Objective:To explore the feasibility of the multiple-choice auditory graphical interactive check（MAGIC） screening module in childhood hearing screening in children aged 3 to 6 years. Methods:A hearing screening was conducted on 366 children（732 ears） aged between 3 and 6 years. The screening methods included MAGIC, DPOAE, and acoustic immittance.The cooperation, screening time, pass rate, and correlation of the three screening methods were compared. Results:There was a statistically significant difference in the degree of cooperation among the three screeningmethods（P=0.004）.The MAGIC pure tone screening method was 98.6%, the screening DPOAE was 99.5%,and the acoustic immittance screening was 100%. For the screening duration, the MAGIC pure tone screening method was（116.3±59.1）s, the screening DPOAE was（27.2±19.7）s, and the acoustic impedance screening was（24.6±14.6）s. There was a significant statistical significance differences among the three or two groups（P<0.01）. The passing rates of MAGIC pure tone screening,screening DPOAE and acoustic immittance screening were 64.7%, 65.4%, and 69.3%, respectively, and there was no significant statistical difference among the three or two groups（P>0.05）. There was no significant difference between MAGIC pure tone screening method and screening DPOAE（P=0.827>0.05）, and acoustic impedance（P=0.653>0.05）, while the difference between screening DPOAE and acoustic impedance was statistically significant（P<0.01）. Conclusion:MAGIC pure sound screening method has good feasibility, can comprehensively reflect the hearing level of screened children, and can be promoted for hearing screening in children aged between 3 and 6 years.
Humans ; Child, Preschool ; Child ; Female ; Male ; Audiometry, Pure-Tone ; Mass Screening/methods* ; Feasibility Studies ; Acoustic Impedance Tests/methods* ; Hearing Loss/diagnosis* ; Hearing Tests/methods*

Objective: This study was to investigate the main characteristics and related factors of wideband absorbance (WBA) in children with normal hearing and to obtain age-specific reference range of WBA. Methods: 384 children between 0-12 years old (615 ears) who visited the Beijing Children's Hospital, Capital Medical University from October 2019 to February 2021 were enrolled, including 230 males (376 ears) and 154 females (239 ears), with totally 306 left ears and 309 right ears. Wideband tympanometry (WBT) was performed and normative WBA data were analyzed by SPSS 24.0 statistical software. Repeated measures and multivariate analysis of variance were applied to the data from 16 points at 1/3-octave frequencies (226, 324, 408, 500, 667, 841, 1 000, 1 297, 1 682, 2 000, 2 670, 3 364, 4 000, 5 339, 6 727 and 8 000 Hz) to evaluate the effects of frequency, age, external auditory canal pressures, gender and ear on WBA. Results: According to the WBT frequency-absorbance curve, the subjects were divided into seven groups: 1-month old group, 2-month old group, 3-month old group, 4-5 month old group, 6-24 month old group,>2-6 year old group and>6-12 year old group. The WBA of normal-hearing children underwent a series of developmental changes with age at both ambient pressure and tympanometric peak pressures. WBA results for 1-month group and 2-month old group exhibited a multipeaked pattern, with the peaks occurring around 2 000 and 4 897 Hz, and a notch around 3 886 Hz. WBA results for 3-month group and 4-5 month old group exhibited a single broad-peaked pattern, with the peak occurring between 2 000-4 757 Hz. The WBA of 1-month old group to 4-5 month old group decreased gradually at low frequency (226-408 Hz) and 6 727 Hz, and increased at middle to high frequency (2 670-4 000 Hz). The WBA of 6-24 month old group were significantly lower than that of 2-month old group to 4-5 month old group at all frequencies except 3 364 and 4 000 Hz. WBA results for 6-24 month old group,>2-6 year old group and>6-12 year old group exhibited a single-peaked pattern, and the peak frequency of WBA moved to the lower frequency successively. From 6-24 month old group to>6-12 year old group, the WBA gradually increased at low to middle frequencies (667-2 670 Hz) and 8 000 Hz, and decreased at middle to high frequencies (3 364-5 339 Hz). Among the 16 frequencies of all age groups, the difference between WBA under ambient pressure and tympanometric peak pressure were -0.09-0.06, and 43.75%-81.25% frequency points had statistically significant difference, which was mainly manifested in that WBA under ambient pressure were lower than that under tympanometric peak pressure at 226-1 682 Hz. There was no significant ear effect on all of the age groups. Similarly, there was no significant gender effect except for 3-month old group and 4-5 month old group. Conclusions: The WBA of normal-hearing children measured at ambient pressure and tympanometric peak pressure varied across the frequencies with age from 1 month to 12 years old, and different frequencies followed different change patterns (increase vs. decrease) in WBA. There was also significant external auditory canal pressures effect on all of the age groups. The establishment of age-specific reference range of WBA for 0-12 years old normal-hearing children in this study would be useful for clinical practice of determining normative data regarding WBT.
Male ; Female ; Humans ; Child ; Infant, Newborn ; Infant ; Child, Preschool ; Cross-Sectional Studies ; Acoustic Impedance Tests/methods* ; Ear ; Reference Values ; Ear Canal

BACKGROUND AND OBJECTIVES: Pre-operative eustachian tube function (ETF) is an important factor for the postoperative success after tympanoplasty, though much debates have been reported. In this study, we investigated the tympanogram changes after tympanoplasty, indirectly checking up ETF, to find out the relationship between tympanogram changes and associated factors of tympanoplasty. SUBJECTS AND METHOD: Included in this study were 238 cases of tympanoplasty (canal wall up mastoidectomy with tympanoplasty type I or tympanoplasty type I only) performed by one surgeon for chronic otitis media from January, 2012 to June, 2017. In all cases, tympanometric tests were undertaken at one month, three month, six month, and one year post-operatively, and pure tone audiometry tests were taken at 1 year, post operatively. RESULTS: The average hearing level and air-bone gap were 41.8±19.7 dB, and 17.1±9.3 dB, pre-operatively, and 29.9±21.1 dB, and 6.9±8.5 dB, 1 year post-operatively, respectively. Most of the cases showed improvement in hearing. The results of tympanometry showed that hearing improvement was greater for the A type than for the B or C type (p<0.001). The smaller the size of the tympanic membrane was, the higher, the type A tympanogram appeared to be (p=0.008). CONCLUSION: The estimation of pre-operative ETF using post-operative tympanogram changes can give insight to the degree and process of recovery of the normal middle ear after tympanoplasty.
Acoustic Impedance Tests ; Audiometry ; Ear, Middle ; Eustachian Tube ; Hearing ; Methods ; Otitis Media ; Otitis ; Prognosis ; Tympanic Membrane ; Tympanoplasty

BACKGROUND AND OBJECTIVES: To evaluate the usefulness of wideband tympanometry in predicting middle ear disorders by comparing the absorbance measurements of the disorder and the norm. SUBJECTS AND METHOD: Wideband tympanometry, pure tone audiometry, and endoscopic examination were performed on 284 ears of 190 subjects. Wideband absorbance (WBA) was measured from normal ears (adults: 128 ears, children: 32 ears), disorders of middle ear included effusion (adults: 24 ears, children: 21 ears), tympanic membrane (TM) retraction (adults: 26 ears, children: 6 ears) and perforation (47 adult ears). RESULTS: The normative data of WBA were similar to previous reports from other countries. WBA of the 17-29 age group showed higher values than other age groups at 1600-3150 Hz. Men had higher absorbance at low frequencies whereas women had higher absorbance at high frequencies. There was a significant gender difference at 4000 Hz. Adults showed higher absorbance at 1000, 1250, and 1600 Hz and lower absorbance at 2500, 3150, and 4000 Hz than children did at those respective frequencies. Compared to the normal group, WBA was decreased at all frequencies by more than 500 Hz in ears with middle ear effusion and at most frequencies by less than 2000 Hz in ear with TM retraction. TM perforation showed higher absorbance in low frequencies; the absorbance decreased as the size of perforation increased. CONCLUSION: The present study established normative WBA data and the results showed comparable statistics to former studies in age and gender difference. WBA provided a high reliability in discrimination of middle ear effusion and TM retraction. WBA is a simple, non-invasive and useful diagnostic tool for middle ear disease.
Acoustic Impedance Tests ; Adult ; Audiometry ; Child ; Discrimination (Psychology) ; Ear ; Ear, Middle* ; Female ; Humans ; Male ; Methods ; Otitis Media with Effusion ; Tympanic Membrane ; Tympanic Membrane Perforation

BACKGROUND AND OBJECTIVES: This study aimed to verify and compare the results of newborn hearing screening (NHS) with that of 1000 Hz tympanometry conducted for newborns. SUBJECTS AND METHOD: For the hospitalized group, NHS and the portable 1000 Hz tympanometry were performed for 148 newborns (296 ears) from June through October in 2015. For the outpatient group, 93 newborns (186 ears) who had been referred after the 1st NHS results were reviewed from 2009 to 2014. We conducted NHS with the automated otoacoustic emissions for healthy babies and automated auditory brainstem response for the babies in the neonatal intensive care unit (NICU). NHS and 1000 Hz tympanometry were performed for all newborns simultaneously. For the impedance audiometry, B type was categorized separately from A and C type. RESULTS: There was a significantly higher incidence of B type of tympanometry in the referred newborns compared to the other newborns in both hospitalized and outpatient group (p<0.01). In the outpatient group, the ears referred from the 1st NHS showed middle ear effusion in 100% of the well babies and 78.6% of the NICU babies. CONCLUSION: 1000 Hz tympanometry can help estimate the causes and middle ear function of the referred newborns after the hearing screening test. Parents could feel relieved by being explained that the refer result of NHS was due to middle ear or ear canal problem rather than to inner ear or neural problem.
Acoustic Impedance Tests* ; Ear ; Ear Canal ; Ear, Inner ; Ear, Middle ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing* ; Humans ; Incidence ; Infant, Newborn* ; Intensive Care, Neonatal ; Mass Screening* ; Methods ; Neonatal Screening ; Otitis Media with Effusion ; Outpatients ; Parents

OBJECTIVE: To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan. METHOD: One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. RESULT: In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. CONCLUSION A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.
Acoustic Impedance Tests ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Otitis Media with Effusion ; diagnosis ; Sensitivity and Specificity

OBJECTIVE: To analyze the judgement standard and evaluate the diagnostic value of the low frequency and high frequency tympanometry in infants with otitis media. METHOD: Tympanograms for admittance with 226 Hz and 1 000 Hz probe tones and resonant frequency were obtained from normal infants (195 cases, 321 ears) and infants with otitis media(122 cases, 171 ears). The mean, standard deviation, median, 5% quantile, 95% quantile and 95% confidence interval of peak admittance, gradient and resonant frequency were measured and calculated in different age groups. The significant differences of 1000 Hz peak admittance, 226 Hz peak admittance and gradient between normal infants and infants with otitis median were analyzed using SPSS 11.0. The false positive rate and the false negative rate of different age groups in infants with otitis media were evaluated according to such judgement standards as 1000 Hz peak admittance, 226Hz peak admittance or gradient. RESULT: The false positive rate and the false negative rate of the 1000 Hz probe tone tympanometry in infants with otitis media unter one year of age were 3.07% and 1.84% as the normal range of positive peak was more than 0.2 mmho. The false positive rate and the false negative rate of the 1000 Hz probe tone tympanometry in infants with otitis media aged 1-2 years and aged 2-3 years were 3.26%, 5.26% and 1.52%, 0.00% respectively,as the normal range of positive peak was more than 0.3 mmho. These was no significant difference in the gradient with 226 Hz probe tone between normal infants and infants with otitis median under one year of age. The false positive rate and the false negative rate of the 226 Hz probe tone tympanometry in infants with otitis media aged 1-2 years and aged 2-3 years were 44.57%, 31.58% and 16.67%, 6.67% respectively, as the gradient with 226 Hz probe tone was a judgement standard. CONCLUSION (1) The diagnostic accuracy of tympanometry with 1000 Hz probe tone for otitis media in infants younger than 3 years of age exceeded 226 Hz probe tone tympanometry, the 1000 Hz probe tone tympanometry is suggested to the evaluation of middle ear function in infants before 3 years. (2) It is reasonable that the normal range of positive peak is more than 0.2 mmho in infants unter one year of age and the normal range of positive peak is more than 0.3 mmho in infants aged 1-3 years.
Acoustic Impedance Tests ; methods ; statistics & numerical data ; Case-Control Studies ; Humans ; Infant ; Infant, Newborn ; Otitis Media ; diagnosis ; Reference Values

OBJECTIVE: To investigate on the Indication and quality of life of the canal wall up and canal wall down surgery in chronic suppurative otitis media, to provide reference for surgical options. METHOD: The clinical data of patients underwent canal wall up or canal wall down surgery are analyzed. Follow up on 312 patients are accomplished with pure tone audiometry, acoustic impedance for surgical cavity volume, ear endoscopy and the Chinese chronic ear survey (CCES). RESULT: (1) The dry ear rate of canal wall up and canal wall down surgery are 98.7% and 98.6% respectively (P > 0.05). (2) The average cavity epithelization and dry ear time are 40.1 +/- 21.2 days for canal wall up surgery and 53.5 +/- 15.0 days for canal wall down surgery (P < 0.05). The postoperative ear volume to the contralateral normal ear volume ratio are 1.16 +/- 0.10 for canal wall up surgery and 2.05 +/- 1.19 for canal wall down surgery (P < 0.05). (4) Score of the CCES: 91.2 +/- 6.8 points for canal wall up surgery and 72.0 +/- 7.7 for canal wall down surgery (P < 0.05). (5) The proportion of patients feeling change of ear appearance is 5.7% for canal wall up surgery and 80.8% for canal wall down surgery (P < 0.05). (6) Hearing after surgery: objective hearing improvement rate is 58.9% for canal wall up surgery and 24.2% for canal wall down surgery (P < 0.05) according to the questionnaire, while the pure tone audiometry shows no significant difference in hearing thresh hold and air-bone gap. (7) The satisfactory score after surgery is 9.55 points for canal wall up surgery and 8.11 points for canal wall down surgery (P < 0.05). CONCLUSION (1) Patients underwent canal wall up surgery have near-normal external ear morphology, shorter dry ear time and much higher quality of life compared to canal wall down surgery. (2) For experienced ear surgeon, the indication for canal wall up surgery can be extended to cases with diploetic or sclerotic type of mastoid and part of the cases with anatomical variation and intracranial or extracranial complications.
Acoustic Impedance Tests ; Audiometry, Pure-Tone ; Chronic Disease ; Ear Canal ; anatomy & histology ; surgery ; Follow-Up Studies ; Hearing ; physiology ; Hearing Tests ; Humans ; Otitis Media, Suppurative ; surgery ; Otologic Surgical Procedures ; methods ; Quality of Life ; Treatment Outcome

OBJECTIVE: This study aims at investigating tympanogram in newborns who passed hearing screening using 226 and 1 000 Hz probe tones in order to interpret the test results correctly and find out its clinical value in audiological evaluation and diagnosis in this population. METHOD: Tympanogram was conducted using 226 and 1000 Hz probe tones in 206 newborns between 2 and 7 days of age (3.92 +/- 1.24) in both ears that passed the DPOAE screening and without any of the high risk register (HRR) factors associated with hearing loss according to the Joint Committee on Infant Hearing in 2007. RESULT: The tympanogram results tested in 408 ear were as following: the percentage of single-peaked, double-peaked, and none-peaked tympanograms using 226 Hz were 52.20% (213 ears), 47.55% (194 ears) and 0.25% (1 ear) respectively. The percentage of single-peaked and other morphological type tympanograms using 1000 Hz were 94.85%(387 ears) and 5.15% (21 ears) respectively. The parameters of 1000 Hz single-peaked tympanogram in this study were as following: the average tympanometric peak pressure was 33.24 +/- 44.37 dapa, the average peak compensated static acoustic admittance was 0.52 +/- 0.25 mmho, the average tympanometric width for right and left ears were 121.38 +/- 28.79 and 108.63 +/- 26.00 dapa respectively with a statistically significant difference between them (P < 0.01). The average volume of ear canal (Vec, using 226 Hz probe tone) at boys and girls were 0.44 +/- 0.10 and 0.43 +/- 0.08 ml respectively with a statistically significant difference between them (P < 0.05). CONCLUSION The morphology of tympanogram using a 226 Hz probe tone in newborns usually includes two main types: single-peaked and double-peaked, while it is primarily the single-peaked tympanogram while using a 1000 Hz probe tone. It is more appropriate to use a 1000 Hz probe tone than 226 Hz when testing newborns' tympanogram. The parameters obtained in this study using 1000 Hz and 226 Hz could be tried and applied to interpret clinical tympanogram test results and evaluate middle ear function. However, more studies with bigger sample size are necessary in this field.
Acoustic Impedance Tests ; Ear, Middle ; physiology ; Female ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; methods

OBJECTIVE: To evaluate the diagnostic value of 226 Hz probe-tone tympanometry in infants with effusion in the middle ear. METHOD: Fifty-two infants aged 3 to 7 months were recruited as clinical subjects in a hearing-ability screening program. After a spiral computerized tomography (CT) scan, we tested their hearing using tympanometry of 226 Hz probe-tone frequency. We recorded the tympanograms and compared the tympanometric results with CT to get the concordance rate between tympanometry and CT diagnose. The date was analyzed by the statistic software SPSS16.0. RESULT: One hundred and four ears in 52 patients,CT tests showed normal in 47 middle ears, but middle ear effusion in 57 ears. Among normal 47 ears,24 ears were type "A" (51.06%), 1 ear type "B" (2.13%), 1 ear type "C" (2.13%), 21 ears type "D" (44.68%); among 57 ears with effusion, 44 ears was type "A" (77.19%), 2 ears type "B"(3.51%0), 11 ears type "D" (19. 30%); 226 Hz probe tone tympanograms and CT test results were consistent with lower rate, kappa=0.103. CONCLUSION In clinical practice, 226 Hz tympanometry should not be recommended to determine the presence of middle ear fluid or not in infants younger than 7 months.
Acoustic Impedance Tests ; methods ; Ear, Middle ; diagnostic imaging ; Female ; Humans ; Infant ; Male ; Otitis Media with Effusion ; diagnosis ; diagnostic imaging ; Tomography, Spiral Computed