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Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.
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Objective To study the relationship between tubomanometry(TMM) and tympanograms before and after the treatment of otitis media with effusion(OME) in children,and to evaluate the function of tubomanometry in forecasting the prognosis of OME.Methods Data from 66 patients(98 ears) were collected before and after one to four weeks treatment,all the patients received tympanometry and tubomanometry ETS,recorded eustachian tube scores(ETS) and tympanogram types.Results Before treatment,there were significant differences between the ETS of normal ears and sick ears,also between ETS of type B tympanograms and type C.There was significant difference between ETS before and after treatment,but not between the ETS of type B tympanograms and type C after treatment.The increased ETS value of type B tympanograms was higher than type C with a significant difference.There was a significant difference between the ETS of the effective group and the invalid group before and after treatment,whether type B tympanograms or type C.Conclusion Eustachian tube scores increased after treatment,and the functions of eustachian tube were improved in children of otitis media with effusion.Before treatment,the ETS of type B tympanograrns was lower than type C,indicating a poorer function of eustachian tube.After treatment,the increased ETS value of type B tympanograms was more than type C.Tubomanometry could forecast the prognosis of otitis media with effusion in children.
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Objective To investigate the clinical characteristic of 1 000 Hz probe tone tympanometry obtained from neonates who didn’t pass the TEOAE screening . .Methods TEOAE screening were performed to screen the hearing with GSI -70 Automated OAE(Grason-Stadler ,USA) .Then neonates were detected the 1 000 Hz probe tone tympanograms by GSI Tympstar Version Ⅱ Middle Ear Analyzer(Grason-Stadler ,USA) .The relative infor-mation ,including tympanometric peak pressure (Tpp) ,peak admittance(Yp) ,peak compensated static acoustic ad-mittance (Ypc)、tympanometric width(TW) were collatea .The of 1 000 Hz probe tone tympanometry of 47 ears that didn’t pass the first TEOAE and 1 300 ears that passed the first TEOAE were asnpared .Results We found in the single-peak type ,the ratio of the experimental group(59 .57% ) was less than that of the control group(74 .00% ) , and in the flat type the ratio of the the experimental group (23 .40% ) was more than that of the control group (8 . 54% ) ,there was a statistical significance between the two groups in each different type proportion (P<0 .05) .But there is not a statistical significance in the relative values of single -peak type admittance between the two groups , such as tympanometric peak pressure (Tpp)、peak admittance(Yp) etc .Conclusion The majority of 1000Hz tympa-nograms of the neonates who passed TEOAE is the single -peak type ,but the neonates who didn’t pass the first TEOAE mostly shored the flat type The .
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Objective To investigate and contrastive analyse the respective value of tympanograms and high resolution CT scan of temporal bone in the diagnosis of secretory otitis media .Methods The clinical data of 150 hos-pitalized patients with secretory otitis media in Department of ENTHNS ,Tongji Hospital ,Wuhan from 2009 to 2012 were retrospectively analyzed .Based on the surgical finding of tympanic cavity fluid ,the diagnostic accordance rate of tympanograms and temporal bone CT for middle ear effusion were calculated respectively ,and their diagnos-tic value were evaluated .Results The diagnostic accordance rate of tympanogram B for the middle ear effusion in secretory otitis media was 94 .5% (138/146 ears) ,the rate of abnormal tympanograms was 91 .6% (206/225 ears) , while temporal bone CT with a rate of 99 .2% (117/118 ears) .The difference between the latter two data was statis-tically significant(P<0 .01) .Conclusion The temporal bone CT scan ,with a higher diagnostic value for middle ear effusion in secretory otitis media ,could be used as a supplement to the acoustic immittance measurement ,especially to non-B tympanograms for the diagnosis of secretory otitis midia .
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This study was conducted to obtain tympanometric normative data for Malay preschoolers and compare them between genders. Non-pathological factors such as age, gender and ethnicity may influence tympanometric normative data. Guidelines for middle ear screening by American Speech and Hearing Association (ASHA) are based on Caucasian children population and may not be applicable to Malay children population. The tympanometric parameters measured were peak compensated static acoustic admitan (peak Ytm), volume ear canal (Vea) and tympanometric width (TW). Onehundred and sixty-one Malay pre-schoolers (eighty boys and eighty-one girls) participated in this study. However only fourty-five boys and fourty-six girls (163 out of 182 ears) had fulfilled the study inclusion criteria which include normal otoscopic findings, pass hearing screening and presence of ipsilateral acoustic reflex at 1000 Hz. Two-way Mixed ANOVA to compare the mean tympanometric parameters of boys and girls showed no significant difference for the mean peak Ytm ( p > 0.05), mean Vea [( p > 0.05), mean TW (p > 0.05). Thus data from the two groups were combined. Overall, the mean peak Ytm was 0.55 ± 0.28 mmhos, mean Vea was 0.90 ± 0.40 cm3, and mean TW was 104.68 ± 32.08 daPa. The 90th percentile values for peak Ytm, Vea and TW were 0.27 to 1.18 mmhos, 0.45 to 1.65 cm3 and 59.60 to 149.80 daPa consecutively. This current study suggests that the data obtained are applicable to Malay preschoolers but gender-specific norms are not necessary. Application of each value of TW > 200 daPa and Vea > 1.0 cm3 by ASHA on Malay preschoolers will cause under referral rate and over-referral rate consecutively.
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Background: Impedanciometry is a sensitive test that allows the diagnosis of intratimpanic efusion. Both tympanogram gradient (TG) and tympanogram width (TW) can be obtained from it. Usually, international reference values for these variables are used, but their distribution in chilean pediatric population remains uncertain. Objective: Establish normal values for these parameters in chilean children 4 to 6 years-old. Method: This study was performed at the Otorhinolaryngology Service of Hospital Militar in Santiago, contemplating all chilean army personnel children, both sexes, 4 to 6 years-old who assisted to the center between March and June 2003. 180 children were evaluated by anamnesis, otoscopy, audiometry and impedanciometry. Results: Normal values for TG were determined with a 95 percent confidence interval. These were 0,21 to 0,62 for girls and 0,22 to 0,57 for boys. Percentiles were determined for TW, where its normal value can be estimated in our population by means of its inverse, with significative correlation with TG. Conclusions: These normal values will improve impedanciometry accuracy in the diagnosis of intratimpanic effusion, at the moment based on timpanometric shape and compliance peak.
Introducción: La impedanciometría es un estudio sensible para la pesquisa precoz de efusión intratimpánica que permite obtener las variables gradiente (GT) y ancho del timpanograma (AT). Generalmente, se utilizan valores de referencia internacionales de dichas variables para este propósito, pues se desconoce su distribución en la población pediátrica chilena. Objetivo: Establecer valores de normalidad de estos parámetros en niños chilenos entre 4 y 6 años. Pacientes y Método: Este estudio se realizó en el Servicio de Otorrinolaringología del Hospital Militar de Santiago. Población: todos los niños y niñas entre 4 y 6 años, hijos del personal del Ejército de Chile, asistentes al hospital entre marzo y junio de 2003. Muestra: 180 niños, evaluados mediante anamnesis, otoscopia, audiometría e impedanciometría. Resultados: Valores normales de GT: 0,21 a 0,62 en niñas y 0,22 a 0,57 en niños. Ambos con un intervalo de confianza de 95 por ciento. Para AT se determinaron percentiles y su valor de normalidad se estima mediante la correlación inversa existente entre GT y AT, que es significativa. Conclusión: Estos valores de normalidad aumentarán la precisión impedanciométrica en el diagnóstico de efusión intratimpánica, que actualmente, en Chile, se basa en la forma timpanométrica y peak de complianza.
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Humans , Child, Preschool , Child , Acoustic Impedance Tests , Otitis Media with Effusion/diagnosis , Chile , Reference Values , Sex DistributionABSTRACT
Objective To investigate the range of normal values of tympanometry of guinea pigs and the possible differences associated with genders and ears. Methods Included in this study were 40 guinea pigs with nor-mal hearing and no ear diseases. Under the anesthetized condition, each guinea pig's tympanogram was recorded, and their values were studied associated with different genders and ears. Results The tympanograms thus obtained were all type A. For all the tympanograms of 80 ears, the equivalent canal volume was about 0.09±0. 02 ml, the static compliance was 0.10 ±0.03 ml, the gradient was 0.14 ±0.06 ml, and the pressure of the peak admittance was -99.44±75.06 daPa . The findings of different gender groups yielded statistic differences in the values of e-quivalent canal volume (P=0. 012) but not in static compliance, gradient and peak admittance pressure (P>0. 05). Typical tympanograms were recorded for the both ears in 40 guinea pigs at the same time. There were no binaural differences (P>0.05). Conclusion The results show significant differences in the equivalent canal volumes be-tween male and female guinea pigs. These tympanograms may serve as a guide to detect middle ear dysfunctions in guinea pigs.
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A Otite Média com Efusão é uma das causas da impotência auditiva que pode ser tratada simplesmente com a miringotomia ou sem a inserção do tubo de ventilação. Objetivo: Este estudo tem o objetivo de avaliar os diferentes tipos de fluidos após a miringotomia em Otite Média com Efusão; avaliar o exame de timpanograma de pacientes que são submetidos à miringotomia; correlacionar o fluído de miringotomia e o timpanograma pré-operatório em crianças portadoras de Otite Média com Efusão. Método: Um estudo retrospectivo em crianças menores de 12 anos portadoras de Otite Média com Efusão foi realizado na seção de otorrinolaringologia na escola da T.U. em Katmandu entre outubro de 2005 e setembro de 2007. Todos os pacientes que foram submetidos à miringotomia foram avaliados pelo exame timpanométrico e este foi comparado com os tipos de fluidos durante a cirurgia. O resultado foi estatisticamente analisado através do teste Qui-Quadrado. Resultados: A faixa etária dos pacientes era entre cinco e oito anos. Cerca de 56,8% das crianças apresentavam fluido de miringotomia espesso com aspiração seca em 27,5%. O timpanograma evidenciou curva tipo B em 90,2% das crianças. Curva tipo B e fluido espesso foram encontrados em 63%, e 21% das crianças apresentavam aspiração seca. Entretanto, todos os pacientes com fluido expesso apresentaram curva tipo B no timpanograma. A sensibilidade da curva B para prever a presença de fluido foi de 97,3%, enquanto a especificidade para foi de 28,6%. Conclusão: A Curva tipo B é a curva comum no timpanograma em pacientes portadores de Otitie Média com Efusão, porém, nem sempre ela indica a presença de fluido na orelha média. O timpanograma é bastante útil para prever a origem do fluído de miringotomia
Otitis Media with Effusion is a common cause of hearing disability that can be treated simply with myringotomy with or without ventilation tube insertion. Aim: The aims of this study are 1) to assess different types of fluid after myringotomy in Otitis Media with Effusion, 2) to assess the Pre Operative Tympanogram in Patients undergoing myringotomy 3)to correlate between myringotomy fluid and pre operative tympanogram in pediatric patients with Otitis Media with Effusion Method: A retrospective study in children (< 12 years) with Otitis media with effusion was carried out in ENT Department, T.U. Teaching Hospital, Kathmandu between October 2005 to September 2007. All patients undergoing myringotomy were assessed by tympanometry and compared with the types of fluid during surgery. Result was analyzed statistically using Chi -Square Test. Results: Most of the patients were in age group 5-8 years. Around 56.8 % of children had thick myringotomy fluid with dry tap in 27.5 %. Tympanogram showed B type curve in 90.2 % children. In patients with B type curve, thick fluid was found in 63.0%, while 21.0 % children had dry tap. But all patients with thick fluid had B type curve in Tympanogram. Sensitivity of B curve to predict fluid was 97.3% while Specificity was 28.6%. Conclusion: Common type of tympanogram curve in patients with Otitis Media with Effusion is B type, but it doesn?t always indicate to have fluid in middle ear. Tympanogram is useful in predicting the nature of the myringotomy fluid.
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Otologic Surgical Procedures , Otitis Media/surgery , Ear Diseases/surgery , Chi-Square Distribution , Child , Retrospective StudiesABSTRACT
PURPOSE: Acute otitis media is one of the most prevalent diseases of childhood and can cause serious complications such as hearing loss. The exact diagnosis is extremely important but may be hard to make because of probabilities of over- and underdiagnosis. We performed impedance audiometry(IA) in routine examinations for acute otitis media and applied it for screening and follow-up methods of acute otitis media. METHODS: We performed IA randomly on whomever were suspected of having acute otitis media due to symptoms and otoscopic appearance. These 95 patients were aged from 1 month to 10 years, and visited our out-patient clinic from December 1998 to February 2000. RESULTS: Male to female ratio was 2:1, Fifty eight patients(61.1%) were under 2 years-old and the most prevalent age group was the 1 year-old group(35.8%). Sixty two cases(65.3%) had abnormal tympanograms, B type, 43 cases(45.3%); C type, 12 cases(12.6%) and As type, 7 cases (7.4%). The follow-up studies of abnormal tympanogram after antibiotics administration showed improved tympanograms(39 cases), chronic otitis media(7 cases) needed to insert ventilation tubes, and congenital cholesteatoma(1 case); and follow-up losses(15 cases). CONCLUSION: Tympanometry played an irnportant role in detecting the middle ear pathology in childhood. So we recommend initial screening tympanometry for acute otitis media and at least two screenings prior to major management decisions.
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Child , Child, Preschool , Female , Humans , Male , Acoustic Impedance Tests , Anti-Bacterial Agents , Diagnosis , Ear, Middle , Electric Impedance , Follow-Up Studies , Hearing Loss , Mass Screening , Otitis Media , Otitis , Outpatients , Pathology , VentilationABSTRACT
BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate improvement in hearing and changes in the tympanogram according to the types of mastoid pneumatization and the mucosal condition of the Eustachian tube orifice after performing tympanoplasty type 1. MATERIALS AND METHODS: Among the patients with chronic otitis media who had received tympanoplasty type 1 at Asan Medical Center from June 1990 to March 1997, sixty five patients were evaluated with pure tone audiometry and tympanometry for a short-term (1 year) follow-up period. RESULTS: Greater improvement in hearing was shown in patients with tympanogram type A as compared to the patients with type B and C in both short-term and long-term follow-ups. Patients who showed normal mastoid pneumatization were found to have type A tympanogram more frequently than patients who showed abnormal mastoid pneumatization. However, the degree of postoperative hearing improvement did not depend on the types of mastoid pneumatization. Mucosal condition of the Eustachian tube orifice had some influence on the outcome of postoperative tympanogram and hearing. Greater improvement in the hearing levels were observed more frequently in the normal mucosa. CONCLUSION: Postoperative improvement in hearing was closely related to the postoperative change in the tympanogram. Postoperative hearing results and tympanograms were mainly influenced by the mucosal condition of the Eustachian tube orifice. Relatively greater improvement in hearing was observed in the long-term follow-up compared to the short-term follow-up. However, in order to reach any conclusion on this matter, a longer follow-up period and closer observation would be required.
Subject(s)
Humans , Acoustic Impedance Tests , Audiometry , Eustachian Tube , Follow-Up Studies , Hearing , Mastoid , Mucous Membrane , Otitis Media , TympanoplastyABSTRACT
The use of electro-acoustic impedance instrument to obtain a tympanogram is an excellent way for determining the status of tube function. The presence of a middle-ear effusion of high negative middle-ear press can be determined by this method. Unfortunately, assessment of the tympanograms is not simple. They always change.