THE CLASSIFICATION OF WIDEBAND SOUND ENERGY ABSORBANCE RATIOS FOR DIFFERENT TYPES OF TYMPANOGRAM IN 3-11 YEARS OLD CHILDREN IN TURKEY
1Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, Bursa, Türkiye2Dokuz Eylül Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz ve Baş Boyun Cerrahisi Anabilim Dalı, İşitme Konuşma Denge Ünitesi, İzmir, Türkiye Objective: The aim of this study is to classify the ambient pressure absorption ratios (APAR) obtained at frequencies between 226-8000 Hz with wideband tympanometry (WBT), which can be used to diagnose middle ear pathologies in children, according to the tympanogram types in 226 Hz conventional tympanometry (CT).
Method: This study was carried out by retrospectively examining the CT and WBT tests performed to pediatric patients aged 3-11 years at Dokuz Eylul University Otolaryngology Department Hearing Speech and Balance Unit between January 2015 and August 2015. In outpatient examinations, the results of 117 patients, who were examined for the diagnosis of otitis with effusion (OME) or Eustachian dysfunction, were included in the study. Descriptive and analytical relationships between WBT APAR and tympanogram types (types A, B, C) were analyzed and ROC analysis was performed to determine the cut-off points of WBT APAR values in distinguishing tympanogram types and the presence of OME.
Results: In this study, the results of CT and WBT belonging to 215 ears (110 right, 105 left) of 117 patients (85 boys and 32 girls) with an average age of 6.05 were examined. A statistically significant difference was found between the APAR values of Type A (44.2%), B (38.6%) and C (17.2%) tympanograms at frequencies other than 8000 Hz (p<0.001). In the presence of OME (54.4%), mean WBT APARs were found lower at other frequencies (p<0.001) except 5656 Hz (p=0.075) and 8000 Hz (p=0.638). According to the area under the ROC curve, APAR ≤0,334 was a good predictive factor for type B tympanogram and ≥0,414 for type A tympanogram at 1000 Hz.
Conclusion: Wideband tympanometry is a fast, easy-to-apply and reliable test in children aged 3-11 years, by means of APARs, which can distinguish different types of tympanogram and the presence of OME.
Keywords : Absorbance, effusion, impedence, tympanogram, wideband tympanometry