Wideband aural acoustic absorbance predicts conductive hearing loss in children.
OBJECTIVE
This study tested the hypothesis that wideband aural absorbance predicts conductive hearing loss (CHL) in children medically classified as having otitis media with effusion.


METHODS
Absorbance was measured in the ear canal over frequencies from 0.25 to 8 kHz at ambient pressure or as a swept tympanogram. CHL was defined using criterion air-bone gaps of 20, 25, and 30 dB at octaves from 0.25 to 4 kHz. A likelihood-ratio predictor of CHL was constructed across frequency for ambient absorbance, and across frequency and pressure for absorbance tympanometry. Performance was evaluated at individual frequencies and for any frequency at which a CHL was present.


METHODS
Absorbance and conventional 0.226-kHz tympanograms were measured in children of age three to eight years with CHL and with normal hearing.


RESULTS
Absorbance was smaller at frequencies above 0.7 kHz in the CHL group than the control group. Based on the area under the receiver operating characteristic curve, wideband absorbance in ambient and tympanometric tests were significantly better predictors of CHL than tympanometric width, the best 0.226-kHz predictor. Accuracies of ambient and tympanometric wideband absorbance did not differ.


CONCLUSIONS
Absorbance accurately predicted CHL in children and was more accurate than conventional 0.226-kHz tympanometry.
Boys Town National Research Hospital, Omaha, NE 68131, USA. Douglas.Keefe@boystown.org
Douglas H
DH
Keefe
Chris A
CA
Sanford
John C
JC
Ellison
Denis F
DF
Fitzpatrick
Michael P
MP
Gorga
D000158:Acoustic Impedance Tests; D000161:Acoustic Stimulation; D001299:Audiometry; D001309:Auditory Threshold; D001844:Bone Conduction; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004424:Ear Canal / Q000503:physiopathology*; D006309:Hearing; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D015999:Multivariate Analysis; D010034:Otitis Media with Effusion / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011312:Pressure; D012372:ROC Curve; D012307:Risk Factors