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Predictive Accuracy of Wideband Absorbance under Various Pressure Conditions in Identifying Infants with a Conductive

Sreedevi Aithal¹, Venkatesh Aithal¹, Joseph Kei²

¹Department of Audiology, Townsville University Hospital, Townsville, Queensland, Australia.

Journal of the American Academy of Audiology

|December 18, 2024

Insights

Wideband absorbance tympanic peak pressure (WBA_TPP) effectively identifies conductive hearing loss in infants. This WBA test shows a good balance of sensitivity and specificity compared to other methods.

Area of Science:

Audiology
Pediatric Medicine
Diagnostic Imaging

Background:

Conductive hearing loss (CHL) in infants can impede auditory development.
Early identification of CHL is crucial for timely intervention.
Wideband absorbance (WBA) offers a potential method for infant hearing screening.

Purpose of the Study:

To evaluate the effectiveness of WBA at ambient pressure (WBA_amb), tympanic peak pressure (WBA_TPP), and 0 daPa (WBA_0) for identifying CHL in infants.
To compare the diagnostic performance of WBA tests against high-frequency tympanometry (HFT) and transient-evoked otoacoustic emissions (TEOAE).

Main Methods:

Included 31 ears from infants without hearing loss and 47 ears from infants with CHL.
Hearing thresholds and CHL were determined using auditory brainstem response (ABR) tests.
WBA, HFT (1000-Hz probe tone), and TEOAE tests were performed on all participants.

Main Results:

WBA measurements were significantly lower in the CHL group compared to the reference group across frequencies.
Area under the receiver operating characteristic curves (AROC) for WBA_TPP reached 0.9 at 1.5 kHz.
WBA tests demonstrated slightly lower sensitivity but higher specificity than HFT and TEOAE.

Conclusions:

WBA_TPP at 1.5 kHz is a highly accurate method for identifying CHL in infants.
WBA_TPP provides a favorable balance of sensitivity and specificity compared to HFT and TEOAE.
WBA tests are valuable tools for CHL detection in infants under six weeks of age.

Read full analysis

Abstract

Objective:

The objectives of the study were to (i) evaluate the effectiveness of wideband absorbance (WBA) at ambient pressure (WBA_amb), tympanic peak pressure (WBA_TPP), and 0 daPa (WBA₀) to identify conductive hearing loss (CHL) in infants and (ii) compare the sensitivity and specificity of the three WBA tests with that of high-frequency tympanometry (HFT) and transient-evoked otoacoustic emissions (TEOAE).

Method:

A total of 31 ears with hearing thresholds no greater than 20 dB HL (reference group from 20 infants [mean age: 3.1 weeks]) and 47 ears with CHL from 31 infants (mean age: 3.4 weeks) were included in the study. Hearing threshold was determined using air-conduction tone-burst auditory brainstem response (TB-ABR) test, whereas CHL was determined using both air- and bone-conduction TB-ABR tests. HFT with a 1000-Hz probe tone, TEOAE, and WBA tests were conducted on all participants.

Results:

WBA_amb, WBA_TPP, and WBA₀ of the CHL group were significantly lower than that of the reference group across a wide frequency range. Area under the receiver operating characteristic (AROC) curve for detecting CHL varied from 0.51 to 0.9 depending on the frequency. The highest AROC was obtained at 1.25 kHz for WBA_amb (0.79), at 1.5 kHz for WBA_TPP (0.9) and at 1 kHz for WBA₀ (0.80). The sensitivity and specificity were 0.98 and 0.45, respectively for HFT, and 1.0 and 0.6, respectively for TEOAE. In comparison, the WBA test had slightly lower sensitivity but higher specificity than the HFT and TEOAE tests.

Conclusion:

WBA_TPP at 1.5 kHz can identify CHL in infants as good as, if not more accurately than, WBA_amb or WBA_0. WBA_TPP test had good balance of high sensitivity and specificity compared with HFT and TEOAE. The three WBA tests are useful tools for identifying CHL in infants under 6 weeks of age.

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