Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss

A preliminary study

Hideko H. Nakajima, Dominic V. Pisano, Christof Roosli, Mohamad A. Hamade, Gabrielle R Merchant, Lorice Mahfoud, Christopher F. Halpin, John J. Rosowski, Saumil N. Merchant

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: The goal of the present study was to investigate the clinical utility of measurements of ear-canal reflectance (ECR) in a population of patients with conductive hearing loss in the presence of an intact, healthy tympanic membrane and an aerated middle ear. We also sought to compare the diagnostic accuracy of umbo velocity (VU) measurements and measurements of ECR in the same group of patients. Design: This prospective study comprised 31 adult patients with conductive hearing loss, of which 14 had surgically confirmed stapes fixation due to otosclerosis, 6 had surgically confirmed ossicular discontinuity, and 11 had computed tomography and vestibular evoked myogenic potential confirmed superior semicircular canal dehiscence (SCD). Measurements on all 31 ears included pure-tone audiometry for 0.25 to 8 kHz, ECR for 0.2 to 6 kHz using the Mimosa Acoustics HearID system, and VU for 0.3 to 6 kHz using the HLV-1000 laser Doppler vibrometer (Polytec Inc, Waldbronn, Germany). We analyzed power reflectance |ECR| as well as the absorbance level = 10 × log10(1 - |ECR|). All measurements were made before any surgical intervention. The VU and ECR data were plotted against normative data obtained in a companion study of 58 strictly defined normal ears (). Results: Small increases in |ECR| at low-to-mid frequencies (400-1000 Hz) were observed in cases with stapes fixation, while narrowband decreases were seen for both SCD and ossicular discontinuity. The SCD and ossicular discontinuity differed in that the SCD had smaller decreases at mid-frequency (∼1000 Hz), whereas ossicular discontinuity had larger decreases at lower frequencies (500-800 Hz). SCD tended to have less air-bone gap at high frequencies (1-4 kHz) compared with stapes fixation and ossicular discontinuity. The |ECR| measurements, in conjunction with audiometry, could successfully separate 28 of the 31 cases into the three pathologies. By comparison, VU measurements, in conjunction with audiometry, could successfully separate various pathologies in 29 of 31 cases. Conclusions: The combination of |ECR| with audiometry showed clinical utility in the differential diagnosis of conductive hearing loss in the presence of an intact tympanic membrane and an aerated middle ear and seems to be of similar sensitivity and specificity to measurements of VU plus audiometry. Additional research is needed to expand upon these promising preliminary results.

Original languageEnglish (US)
Pages (from-to)35-43
Number of pages9
JournalEar and hearing
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Conductive Hearing Loss
Ear Canal
Semicircular Canals
Audiometry
Stapes
Tympanic Membrane
Middle Ear
Ear
Mimosa
Vestibular Evoked Myogenic Potentials
Pathology
Pure-Tone Audiometry
Otosclerosis
Acoustics
Germany
Lasers
Differential Diagnosis
Air
Tomography
Prospective Studies

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing

Cite this

Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss : A preliminary study. / Nakajima, Hideko H.; Pisano, Dominic V.; Roosli, Christof; Hamade, Mohamad A.; Merchant, Gabrielle R; Mahfoud, Lorice; Halpin, Christopher F.; Rosowski, John J.; Merchant, Saumil N.

In: Ear and hearing, Vol. 33, No. 1, 01.01.2012, p. 35-43.

Research output: Contribution to journalArticle

Nakajima, HH, Pisano, DV, Roosli, C, Hamade, MA, Merchant, GR, Mahfoud, L, Halpin, CF, Rosowski, JJ & Merchant, SN 2012, 'Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss: A preliminary study', Ear and hearing, vol. 33, no. 1, pp. 35-43. https://doi.org/10.1097/AUD.0b013e31822ccba0
Nakajima, Hideko H. ; Pisano, Dominic V. ; Roosli, Christof ; Hamade, Mohamad A. ; Merchant, Gabrielle R ; Mahfoud, Lorice ; Halpin, Christopher F. ; Rosowski, John J. ; Merchant, Saumil N. / Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss : A preliminary study. In: Ear and hearing. 2012 ; Vol. 33, No. 1. pp. 35-43.
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