Measurements of middle ear functioning- traditional (acoustic impedance and acoustic admittance) and modern (middle ear reflectance and middle ear absorbance): a review
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20212137Keywords:
Impedance, Admittance, Reflex, Tympanometry, Reflectance, AbsorbanceAbstract
Estimation of the middle ear functioning is necessary for the assessment and management of the middle ear disorders. It is also crucial for deciding upon the management of hearing loss. Though very important for audiologists and otologist clinically, there are many misconceptions behind the scientific principle/rationale and confusions related to the terminologies and units used for the measurements of middle ear functioning such as acoustic impedance, acoustic admittance, middle ear reflectance and middle ear absorbance. Literature included in this review was searched from book chapters, instrument manuals, journal articles, monographs, scientific guidelines and standard specifications on the related topics. This review work threw light and eases understanding on the principles used by different instruments to estimate various measures of middle ear functioning. It will enhance understanding of the measurements and also of the relation between different measurements of middle ear functioning. Clinically, it will help professionals in analyzing results better considering the measurements variables (if present) and bring continuity in reporting the results of middle ear functioning.
References
Dhingra PL, Dhingra S. Diseases of ear, nose and throat. 7th ed. India: Elsevier; 2017.
Hunter LL, Shahnaz N. Acoustic immittance measures: Basic and advanced practice. 1st ed. San Diego, USA: Plural Publishing; 2013.
Silman S, Silverman CA, Arick DS. Acoustic-immittance screening for detection of middle-ear effusion in children. J Am Acad Audiol. 1992;3(4):262-8.
Stach B. The audiologists assessment tools: Immitance measures. Clinical audiology: An introduction. Delmar, USA: Cengage Learning; 2008: 314-354.
ANSI. American national standards specification for instruments to measure aural acoustic impedance and admittance (aural acoustic immittance). New York, USA: American National Standards Institute; 1987.
American Speech-Language-Hearing Association. Guidelines for screening for hearing impairment and middle-ear disorders. ASHA. 1990:(2):25-30.
Fowler CG, Shanks JE. Tympanometry. In: Katz J, Burkard RF, Medwetsky L, eds. Handbook of clinical audiology. 5th ed. Philedelphia, USA: Lippincott Williams & Wilkins: 2002.
Hunter LL, Sanford CA. Tympanometry and wideband acoustic immitance. In: Katz J, Chasin M, English K, Hood LJ, Terry KM, eds. Handbook of clinical audiology. 7th ed. Philedelphia, USA: Lippincott Williams & Wilkins; 2015: 137-163.
Gelfand SA. Acoustic immittance assessment. In: Gelfand SA, eds. Essentials of audiology. 3rd ed. New York, USA: Thieme; 2011: 205-238.
Martin FN, Clark JG. Diagnostic Hearing Tests. In: Martin FN, and Clark JG, eds. Introduction to audiology. 9th ed. Boston, USA: Allyn and bacon; 2006: 148-185.
Shanks JE, Lilly DJ, Margolis RH, Wiley TL, Wilson RH. Tympanometry. J Speech Hear Disord. 1988;53(4):354-77.
Wiley TL, Fowler CG. Acoustic immittance measures in clinical audiology: A primer. San Diego, USA: Singular Publishing; 1997.
Wiley TL, Stoppenbach DT. Basic principles of acoustic immittance measures. In: Katz J, Burkard RF, and Medwetsky L, eds. Handbook of clinical audiology. 5th ed. Philedelphia, USA: Lippincott Williams & Wilkins; 2002.
Popelka GR. Acoustic immittance measures: terminology and instrumentation. Ear Hear. 1984;5(5):262-7.
Camp KJ, Margolis RH, Wilson RH, Creten WL, Shanks JE. Principles of tympanometry. ASHA Monogr. 1986;(24):1-88.
Camp KJ, Creten WL. Principles of acoustic impedance and admittance. In: Felman AS, Wilber A, eds. Acoustic impedance and admittance-the measurement of middle ear function. Baltimore, USA: Williams & Wilkins; 1976: 300-335.
Margolis RH, Hunter LL. Tympanometry: Basic principles and clinical applications. In: Musiek FE, Rintelmann WI, eds. Contemporary perspectives in hearing assessment. Boston, USA: Allyn & Bacon; 1999: 89-130.
Bernstein JL. Audio systems, 1966. Available at: https://en.wikipedia.org/wiki/JL_Audio. Accessed on 18 October 2020.
Gelfand SA. Essentials of audiology. 2nd ed. New York, USA: Thieme; 2001.
Northern JL. Acoustic Immittance Measures in Clinical Audiology: A Primer. Ear Hear. 1998;19(2):168.
Saxena U, Allan C, Allen P. Crossed and uncrossed acoustic reflex growth functions in normal-hearing adults, typically developing children, and children with suspected auditory processing disorder. Int J Audiol. 2015;54(9):620-6.
Saxena U, Allan C, Allen P. Acoustic reflexes in normal-hearing adults, typically developing children, and children with suspected auditory processing disorder: Thresholds, real-ear corrections, and the role of static compliance on estimates. J Am Acad Audiol. 2017;28(6):480-90.
Bennett M. Impedance Concepts Relating to the Acoustic Reflex. The acoustic reflex: Basic principles and clinical applications. Florida, USA: Academic Press; 1984: 36-59.
Schairer KS, Feeney MP, Sanford CA. Acoustic Reflex Measurement. Ear Hear. 2013;34:43-7.
Keefe DH, Levi E. Maturation of the middle and external ears: acoustic power-based responses and reflectance tympanometry. Ear Hear. 1996;17(5): 361-73.
Liu YW, Sanford CA, Ellison JC, Fitzpatrick DF, Gorga MP, Keefe DH. Wideband absorbance tympanometry using pressure sweeps: System development and results on adults with normal hearing. J Acoust Soc Am. 2008;124(6):3708-19.
Keefe DH, Simmons JL. Energy transmittance predicts conductive hearing loss in older children and adults. J Acoust Soc Am. 2003;114(6):3217-38.
Interacoustics. TITAN-Instruction for use. 2013.