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Wideband reflectance in normal school-aged children and in children with otitis media Beers, Alison Nicole


In addition to the high prevalence of otitis media with effusion (OME), researchers are motivated to develop methods for early and accurate OME diagnosis because of the financial strain on the health care system associated with its diagnosis and management, and the medical and developmental consequences that may manifest if OME is left untreated. Standard (226 Hz) and high frequency (1000 Hz) tympanometry have traditionally been used clinically to assess middle ear status in children. A relatively new advanced middle ear analysis technique is Wideband reflectance (WBR). WBR has the potential to provide more information regarding the status of the middle ear than the methods currently being used clinically. This technique provides frequency-specific information about sound conduction through the peripheral auditory system. As a result of its recent introduction as an analysis method there is limited normative data available for this measurement system for pediatric populations and for those with middle ear pathology. Development of normative pediatric WBR data may render this technique a highly useful diagnostic tool for assessing the mechano-acoustical properties of middle ear function and for differentiating between healthy and pathological middle ears. WBR patterns from 55 subjects (102 ears) with normal middle ear status and 39 subjects (57 ears) with varying degrees of middle ear pathology were measured. The mean and the 5t h and 95t h percentile ranges were graphically presented. Repeated measures analysis of variance was performed with frequency as the within subjects factor and age (child versus adult), middle ear condition (normal, mild negative pressure, severe negative pressure or effusion), race (Caucasian versus Chinese) and/or gender as the between subjects factors. Frequency-specific significant WBR pattern differences existed for reactance-based and impedance-based measures, between pediatric and adult groups, Caucasian children and Chinese children, and all four middle ear conditions. Wideband reflectance must be further explored within a pediatric population before results can be generalized, but this measurement technique shows promise of providing a better understanding of the mechanico-acoustic properties of the middle ear and the changes to the system's functioning with middle ear pathology.

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