Energy transmittance predicts conductive hearing loss in older children and adults

The test performance of a wideband acoustic transfer function (ATF) test and 226-Hz tympanometry was assessed in predicting the presence of conductive hearing loss, based on an air-bone gap of 20 dB or more. Two ATF tests were designed using an improved calibration method over a frequency range (0.2...

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Bibliographic Details
Published in:The Journal of the Acoustical Society of America 2003-12, Vol.114 (6 Pt 1), p.3217-3238
Main Authors: Keefe, Douglas H, Simmons, Jeffrey L
Format: Article
Language:English
Subjects:
Acoustic Impedance Tests
Adolescent
Adult
Bone Conduction - physiology
Child
Ear, Middle - physiopathology
Female
Hearing Disorders - diagnosis
Hearing Disorders - physiopathology
Hearing Loss, Conductive - diagnosis
Hearing Loss, Conductive - physiopathology
Humans
Male
Middle Aged
Otoacoustic Emissions, Spontaneous - physiology
Predictive Value of Tests
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Summary:The test performance of a wideband acoustic transfer function (ATF) test and 226-Hz tympanometry was assessed in predicting the presence of conductive hearing loss, based on an air-bone gap of 20 dB or more. Two ATF tests were designed using an improved calibration method over a frequency range (0.25-8 kHz): an ambient-pressure test and a tympanometric test using an excess static pressure in the ear canal. Wideband responses were objectively classified using moment analyses of energy transmittance, which was a more appropriate test variable than energy reflectance. Subjects included adults and children of age 10 years and up, with 42 normal-functioning ears and 18 ears with a conductive hearing loss. Predictors were based on the magnitudes of the moment deviations from the 10th to 90th percentiles of the normal group. Comparing tests at a fixed specificity of 0.90, the sensitivities were 0.28 for peak-compensated static acoustic admittance at 226 Hz, 0.72 for ambient-pressure ATF, and 0.94 for pressurized ATF. Pressurized ATF was accurate at predicting conductive hearing loss with an area under the receiver operating characteristic curve of 0.95. Ambient-pressure ATF may have sufficient accuracy to use in some hearing-screening applications, whereas pressurized ATF has additional accuracy that may be appropriate for hearing-diagnostic applications.
ISSN:0001-4966
1520-8524
DOI:10.1121/1.1625931