title: Compensating for deviant middle ear pressure in otoacoustic emission measurements, data, and comparison to a middle ear model.
abstract: OBJECTIVE
  Deviant middle ear pressure has a negative effect on the forward and backward transmission of stimulus and emissions through the middle ear. Resolving this deviant middle ear pressure is expected to lead to better middle ear transmission and, as a result of this, stronger otoacoustic emissions, which are better detectable. We investigated the effect of compensation o a deviant tympanic peak pressure on click-evoked otoacoustic emissions (CEOAEs). Second, we compared patient data to model predictions made by Zwislocki's middle ear model.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  Fifty-nine children aged between 0.5 and 9 years (mean, 4.4 yr).
  
  
  METHODS
  Hearing investigations including CEOAE measurements at ambient and at compensated tympanic peak pressure (TPP).
  
  
  METHODS
  CEOAEs at ambient and compensated TPP.
  
  
  RESULTS
  Compensation of TPP resulted in higher emission amplitudes below 2 kHz (increase of 8-11 dB). In addition, the compensated measurement showed an increased phase lag (up to one-fourth cycle). For ears with mild deviations of TPP, Zwislocki's model could describe these changes. Pressure compensation was well described by a compliance increase of the tympanic membrane, the malleus, and the incus.
  
  
  CONCLUSIONS
  Compensating the ear canal pressure for negative tympanic peak pressure increased CEOAE amplitudes below 2 kHz and increased the phase lag. These changes can be predicted from an increase of the compliance of the tympanic membrane, incus, and malleus, as a consequence of the pressure compensation.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. janny.hof@mumc.nl
authors.forename: Janny R
authors.initials: JR
authors.lastname: Hof
authors.forename: Emile
authors.initials: E
authors.lastname: de Kleine
authors.forename: Paul
authors.initials: P
authors.lastname: Avan
authors.forename: Lucien J C
authors.initials: LJ
authors.lastname: Anteunis
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koopmans
authors.forename: Pim
authors.initials: P
authors.lastname: van Dijk
mesh_terms: D000158:Acoustic Impedance Tests; D002648:Child; D002675:Child, Preschool; D004424:Ear Canal / Q000502:physiology; D004432:Ear, Middle / Q000502:physiology*; D006309:Hearing / Q000502:physiology*; D006801:Humans; D007223:Infant; D008954:Models, Biological; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D011312:Pressure; D014432:Tympanic Membrane / Q000502:physiology