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Published on: January 23, 2017
Wideband middle ear power measurement in infants and children
Lisa L Hunter1, Lindsay Tubaugh, Adrienne Jackson
1Division of Audiology, ML 2002, Cincinnati Children's Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. lisa.hunter@cchmc.org
Insights
Wideband middle ear power (WMEP) measurements show reliable results in children, offering potential for improved diagnosis of middle ear conditions like otitis media with effusion.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Biomedical Engineering
Background:
- Wideband middle ear power (WMEP) measurement offers potential for enhanced diagnostic capabilities compared to traditional single-frequency tympanometry.
- Clinical application of WMEP requires normative data, test-retest reliability information, and data from pediatric populations with various middle ear conditions.
Purpose of the Study:
- To establish normative and test-retest reliability data for WMEP measurements in infants and young children.
- To evaluate the influence of age, ear status, and stimulus type on WMEP values in a pediatric cohort.
Main Methods:
- A prospective study was conducted on 97 children aged 3 days to 47 months from a pediatric clinic.
- WMEP measurements were performed using a prototype commercial instrument with both broadband chirp and sine wave stimuli.
- Comparisons were made based on age, gender, middle ear status (including otitis media with effusion), and stimulus type.
Main Results:
- No significant age-related effects on power reflectance were observed, except at 6000 Hz.
- Significantly higher power reflectance was found in ears with otitis media with effusion.
- High test-retest reliability (intraclass correlation coefficients 0.68–0.97) was demonstrated with the chirp stimulus.
- Stimulus type, ear, and gender did not significantly affect WMEP results.
Conclusions:
- This study provides essential normative and reliability data for WMEP analysis in children from birth to four years.
- WMEP shows promise as a diagnostic tool for identifying middle ear pathologies in pediatric populations.
- The findings support the clinical utility of WMEP for middle ear assessment in infants and children.
Abstract:
Wideband middle ear power (WMEP) measurement is a method of middle ear analysis that may provide improved diagnostic capability over single-frequency tympanometry. However, normative data, information about test-retest reliability, and results in clinical disorders are needed for clinical application. Normative and reliability data on WMEP in children three days to 47 months of age were obtained using a prototype commercial instrument. A prospective study was conducted in children enrolled from a well-child pediatric clinic (n = 97), with comparisons of age, gender, and middle ear status and stimulus type (broadband chirp and sine wave). No significant age effect for power reflectance across the age range of this study was found, except at 6000 Hz. Significantly higher-power reflectance was found for ears with poor ear status, specifically otitis media with effusion. Smaller but nonsignificant differences in power reflectance were found for ears with positive and negative tympanometric peak pressure. Intraclass correlation coefficients showed significant correlations of 0.68 to 0.97 at various test frequencies using the chirp stimulus. Multivariate analysis of variance showed no significant effect of stimulus type (sine wave vs broadband chirp), ear, or gender. These results provide normative data for wideband middle ear power analysis for infants and children from birth to age four years.
