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Accuracy of tympanometry cutoff points in children from Central-Western Brazil
Cláudia Cruvinel Câmara1, Melissa Ameloti Gomes Avelino1, Paulo Sergio Sucasas da Costa1
1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás - UFG - Goiânia (GO), Brasil.
Insights
This study determined optimal tympanometric cutoff points for infant hearing screening. A -180 daPa peak pressure and <0.2 mL static compliance improved transient evoked otoacoustic emissions screening accuracy.
Area of Science:
- Audiology
- Pediatric Hearing Screening
Background:
- Transient evoked otoacoustic emissions (TEOAEs) are crucial for infant hearing assessment.
- Establishing accurate tympanometric criteria is essential for effective screening.
Purpose of the Study:
- To evaluate tympanometric cutoff points for transient evoked otoacoustic emissions (TEOAEs).
- To determine the diagnostic accuracy of tympanometric peak pressure and static compliance for TEOAEs.
Main Methods:
- An analytical study involving 84 children (6-42 months) from Brazilian childcare centers.
- Utilized Fisher's exact test, Chi-square, Spearman correlation, and ROC curves for analysis.
- Diagnostic accuracy was confirmed using EpiDat 3.1 software.
Main Results:
- A significant correlation was found between tympanometric peak pressure and static compliance.
- ROC analysis identified -180 daPa as the most accurate cutoff for TEOAEs (AUC = 0.781).
- A static compliance cutoff of <0.2 mL demonstrated high specificity (98.5%) and accuracy (88.1%).
Conclusions:
- The combined cutoff of -180 daPa and <0.2 mL static compliance enhances infant hearing screening accuracy.
- This criterion reduces unnecessary referrals by providing a better balance of specificity, sensitivity, and accuracy.
- Updating tympanometric criteria in infant hearing screening is supported by these findings.
Purpose:
This study evaluated tympanometric cutoff points (tympanometric peak pressure and static compliance) for transient evoked otoacoustic emissions (TEOAEs) and determined their diagnostic accuracy.
Methods:
This analytical study, based on a randomized clinical trial, included 84 children (6-42 months; median 24 months) from public childcare centers in Brazil. Associations between cutoff points and TEOAEs were verified by Fisher's exact test and Chi-square. Kappa assessed agreement between ears, and the correlation between tympanometric peak pressure and static compliance was analyzed by Spearman. Diagnostic accuracy was determined using ROC (Receiver Operating Characteristic) curves and confirmed with EpiDat 3.1.
Results:
In the 84 children, 66 right ears and 73 left ears were examined; however, 42 ears were randomly selected from each side for the final analysis. A significant correlation was found between peak pressure and static compliance. ROC analysis identified -180 daPa as the most accurate cutoff (AUC = 0.781; 95% CI: 0.656-0.905; p < 0.001). EpiDat indicated a specificity of 93.9%, a sensitivity of 55.6%, and an overall accuracy of 85.7%. Static compliance <0.2 mL showed comparable performance (specificity = 98.5%, sensitivity = 50.0%, accuracy = 88.1%).
Conclusion:
The cutoff point of -180 daPa combined with static compliance <0.2 mL improved screening accuracy and reduced unnecessary referrals. It provided the best balance between specificity, sensitivity, and accuracy, aligning more closely with TEOAEs results and supporting updating this tympanometric criterion in infant hearing screening.
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