Wideband energy reflectance measurements in adults with middle-ear disorders

The purpose of this study was to examine wideband energy reflectance (ER) at ambient pressure in adults with a variety of middle-ear disorders. The ER results from 9 participants with middle-ear disorders and 1 participant with bilateral sensorineural hearing loss were compared with data provided by a group of 40 young adults with normal hearing sensitivity. Wideband ER results for the participant with sensorineural hearing loss followed the typical pattern of the data for young adults with normal hearing. For the 9 participants with middle-ear disorders (13 ears), the wideband ER responses fell outside the 5th to 95th percentile of the normative data for some portion of the frequency range in patterns that were distinct for otitis media with effusion, otosclerosis, ossicular discontinuity, and perforation of the tympanic membrane. Two ears with hypermobile 226-Hz tympanograms and normal hearing sensitivity had low-frequency ER patterns similar to that of a patient with ossicular discontinuity. One participant with negative middle-ear pressure had high ER in the low frequencies. This distinct ER pattern was similar to the patterns produced by participants with otosclerosis, demonstrating that a correction for middle ear pressure will be important for the clinical application of ER. Overall, the results suggest that wideband ER may be useful as a diagnostic tool in the assessment of middle-ear disorders.