Multifrequency tympanometry in infants

 

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Summary

Introduction: The use of conventional tympanometry is not sufficiently sensitive to detect all cases of middle ear changes, and this hinders accurate diagnosis.

Objective: To characterize acoustic immittance measures of infants from 0 to 3 months of age using multifrequency tympanometry in a prospective study.

Method: 54 infants from 0 to 3 months of age were evaluated. The inclusion criteria included absence of respiratory infections during the evaluation, presence of transient evoked otoacoustic emissions, and absence of risk indicators for hearing loss. The subjects were evaluated by an audiologic interview, a visual inspection of the ear canal, and measures of acoustic immittance at the frequencies of 226 Hz, 678 Hz, and 1,000 Hz. Tympanometric records of the occlusion effect, tympanometric curve type, tympanometric peak pressure, equivalent ear canal volume, and peak compensated static acoustic admittance were collected.

Results: The results indicated the presence of an occlusion effect (2.88% at 226 Hz, 4.81% at 678 Hz and 3.85% at 1,000 Hz), predominance of a tympanometric curve with a single peak (65.35% at 226 Hz, 81.82% at 678 Hz, and 77.00% at 1,000 Hz), and tympanometric peak pressure ranging from -155 to 180 daPa. Further, the equivalent ear canal volume increased with the frequency of the probe (0.64 mL at 226 Hz, 1.63 mho at 678 Hz, and 2.59 mmho at 1,000 Hz) and the peak compensated static acoustic admittance values increased with an increase in frequency (0.51 mL at 226 Hz, 0.55 mmho at 678 Hz and 1.20 mmho at 1,000 Hz). 93.06% of the tympanograms were classified as normal at 226 Hz, 81.82% at 678 Hz, and 77.00 % at 1,000 Hz, respectively.

Conclusion: Taken together, these results demonstrated that utilizing these evaluations made it possible to characterize the acoustic immittance measures of infants.

Resumo

Introdução: O uso de uma única frequência na timpanometria não é sensível na detecção de todos os casos de alteração na orelha média, dificultando o diagnóstico preciso.

Objetivo: Caracterização das medidas de imitância acústica de lactentes utilizando três tipos de sonda. Estudo prospectivo.

Método: Foram avaliados 54 lactentes, com idade entre zero e três meses. Os critérios de inclusão foram ausência de infecções de vias aéreas, presença de emissões otoacústicas evocadas transientes, ausência de indicadores de risco para perda auditiva. Foi realizada entrevista audiológica, inspeção visual do meato acústico externo e medidas de imitância acústica nas frequências de 226Hz, 678Hz e 1000Hz. Foram coletados os registros timpanométricos de efeito de oclusão, curva e pressão de pico timpanométrico, volume equivalente do meato acústico externo e pico compensado da admitância acústica estática.

Resultados: Os resultados indicaram presença de efeito de oclusão (2,88% em 226Hz, 4,81% em 678Hz e 3,85% em 1000Hz); predomínio de curva em pico único (65,35% em 226Hz, 81,82% em 678Hz e 77,00% em 1000Hz); pressão de pico variando de -150 a 180daPa; aumento do volume equivalente do meato acústico externo com aumento da frequência da sonda (0,64ml em 226Hz, 1,63mmho em 678Hz e 2,59mmho em 1000Hz); aumento do pico compensado da admitância acústica estática (0,51ml em 226Hz, 0,55mmho em 678Hz e 1,20mmho em 1000Hz). Foram classificados como normais 93,06% dos timpanogramas com 226Hz, 80,81% em 678Hz e 82,00% em 1000Hz.

Conclusão: Por meio destas avaliações e resultados foi possível caracterizar as medidas de imitância acústica dos lactentes.

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