Energy Reflectance and Tympanometry in Normal and Otosclerotic Ears
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Résumé
In Brief Objective: The major goal of this study was to examine differences in the middle ear mechano-acoustical properties of normal ears and ears with surgically confirmed otosclerosis using conventional and multifrequency tympanometry (MFT) as well as energy reflectance (ER). Second, we sought to compare ER, standard tympanometry, and MFT in their ability to distinguish healthy and otosclerotic ears examining both overall test performance (sensitivity and specificity) and receiver- operating characteristic analyses. Design: Sixty-two normal-hearing adults and 28 patients diagnosed with otosclerosis served as subjects. Tympanometric data were gathered on a clinical immittance machine, the Virtual 310 equipped with a high-frequency option. Two of the parameters, static admittance and tympanometric width, were measured automatically at a standard 226 Hz frequency. The remaining two parameters, resonant frequency and frequency corresponding to admittance phase angle of 45 degree (F45°), were derived from MFT, multicomponent tympanometry, using a mathematical approach similar to the method used in GSI Tympstar Version 2. ER data were gathered using Mimosa Acoustics (RMS-system v4.0.4.4) equipment. Results: Analyses of receiver-operating characteristic plots confirmed the advantage of MFT measures of resonant frequency and F45° over the standard low-frequency measures of static admittance and tympanometric width with respect to distinguishing otosclerotic ears from normal ears. The F45° measure was also found to be the best single index for making this distinction among tympanometric parameters. ER less than 1 kHz was significantly higher in otosclerotic ears than normal ears. This indicates that most of the incident energy below 1 kHz is reflected back into the ear canal in otosclerotic ears. ER patterns exceeding the 90th percentile of the normal ears across all frequencies correctly identify 82% of the otosclerotic ears while maintaining a low false alarm rate (17.2%); thus, this measure outperforms the other individual tympanometric parameters. Combination of ER and F45° were able to distinguish all otosclerotic ears. Correlations and the individual patterns of test performance revealed that information provided by ER is supplemental to the information provided by conventional and MFT with respect to distinguishing otosclerotic ears from normal ears. Conclusion: The present findings show that the overall changes of ER across frequencies can distinguish otosclerotic ears from normal ears and from other sources of conductive hearing loss. Incorporating ER in general practice will improve the identification of otosclerotic ears when conventional tympanometry and MFT may fail to do so. To further improve the false alarm rate, ER should be interpreted in conjunction with other audiologic test batteries because it is unlikely that signs of a conductive component, including abnormal middle ear muscle reflex and ER responses, would be observed in an ear with normal middle ear function. Sixty-two normal-hearing adults and 28 patients diagnosed with otosclerosis served as subjects. Overall, energy reflectance (ER) in the otosclerotic ears was statistically higher than ER in the normal ears between 400 and 1000 Hz. Analysis of receiver operating characteristic plots revealed that ER is potentially useful in differentiating otosclerotic ears from normal ears. More importantly, comparison of the test performance in individual otosclerotic ears between ER and tympanometric measures revealed that the information provided by ER is supplemental to the information provided by tympanometry. Therefore, combination of tympanometry and ER could potentially improve distinguishing otosclerotic ears from normal ears.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle