听力正常新生儿1000Hz声导抗分析

目的 分析通过耳声发射(OAE)听力筛查正常新生儿1000 Hz声导抗测试的特点,为新生儿听力筛查及新生儿中耳功能的评估提供参考依据.方法 采用GSI-70型自动耳声发射听力筛查仪对新生儿进行听力筛查,将双耳通过OAE听力筛查的正常新生儿按照纳入标准选为研究对象,共650例(1300耳),然后采用GSI TympStar VersionⅡ中耳分析仪对该研究对象进行中耳功能测试,收集探测音为1000 Hz的鼓室导抗图及其相关指标,对图形进行分型并计算各指标的95％医学参考值范围.结果 将纳入的1300耳的鼓室导抗图分类,其中1Y1B1G型732耳(占56.3％)、1Y3B1G型145耳(占11.2％)、0Y0B0G型269耳(占20.7％)、其他154耳(占11.8％).其中声导纳图Y中单峰型有967耳,计算单峰型声导纳图Y各指标的95％医学参考值范围,其中鼓室图峰压(tympanometric peak pressure,Tpp)为- 55.0～180.0 daPa、峰补偿静态声导纳值(peak compensated static acoustic admittance,Peak Ytm)为0.03 ～1.18 mmHo、鼓室图宽度(tympanometric width,TW)为70.0～230.0 daPa.结论 通过OAE听力筛查的正常新生儿1000 Hz探测音的声导纳图Y以单峰型为主.1000 Hz探测音的单峰型声导纳图Y的Tpp、Peak Ytm、TW的95％医学参考值范围可作为新生儿听力筛查及新生儿中耳功能评估时的参考依据.     

正常新生儿226Hz及1000Hz探测音鼓室导抗测试

探讨通过瞬态诱发耳声发射(TEOAE)筛查的正常新生儿低频（226Hz）及高频（1000Hz）探测音鼓室导抗图的特点、获得峰声导纳值等指标的正常值范围,为临床新生儿及婴幼儿中耳功能评估和诊断提供依据。方法采用中耳分析仪（GSI-33型）对足月顺产,并通过TEOAE筛查的正常新生儿分别进行低、高频探测音下的鼓室导抗测试,分析鼓室导抗图形态特征并对峰声导纳值等重要数据进行统计。结果在100例首次双耳通过TEOAE筛查的新生儿鼓室导抗测试中,低频鼓室导抗图以双峰型为主（占96%）,高频鼓室导抗图以单峰型为主（占90%）;低频探测音鼓室导抗图为双峰型而其高频探测音鼓室导抗图为单峰型的有174耳（占总耳数87%）;低频及高频探测音鼓室导抗图均为单峰型的仅有6耳（占总耳数3%）。结论正常新生儿低频探测音鼓室导抗图以双峰型为主,高频探测音鼓室导抗图以单峰型为主,应将两者结合来对新生儿及婴幼儿中耳功能进行评估;所获得相应的峰声导纳值、峰声导纳值处外耳道压力、外耳道容积等指标的正常值可以用于初步评估新生儿中耳功能状态。     

High frequency immittance for neonates: a normative study

CONCLUSION: High frequency immittance measurements demonstrate promise in clarifying middle ear status for neonates but age- and gender-specific norms should be consulted. OBJECTIVE: To describe high frequency immittance measurements using a 1000 Hz probe tone for a sample of 278 neonatal ears (0-4 weeks of age) in order to compile normative tympanometric and acoustic reflex criteria. SUBJECTS AND METHODS: Assessment of neonatal ears included 1000 Hz probe tone immittance measurements (tympanograms and ipsilateral acoustic reflexes), and distortion product oto-acoustic emission (DPOAE) screening. Results were compared and normative values were compiled for immittance measures in ears controlled for normal middle ear functioning (n=250). RESULTS: Comparison of immittance results to OAE screening outcome provides estimates of sensitivity and specificity for middle ear fluid with tympanometry of 57% and 95%, and 57% and 90% for acoustic reflex presence, and 58% and 87% for combined tympanogram and acoustic reflex results, respectively. Normative data indicate that static peak admittance values differ significantly across gender and age with the 5th percentile cut-off value for the entire sample at 1.4 mmho. The 90% range of tympanic peak pressure normative values increases with increasing age from 140 daPa for neonates 1 week of age to 210 daPa for neonates 2-4 weeks of age. Acoustic reflexes were elicited at 93+/-9 dB with a 90% normality range of 80-105 dB.     

低频和高频探测音鼓室声导抗测试在婴儿中耳功能诊断中的作用

目的评价低频和高频探测音鼓室声导抗测试在诊断婴儿中耳功能异常中的作用。方法使用GSI Tympstar中耳分析仪，对年龄5—25周的听性脑干反应（auditory brainstem response，ABR）检查正常婴儿15例（30耳）和Ⅰ波潜伏期延长提示可能存在中耳功能异常婴儿17例（20耳），进行226、678、1000Hz探测音鼓室声导抗测试的比较。结果226Hz探测音鼓室声导纳图的静态声导纳值、图形、峰压和梯度在2组间的差异无统计学意义。678Hz探测音鼓室声导纳图、声纳图及声导图在2组中均可见无峰型、单峰型、双峰型、三峰型图形，其与ABR检查的一致率分别为70．0％、58．0％、64．0％，kappa值分别为0．324、0．234、0．118。1000Hz探测音鼓室声导纳图、声纳图及声导图在正常组中单峰型分别为28耳（93．3％）、25耳（83．3％）、26耳（86．7％），在异常组中无峰型分别为15耳（75％）、17耳（85％）、13耳（65％），其与ABR的一致率分别为90．0％、92．0％、86．0％，kappa值分别为0．783、0．831、0．690。结论1000Hz探测音鼓室声导抗测试是诊断小于25周婴儿中耳功能的较准确的检查方法，226、678Hz探测音鼓室声导抗测试则不能提供这些婴儿中耳功能的准确的信息。     

Test-retest reliability in tympanometry.

Test-retest reliability for tympanometric measures was evaluated across five sessions in 20 subjects with normal hearing and normal middle-ear function. Tympanograms were obtained on each ear for probe frequencies of 226, 678, and 1000 Hz using both ascending and descending directions of pressure change. Across all conditions, the tympanometric measure that consistently demonstrated the highest test-retest reliability was compensated static acoustic admittance. Test-retest correlations for peak compensated static acoustic admittance measures were higher than those for ambient measures across all probe frequencies and both directions of pressure change; the differences in correlations for peak and ambient measures, however, reached significance only for 226-Hz conditions. Across-session correlations for tympanogram width did not differ significantly for measures referenced to the lowest tympanogram tail and those referenced to +200 daPa.     

High- and Low-Frequency Probe Tone Tympanometry in Chinese Infants

Objective To assess the utility of low- and high-frequency tympanometry in the diagnosis of middle ear dysfunction in Chinese infants. Methods Tympanograms were obtained with 226 Hz, 678 Hz and 1000 Hz probe tones from infants aged 5-25 weeks with normal auditory brainstem responses (ABRs)(15 infants,30 ears) and withprolonged wave Ⅰ latencies(17 infants, 20 ears), suggesting middle ear dysfunction, using a GSI Tympstar middle ear analyzer Version Ⅱ. Results The single-peaked tympanogram was the most characteristic type in both groups and seen in 25 ears (83.3%) in the normal ABR group and in 18 ears (90%) in the delayed wave Ⅰ group, respectively. The peak pressure, peak compensated static acoustic admittance and gradient of 226 Hz tympanometry were of no significant differences between the two groups. The 678 Hz tympanograms of admittance, susceptance and conductance demonstrated non-peak, single-, double- and tri-peaked patterns in both groups. The agreement between ABRs and 678 Hz tympanograms of admittance,susceptance and conductance were 70.0%, 58.0% and 64.0%(kappa=0.324, 0.234 and 0.118) respectively. For 1000 Hz probe tone, admittance,susceptance and conductance tympanograms showed single peaked patterns in 28 (93.3%), 25 (83.3%) and 26 (86.7%) of the 30 normal ears. Admittance, susceptance and conductance tympanograms using the 1000 Hz probe tone were flat in 15 (75%), 17(85%) and 13 (65%) of the ears in infants with prolonged wave Ⅰ latencies. For 1000 Hz admittance, susceptance and conductance Tympanograms, the agreement between tympanometry and ABR results were 90.0%, 92.0% and 86.0% with kappa at 0.783, 0.831 and 0.690, respectively. Conclusion 1000 Hz probe tone tympanometry is a promising middle ear function test for infants of 1-6 months age, while 226 Hz and 678 Hz probe tones are less efficient in detecting middle ear dysfunction in infants.     

Tympanometric and acoustic-reflex studies in neonates

Tympanograms and acoustic reflexes for a broadband noise and for a 1000-Hz tone were measured in normal neonates. Notched tympanograms were typical of neonatal ears for a 220-Hz probe tone. A single-peaked tympanogram was most characteristic for a probe frequency of 660 Hz. Ipsilateral and contralateral acoustic reflexes were present more frequently for a 660-Hz probe tone compared to a 220-Hz probe tone, but acoustic-reflex thresholds were not significantly different between probe tones. As with adults, acoustic-reflex thresholds for the noise were significantly lower than for the tone, and ipsilateral reflex thresholds were lower than contralateral reflex thresholds. Reliability of acoustic-reflex and tympanometric measures was high. Age change from 2 to 4 days had no significant effect on tympanometric or acoustic-reflex characteristics. There was no apparent relation between tympanometric pattern and acoustic-reflex characteristics.     

足月正常新生儿多频探测音鼓室声导抗正常值测定

目的：探讨正常新生儿多频探测音鼓室声导抗图的图型、声导纳值、声纳值和声导值的正常范围。方法：使用GSI-33中耳分析仪,对足月顺产并通过瞬态诱发性耳声发射和畸变产物耳声发射筛查的新生儿55例（110耳）进行226、6781、000 Hz探测音鼓室声导抗测试,对比分析各种探测音鼓室声导抗的图形,声导纳值、声纳值和声导值,并进行统计学分析。结果：226 Hz探测音鼓室声导纳图、声纳图和声导图以双峰型为主,分别占90.0%、99.1%和85.5%,少数为单峰型,无多峰型出现;678 Hz探测音鼓室声导纳图、声纳图和声导图以单峰型为主,分别占62.7%、77.3%和62.7%,双峰型分别占34.6%、20.9%和31.8%,少数出现三峰型;1 000 Hz探测音鼓室声导纳图、声纳图和声导图以单峰型为主,分别占96.4%、99.1%和97.3%,极少数为双峰型,无三峰型出现。226 Hz与678 Hz探测音测试,鼓室声导纳值与声纳值、声纳值与声导值的均差异有统计学意义（均P〈0.05）;声导纳值与声导值差异无统计学意义（P〉0.05）。1 000 Hz探测音测试,鼓室声导纳值、声纳值与声导值的两两比较均差异有统计学意义（均P〈0.05）。结论：获得正常新生儿多频探测音鼓室声导抗图的图形、声导纳值、声纳值和声导值的正常范围,结果提示,1 000 Hz探测音鼓室声导抗测试可以较好反映正常新生儿的中耳功能。     

Classification of trace patterns of 226- and 1000-Hz tympanometry in healthy neonates

Objective

Accurate evaluation of middle ear function is a challenge especially in babies referred from newborn hearing screening programs. The aim was to assess the feasibility of tympanometry using 226- and 1000-Hz probe tones in neonates.

Methods

Hearing was evaluated by transient evoked otoacoustic emission (TEOAE) in 96 ears of healthy neonates in well-baby nursery. Babies with risk factors for hearing loss as identified in Joint Committee on Infant Hearing (JCIH, 1994) were excluded. Tympanograms recorded with 226 and 1000 Hz probe tones were analyzed and classified.

Results

Tympanograms were classified according to Method A (Jerger/Liden) and visual classification systems, Method B (adapted from Marchant et al.) and Method C (adapted from Kei et al.), without difficulty. In 72 ears with normal TEOAE, 226 Hz tympanograms were classified as normal in 72 ears in Methods A and B, and 16 ears in Method C. 1000 Hz tympanograms were normal in 68 ears in Method A, 72 ears in Method B and 68 ears in Method C. In 24 ears with abnormal TEOAE, 226 Hz tympanograms were interpreted as normal in most ears (23 ears in Method A, 24 ears in Method B), whereas 1000 Hz tympanograms were abnormal in 13 ears in Method A and 6 ears in Method B, possibly reflecting middle ear dysfunction.

Conclusion

In healthy neonates without risk factors for hearing loss, 1000 Hz tympanograms can be recorded and interpreted. A single-peaked tympanograms was most common in ears with normal TEOAE. In ears with abnormal TEOAE, tympanograms were classified as abnormal more frequently using 1000 Hz than 226 Hz. Implementation of tympanometry using 1000 Hz probe tone in newborn hearing screening programs may provide valuable information regarding middle ear dysfunction that may cause transient conductive hearing loss.     

Impedance audiometry with 3-probe frequency]

The 3-probe frequency (226, 678, 1000Hz) admittance (Y), susceptance (B) and conductance (G) tympanograms were recorded from 28 normal-hearing adults with a GSI 33 Version 2 Middle-Ear analyzer, and the 3-frequency ipsilateral acoustic-reflex thresholds were measured too. In all subjects, there were normal values of tympanometric indices, such as peak compliances, peak pressures, gradients and ear canal volumes, and of ipsilateral acoustic-reflex thresholds at a 226-Hz probe tone. From 226 to 1000Hz, Y, B and G increased in magnitude while the corresponding admittance-,susceptance- and conductance-tympanogram peak pressures (PY, PB, PG) shifted towards positive evidently. In comparison with 226 Hz, the 678-Hz static admittance (Y') and static susceptance (B') values were large but had no significant differences as compared with those of 1000 Hz. The relation among Y, B and G, among PY, PB and PG, and between Y' and B' changed as a function of probe frequency from 226 to 1000 Hz. The average reflex thresholds of 25 adults (30 ears) were 83 dB HL at 226-Hz probe frequency, 91 dB at 678 Hz, and 88 dB at 1000 Hz, using a 1000-Hz tonal activator. There were significant differences among the 3 values (all P less than 0.01). The ipsilateral acoustic reflexes from 3 adults (4 ears) were present at 226-and 678-Hz probe tones, but not at 1000 Hz.     

Otoacoustic emissions and tympanometry in children with otitis media

OBJECTIVE: To examine otoacoustic emission and tympanometric findings in children with surgically confirmed middle ear effusion (MEE). DESIGN: A total of 102 children aged 0.7 to 11.4 yr undergoing surgery because of otitis media were included in the study. A tympanometric examination and transient evoked otoacoustic emission (TEOAE) measurement were performed on each ear before myringotomy. MEE was aspirated, weighed and classified as mucoid or nonmucoid. TEOAE measurements were compared with the quantity and quality of MEE and to the tympanometric findings. RESULTS: Fifty (72%) ears out of the 65 ears containing effusion showed reduced TEOAE. The quantity of effusion was associated significantly (p < 0.001) with the TEOAE responses, and mucoid effusion reduced the emissions more than nonmucoid. The sensitivity of tympanometry in identifying the ears without recordable TEOAE was 73% and the specificity 81%. CONCLUSION: MEE results in a significant reduction in TEOAEs even when the effusion is nonmucoid. This suggests that transmission of acoustic energy to and from the middle ear is altered in children experiencing any form of otitis media with effusion.     

正常婴儿1000Hz探测音及多频率扫描声导纳测试分析

目的分析正常婴儿1000 Hz探测音及多频率扫描声导纳检测的临床特征。方法对164例正常听力婴儿（250耳）的1000 Hz探测音声导纳图,用基线法分型并测量正峰声导纳值;通过声纳差（ΔB）-频率函数曲线和相位角差（Δθ）-频率函数曲线检测中耳共振频率。运用SPSS11.0软件,分年龄段分别统计正峰声导纳、共振频率和相位角差（Δθ）的平均值、标准差、中位数、5%分位数、95%分位数及95%置信区间。结果全部样本均可测得基线上正峰声导纳值,各年龄组的5%分位数均≥0.2 mmho;各年龄组共振频率从311.01～599.06 Hz递增,相位角差（Δθ）的绝对值平均值从44.52～22.84递减。结论高频率探测音声导纳检测和多频率扫描声导纳检测,充分反映婴儿中耳声学特性的转变过程,更适用婴儿的中耳功能评估。     

Analysis of the resonant frequency of the middle ear in otosclerosis

Multifrequency tympanometry scans pressures and frequencies from 226 to 2000 Hz to analyze the resonant frequency of the middle ear, which determines the balance between stiffness and mass. We studied 143 patients (a total of 200 ears) diagnosed as otosclerosis at the E.N.T. Service of Santiago de Compostela University Hospital Complex, and 136 control subjects. The mean age of patients was 47.7 years; women were predominant (female/male ratio 2.25:1). The mean duration of the disease was 10.4 years. Using the Virtual model 310 tympanometer, we calculated the resonant frequency through the susceptance tympanogram, corresponding to the minimal frequency at which the central notch of the tympanograrn was equal to or less than the negative tail. The mean resonant frequency was 1230 Hz, the tympanometric amplitude was 88.32 daPa, and the admittance of the middle ear was 0.63 cc. We confirmed an increase in the resonant frequency in patients with otosclerosis compared with normal subjects (1132.33 Hz), and a decrease in the admittance of the middle ear. The relation between the two values was significant.     

Developmental changes in multifrequency tympanograms

The normal maturational course of tympanometric shape, static aural acoustic admittance and ear canal wall characteristics were investigated in healthy infants, who were followed at various time intervals in the first 4 months of life. Susceptance and conductance tympanograms were recorded from both ears of each subject at four probe frequencies or more. In addition, quantitative pneumatic otoscopy was performed utilizing air pressure changes of the same magnitude as those typically used in tympanometry. Results for the group were an increase in admittance magnitude with increasing age at frequencies above 226 Hz. Admittance phase angle increased with age at all frequencies, indicating a growing contribution of compliant elements in the first 4 months of life. The course of development of input admittance at the tympanic membrane differed among individual infants. Otoscopic findings indicated that external ear canal differences cannot completely account for tympanometric differences between young infants and adults.     

Immittance audiometry. Normative data at 220 and 660 Hz

Normative immittance data for normal ears were collected at 220 and 660 Hz probe tone frequencies. The experimental set-up enabled conversion of simultaneously recorded susceptance and conductance data to resistance, reactance, admittance and phase angle tympanograms. Special attention was given to the subtraction of the ear canal admittance and to the pump speed. This paper demonstrates first the frequent occurrence (43.2%) of W-shaped tympanograms at 660 Hz probe tone in healthy ears. This percentage is not influenced by age, sex or pump direction. Normative data of the central extremum of the tympanogram are reported only for those immittance components in which W-notching does not occur. The wide variance of measurements in the population precludes the creation of subcategories. The intra-individual variation is much smaller and the authors advocate to use the value of the contralateral healthy ear as a reference.     

Parameters of normality in multifrequency tympanometry

Multifrequency tympanometry studies consist of tympanography using probe tone frequencies ranging from 200 to 2000 Hz, improving the study of acoustic transmission through the tympano-ossicular system because then two components of admittance, conductance and susceptance, can be separated. The resonance frequency is the frequency at which mass and spring elements of the middle ear cancel each other out, leaving only the friction component. This measurement has been found to be more sensitive to the presence of pathologies that affect the tympano-ossicular system, such as otosclerosis and rheumatoid arthritis. It is necessary to know normal pattents of tympanometric parameters to improve the study of these diseases. Multifrequency tympanometry performed on 136 patients, 91 women and 45 men, age range 11-78 years. The mean resonant frequency of the middle ear was 1132.33 Hz, mean static admittance 0.76 dapa, and mean tympanometric amplitude 94.31 mmhos ac. Age showed no systematic effect of age on any of these measures in this population, and no significant association was found between static admittance or tympanometric amplitude and resonance frequency.     

Anomalous screening outcomes from click-evoked otoacoustic emissions and auditory brainstem response tests

Transiently evoked otoacoustic emissions (TEOAE) and auditory brainstem response (ABR) tests were used in parallel to screen 862 neonates with risk factors for hearing loss. Seven neonates (0.81%) passed on TEOAE screen yet failed on ABR in one ear (six neonates) or both ears (one neonate). This combination of results has been termed 'anomalous'. Examination of audiometric results obtained on follow-up shows that in one ear of one neonate the result was consistent with the later confirmed audiogram shape. The explanation for the anomalous results in the remaining ears is unclear although neural maturation and the effects of hyperbilirubinaemia are possibilities. There were no instances of progressive or retrocochlear hearing loss identified. None of the seven neonates had better ear hearing loss of > or = 40 dB on long term follow-up.     

颞骨CT正常儿童1kHz鼓室声导纳特征

目的探讨颞骨CT正常儿童1 kHz鼓室声导纳的特点。方法双耳或单耳颞骨薄层CT示外、中、内耳结构均正常的儿童93例(162耳),其中,男58例(97耳),女35例(65耳),年龄2~66月龄(中位数19月),采用GSI-Tympstar中耳分析仪对其行1 kHz探测音鼓室导纳测试,记录鼓室导纳图形及峰导纳值(tympanometricpeak admittance,Ypeak)、鼓室图峰压(tympanometric peak pressure,TPP)、负尾部补偿导纳值(negative tail com-pensated admittance,Comp Y-400,为Ypeak值与-400 daPa处的导纳值之差)等指标的均值、标准差及95%可信区间,并分析耳别、性别及年龄对上述各指标的影响。结果①鼓室导纳图形态:单峰型149耳(91.98%,149/162),双峰型3耳(1.85%,3/162),平坦型5耳(3.09%,5/162),其它类型5耳(3.09%,5/162)。②各指标均值、标准差及95%可信区间分别为:Ypeak:4.13±1.42 mmHo,2.12~7.96 mmHo,TPP:29.56±74.92 daPa,-186.75~142.63 daPa,CompY-400:2.11±1.14 mmHo,0.89~5.25 mmHo。③不同耳别间Ypeak、TPP及CompY-400的差异无统计学意义(P>0.05);④不同性别间Ypeak和CompY-400的差异有统计学意义(男性高于女性,P=0.001,P=0.000),但TPP的性别间差异无统计学意义;⑤不同年龄组间Ypeak、CompY-400及TPP的差异有统计学意义,0~6月龄婴儿Ypeak及CompY-400均值显著低于其他年龄组。结论①颞骨CT正常儿童1 kHz鼓室导纳图多数为单峰型,但其Ypeak、TPP、CompY-400的95%可信区间范围较大。②男性的Ypeak显著高于女性;Ypeak和CompY-400随着年龄的增长而增长,Ypeak在12月龄、CompY-400在6月龄时此增长趋于缓和;TPP随年龄变化的特点不明显。     

226Hz和1000Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨

目的：以影像学检查为诊断分泌性中耳性的标准,分析不同年龄段分泌性中耳炎常婴幼儿226Hz和1000Hz2种探测音鼓室声导纳曲线类型分布特点和趋势,比较2种方法在敏感度和特异度,为临床诊断提供依据。方法：经颞骨薄层CT证实为分泌性中耳炎婴幼儿177例（226耳）,中耳结构正常的婴幼儿158例（266耳）,年龄1～60个月。根据年龄分为6组,分别为O～6月龄组,6～12月龄组,12～18月龄组。18～24月龄组,24～36月龄组,36～60月龄组,分别进行226Hz和1000Hz探测音鼓室声导纳测试。用配对Y。检验对不同年龄组受试儿童两种声导纳测试法结果进行检验,并用ROC方法分析2种方法的敏感度和特异度。结果：分泌性中耳炎婴幼儿各组226Hz鼓室声导纳异常检出率分别为21．1％、35．2％、46．9％、42．0％、62．5％及68％,1000Hz鼓室声导纳异常检出率分别为94．7％、98．1％、96．9％、91．2％、95．8％及88．0％。中耳功能正常婴幼儿,226Hz鼓室声导纳正常型检出率分别为95．1％、88．6％、85．1％、93．3％、88．5％及93．5％,l000Hz鼓室声导纳正常型检出率分别是为87．8％、94．3％、89．4％、95．6％、94．2％及97．8％。2种测试方法对分泌性中耳炎的检出率在36月龄以下差异有统计学意义,2种测试方法的敏感度和特异度在0～36个月差异有统计学意义,36个月以上差异无统计学意义。结论：36月龄以下婴幼儿探测分泌性中耳炎应以1000Hz鼓室声导纳为主,36～60月龄幼儿应同时测试226及1000Hz鼓室声导纳。以单峰型和双峰型1000Hz鼓室声导纳作为分泌性中耳炎的正常标准,具有很高的可靠性和实用性。     

Otitis media with effusion with or without atopy: audiological findings on primary schoolchildren

Objective

The objective of the study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school, focusing on the audiometric and tympanometric measurements among atopic and nonatopic subjects suffering from OME.

Materials and Methods

Three hundred ten children (5-6 years old) were screened in Western Sicily by skin tests and divided into atopics (G1) and nonatopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram, and acoustic reflex tests. The parameters considered were as follows: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months, presence of B or C tympanogram, absence of ipsilateral acoustic reflex, and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz through 4 kHz.

Results

The overall prevalence rate of OME was 12.9% (42.85% for G1 and 6.30% for G2, odds ratio = 11.16); OME was bilateral in 28 children (70%). B tympanogram was evidenced in 48 ears (70.59%), with a significative difference between G1 and G2 (P < .001). The analysis of mean air conduction pure tone (31.97 dB for G1 and 29.8 dB for G2) and of tympanometric measurements such as ear canal volume, tympanometric peak pressure, and static compliance by analysis of variance test showed a significative difference between G1 and G2 (P < .05).

Conclusions

The higher prevalence of OME in atopic children and the statistically significant differences in audiometric and tympanometric measurements among atopic and nonatopic subjects suffering from OME suggest the important role of allergy in the genesis and recurrence of OME.