Normative Wideband Acoustic Immittance Data: Toward Clinical Application

描述（由申请人提供）：基于耳道的声学测量，即宽带声阻抗（WAI）测试，显示出作为强大的中耳评估工具的前景，与传统的中耳评估方法相比，具有潜在的显著优势。WAI的一些优点包括能够获得对语音感知重要的频率（0.25-8 kHz）的响应，提高对中耳声学特性与年龄相关变化的敏感性，提高对各种中耳疾病的敏感性，以及预测传导性听力损失（CHL）的能力。此外，由于某些中耳疾病的医疗管理决策（即抗生素和/或手术）通常是基于是否存在传导性听力损失（CHL），因此依靠准确、客观的中耳检查来检测CHL的能力可能有助于限制不必要的手术和/或抗生素的使用。虽然确定了某些年龄组对WAI的成熟影响，表明有必要制定针对特定年龄的规范数据，但缺乏对广泛年龄组WAI中年龄相关差异的充分研究和全面的规范数据库，严重限制了WAI测试的临床应用。因此,这个建议的目的是收集围数据跨广泛的年龄范围从个人(6个月到75岁),1)识别与年龄相关的围差异特征和建立一个围规范数据库在一个广泛的年龄范围,2)确定纵向变化围数据小组的主题(6 - 11个月)跟踪中耳开发更多的样品在一个时间最伟大的围预计将发生的变化,3)描述渗出性中耳炎（OME）患者中耳功能变化的自然历史，以确定在病理进展过程中是否出现明显的WAI特征。在完成拟议的项目后，我们期望能够确定对WAI存在显著成熟影响的年龄，建立一个从婴儿期到成年期选定年龄的全面的WAI规范数据库。并在儿童OME的自然史上获得了有价值的结果。由于WAI有可能显著提高我们识别中耳功能障碍和预测CHL的能力，因此拥有一个规范的数据库，为解释中耳疾病的WAI测量提供背景，将是提高WAI测试临床应用的重要一步。

DESCRIPTION (provided by applicant): Ear-canal based acoustic measurements known as wideband acoustic immittance (WAI) tests are showing promise as powerful middle-ear assessment tools, with potential for significant advantages over traditional middle-ear assessment measures. Some advantages of WAI include the ability to obtain responses over frequencies important for speech perception (0.25-8 kHz), heightened sensitivity to age-related changes in the acoustic properties of the middle ear, improved sensitivity to a wide variety of middle-ear disorders, and the ability to predict conductive hearing loss (CHL). Furthermore, because medical management decisions (i.e., antibiotics and/or surgery) with some middle-ear disorders are often based on the presence/absence of a conductive hearing loss (CHL), the ability to rely on an accurate, objective middle-ear tests to detect CHL may help restrict the unnecessary use of surgery and/or antibiotics. While identification of maturational effects on WAI for some age groups has brought to light the need to develop age-specific normative data, absence of sufficient study of age-related differences in WAI across a broad age range and a comprehensive normative database severely limits the clinical application of WAI tests. Therefore, the aims of this proposal are to gather WAI data from individuals across a broad age range (6 months to 75 years) to, 1) identify age-related differences in WAI characteristics and build a WAI normative database across a broad age range, 2) Identify longitudinal changes in WAI data for a subgroup of subjects (6 to 11 months) to track middle-ear development with more samples across a time period when the greatest changes in WAI are expected to occur, and 3) describe the natural history of changes in middle-ear function for ears with otitis media with effusion (OME) to determine if distinctive WAI characteristics emerge during the progression of pathology At the completion of the proposed project, it is our expectation that we will have identified ages at which significant maturational effects on WAI are present, established a comprehensive WAI normative database at selected ages from infancy through adulthood, and obtained valuable results on the natural history of OME in children. Inasmuch as WAI has potential to significantly improve our ability to identify middle-ear dysfunction and predict CHL, having a normative database to provide context with which to interpret WAI measurements from ears with middle-ear disorders will be a significant step forward in enhancing the clinical utility of WAI tests.