Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power.
Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power.
复制标题
DOI：
10.1097/aud.0000000000000968
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Garinis AC
中科院分区：
文献类型：
--
作者：
Feeney MP;Keefe DH;Hunter LL;Fitzpatrick DF;Putterman DB;Garinis AC
在一组经手术证实的耳硬化症（Oto组）受试者（平均年龄51.6岁）中评价宽带吸光度和吸收功率。这是第一次使用吸收功率评估中耳疾病。结果与两组成年人的对照数据进行比较，一组听力正常，（NH组）平均年龄为31岁，另一组与Oto组年龄和性别匹配，并有感音神经性听力损失（SNHL组）。目的是使用吸光度和吸收功率评估组间差异，以确定检测耳硬化症的测试性能，并评估术前和术后测试结果。听力和宽带测试进行了频率高达8千赫。使用方差分析对三组进行宽带测试比较，以评估组平均差异。还使用受试者工作特征（ROC）曲线分析来评估使用ROC曲线下的面积（AUC）将耳朵分类为属于Oto组或对照组的测试准确性。采用纵向设计比较3个月和6个月时的术前和术后结果。Oto组和对照组之间的宽带参数存在显著的平均差异，Oto组在环境和鼓室峰值压力（TPP）下的吸光度和吸收功率通常较低，这取决于频率。SNHL组与Oto组在环境压力下的吸收功率和TPP处的鼓室吸收功率的高频以及鼓室尾部的差异比NH组更显著。将耳朵分类为Oto组或对照组的最大准确度是在0.71 kHz环境压力下的吸收功率，Oto组和NH组的AUC为0.81。吸光度测量的最大准确度是在峰-负尾条件下Oto组和NH组之间的比较，AUC为0.78。相比之下，在226 Hz的静态声导纳（SAA）的控制或Oto组的耳朵分类的准确性是接近机会的性能，这是与以前的研究结果一致。本研究与峰-正尾条件下2.83 kHz和峰-负尾条件下4 kHz两项研究的吸光度峰-尾差异具有良好的一致性，AUC较高。术前和术后吸光度和吸收功率测试之间存在显著平均差异。与以前的研究一致，宽带吸光度显示出更好的灵敏度检测耳硬化症对中耳功能的影响比SAA在226 Hz。这项研究表明，宽带吸收功率同样敏感，在某些情况下，在将耳朵分类为患有耳硬化症时，其表现甚至比吸光度更好。使用与Oto组年龄和性别匹配的组通常会导致组间吸收功率的高频差异更大，这表明成人中与年龄相关的规范可能对宽带临床应用有用。吸光度和吸收功率似乎有用的监测中耳功能的变化手术后的耳硬化症。
Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing, (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate pre-operative and post-operative test results. Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare pre- and post-operative results at 3 and 6 months. There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance (SAA) at 226-Hz was near chance performance, which is consistent with previous findings. There was good agreement between the present study and for absorbance peak-to-tail differences with high AUCs for both studies at 2.83 kHz for the peak-to-positive tail condition and at 4 kHz for the peak-to-negative tail condition. There were significant mean differences between pre- and post-operative tests for absorbance and absorbed power. Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than SAA at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.