary care center Population - All records of patients referred for audiologic testing at PNEI in 2006 were reviewed and encoded into analyzable format. Results: A total of 1,756 patients had audiologic records for review. Median age was 32.5 years, with the age distribution presented according to sex, type of tests done including common reasons for referral, and median threshold levels by frequency. Coverage was national in scope, with most patients coming from the National Capital Region and from Regions III and IVa. Occupation was indicated in 37.8 percent of the working age group, most of whom were unemployed. The most common pretest diagnosis was chronic otitis media (26.6 percent), followed by hearing loss of unknown etiology (13.0 percent) and tinnitus (9.3 percent). Severity of hearing impairment based on pure tone audiometry was variable, and was presented according to common diagnoses. About 39 percent of hearing impairment cases were sensorineural, 36 percent conductive and 25 percent due to mixed defect. Bilateral Type A ears were found in 45.4 percent of patients by tympanometry, while 29.3 percent were bilateral Type B. For otoacoustic emissions, 69.0 percent were labeled as "refer" in at least one ear. Conclusion: The PNEI is a major national referral center for audiology that holds much promise in developing programs for national surveillance of the hearing status of different sectors in Philippine society. (Author)
HEARING AUDIOLOGY ACOUSTIC IMPEDANCE TESTS OTITIS MEDIA

We present a case report of primary middle ear lipoma diagnosed in right ear of a 25-month-old girl with right otitis media. We identified injection and retraction at right ear drum. Impedance tympanometry of right ear was type B and temporal bone CT was suggestive of a congenital cholesteatoma. During the tympanoplasty, a mass of tissue obstructing the eustachian tube orifice was noted in the middle ear. We have treated a case of a lipoma that originated from the middle ear; only 5 such cases have been reported worldwide.
Acoustic Impedance Tests ; Cholesteatoma ; Ear ; Ear, Middle ; Electric Impedance ; Eustachian Tube ; Lipoma ; Otitis Media ; Preschool Child ; Temporal Bone ; Tympanoplasty

BACKGROUND AND OBJECTIVES: Impedance audiometry is a clinically useful method for measuring the physical volume of pneumatized middle ear and mastoid medial using a hermetically sealed probe tip. This study was performed to evaluate the obstructive pathologies of middle ear and mastoid by measuring their volumes in patients of chronic otitis media. MATERIALS AND METHODS: The volume of middle ear and mastoid was measured in 37 ears with dry eardrum perforation by chronic otitis media. For control, we measured the volume in 23 ears with the traumatic tympanic membrane perforation. A comparison was made between the volumes and pneumatization in the mastoid X-ray, the soft tissue density in the computed tomography of temporal bone, and the obstruction site at operative findings. RESULTS: The mean volume of the traumatic tympanic membrane perforation was 6.75+/-0.42 ml. The mean volume of chronic otitis media was 3.36+/-2.19 ml and the volume of the sclerotic group was significantly smaller than that of the pneumatic group in the mastoid X-ray. The pathological group had significantly smaller volume than the non-pathological group at operative findings. CONCLUSIONS: The impedance audiometry enables a rapid and valuable evaluation of the presence or absence of obstructive pathologies in the middle ear and mastoid in chronic otitis media with dry tympanic perforation.
Acoustic Impedance Tests* ; Ear ; Ear, Middle ; Electric Impedance* ; Humans ; Mastoid ; Otitis Media* ; Otitis* ; Pathology* ; Temporal Bone ; Tympanic Membrane Perforation

BACKGROUND: This study investigated the prevalence of tinnitus and relationship between tinnitus and hearing disturbance of workers with noise-induced hearing loss. METHODS: One hundred thirty three workers with noise-induced hearing loss responded to a self-admiministered questionaire concerning tinnitus, present symptoms and past medical history. Also pure tone audiometry, tympanometry and otoscopic examination was done. RESULTS: The prevalence of tinnitus was 54.14%. There were no significant difference in the prevalence of tinnitus according to age, symptoms (fatigue, sleep disturbance and dizziness), duration of noise exposure, wearing of ear protector, and duration of self-reported hearing difficulty. However, the location of more serious tinnitus was significantly associated with subjective hearing disturbance. CONCLUSION: In hearing conservation program of workers with noise-induced hearing loss, tinnitus management has to be considered as an essential part of the program.
Acoustic Impedance Tests ; Audiometry ; Ear ; Hearing ; Hearing Loss, Noise-Induced* ; Noise ; Prevalence ; Tinnitus*

OBJECTIVES: The aim of this study was to establish the rate variation of sonotubometric measurements using a specific broadband class of signals, the so-called perfect sequences (PSEQ) among healthy adults and to identify an optimal and technically simple test to provoke Eustachian tube (ET) openings. METHODS: Sonotubometry was performed on 105 healthy adult subjects. Three different consecutive maneuvers were performed for ET opening: dry swallowing, water swallowing (a small [2 mL] and a large [5 mL] water bolus). Values of the amplitude and duration of each measured ET opening were calculated. RESULTS: A total of 6,300 measurements were performed. Sonotubometric ET openings were detected for all subjects but not for each measurement. In 6,180 of 6,300 measurements (98.1%), objective ET openings were registered. In 11 of 105 subjects (10.5%) at least one sonotubometric ET opening was not detected. The mean ET opening duration time and the mean sound amplitude similar for all performed test and were 270 (SD, ±96) msec, 13.48 (SD, ±6.57) dB. CONCLUSION: Sonotubometry based on PSEQ stimuli is a reliable methodology to assess the ET opening function in healthy subjects. Mean ET opening duration time and the mean sound wave amplitude performed similarly in all analysed tests, hence it might be concluded that dry (saliva) and water swallowing are reliable sonotubometric maneuvers and may be used when examining ET opening function. The size of a sip during water swallowing does not affect the sonotubometry result. All maneuvers can be equally used as the optimal test, and water swallow is most comfortable for the subject.
Acoustic Impedance Tests ; Adult* ; Deglutition ; Eustachian Tube* ; Healthy Volunteers ; Humans ; Sound ; Water

Tinnitus is a common auditory phenomenon associated with many otological diseases, and is usually subjective. Objective tinnitus can be generated by para-auditory structures, usually derived from vascular or myogenic sources, or the eustachian tube. We present a rare case of intermittent unilateral tinnitus associated with eye blinking. Otoendoscopic examination showed that the external auditory canals and tympanic membranes were normal; however, rhythmic movements of both tympanic membranes, concomitant with the tinnitus, were evident whenever the patient blinked. The tympanometry and stapedial reflexes measured via impedance audiometry exhibited saw-tooth patterns; movement of the tympanic membrane was associated with eyelid blinking. The patient was managed conservatively, with reassurance and medication, and the condition became well-controlled. Here, we present this educational case and review the literature.
Acoustic Impedance Tests ; Blinking* ; Ear Canal ; Ear Diseases ; Eustachian Tube ; Eyelids ; Humans ; Reflex ; Tinnitus* ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: This paper aimed at evaluating the characteristics of high-frequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group. SUBJECTS AND METHODS: Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0–104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram. RESULTS: The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group. CONCLUSIONS: There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.
Acoustic Impedance Tests* ; Acoustics ; Ear, Middle ; Female ; Humans ; Infant, Newborn* ; Male

OBJECTIVETo evaluate the fluid in middle ear of otitis media with effusion (OME) by tympanometry, hearing threshold and in order to an effective and promptly way for treatment.

METHODSForty Patients (75 ears) with OME were collected since January 2007 to June 2008. The history of hearing loss, hearing threshold, CT results and the final fluid in the middle ear during operation were analyzed.

RESULTSThere were 28 males and 12 females enrolled in this study. The average age of the patients was 78 months. All the 75 ears were with type "B" according to tympanometry test. For all the patients myringotomy was performed and the ventilation tubes were placed in 23 ears. Among all the ears, there were fluid in 62 ears (82.7%) and no fluid in 13 ears (17.3%). There was correlation between the levels of hearing loss, CT results and the fluid in middle ear (P < 0.05).

CONCLUSIONSTympanometry and hearing threshold results should have a better sensitivity and specificity rates for diagnosis of OME.

OBJECTIVESSonotubometry is wildly used in developed countries, offers a easy, versatile and objective way to assess the function of Eustachian tube. The objectives of this study are to develop a low-cost digitalized device.

METHODSThe digitalized sonotubometry device was made of a personal computer with sound input and output accessories. The PC sound card, connected to a signal amplifier, exported probe band noise, while feedback sound was collected by a microphone. All 36 volunteers (72 ears) were involved in the sonotubometry test with JK-04A and CHN-08, in the conditions of dry-swallowing and wet-swallowing. The data were statistically analyzed using SPSS 13.0.

RESULTSThe basic electroacoustic performance of the CHN-08 was acceptable. CHN-08 (7 kHz) detection and JK-04A consistency of kappa index was 0.472; CHN-08 (8 kHz) and JK-04A consistency of kappa index was 0.487; CHN-08 (7 kHz) and CHN-08 (8 kHz) consistency of kappa index was 0.688.Under the JK-04A, CHN-08 (7 kHz) and CHN-08 (8 kHz) three setups, Eustachian tube opening frequency was significantly lower for wet-swallowing than dry-swallowing, P < 0.05.

CONCLUSIONSA low-cost digitalized sonotubometry is successfully developed. Its electroacoustic performance proved acceptable by authority assessments. The detection rate of CHN-08 is in accordance with that of JK-04A moderately. The study revealed that Eustachian tube is opened more easily by dry-swallowing than by wet-swallowing.