Final Flashcards
Understand the limitations of using 226 Hz tympanometry in infants.
- not useful for evaluating the ME system of infants because infants have mass dominated systems
- Low sensitivity to the presence of MEE
Flat tymps for the 226 Hz probe tone observed in some neonates with normal MEs
Normal tymps were obtained in infants with diagnosed MEE
Notched 226 Hz tymps in infants with confirmed OME
Identify and describe the anatomical differences in the outer and middle ear structures between infants and adults and explain how these differences affect immittance measurements.
ME space is smaller in infants
Increase in aeration and size of the ME cavity including pneumatization of the mastoid air cells; at birth, the ME may not be completely aerated
Length of ME cavity increases in first 6 months from the TM to the footplate
ET is more horizontal. Narrower, less rigid, and shorter
Horizontal orientation of the TM
Underossified ossicular chain
Adult ME = stiffness dominated with lower resonant frequency (<500Hz)
Infant ME = mass dominated with higher resonant frequency
Adult ME = ______ dominated with ______ resonant frequency
Adult ME = stiffness dominated with lower resonant frequency (<500Hz)
Infant ME = ______ dominated with ______ resonant frequency
Infant ME = mass dominated with higher resonant frequency
Describe the advantages of using 1000 Hz tympanometry in infants and be able to interpret the results.
More sensitive to changes in ME status compared to 226 Hz probe in infants less than 4 months
Tend to be single peaked or flat, making it easier to differentiate between normal and abnormal ears.
Shows the presence or absence of fluid - doesn’t report ECV
Uncompensated
Uncompensated = when the tail does not start at 0.
Compensated
Compensated = when tail starts at 0
Explain why clinicians need to be cautious when assessing ARTs at higher levels in neonates and infants.
The potential risk of permanent threshold shift is higher in infants due to the smaller ear canal volumes and corresponding higher SPL and can be at least 10 dB higher than in the adult ear
Test 5, 1, 2 kHz ipsilaterally - if child is difficult, use BBN
Describe the advantages of using WB tympanometry in pediatric patients as well as how to interpret test results.
Broad frequency range
More sensitive and specific
Less affected by ear canal volume and probe position
It is measured at ambient pressure
An airtight seal between the probe tip and ear canal wall is not required
The technique quickly provides information on ME function across a wide frequency region
Distinctive wideband reflectance patterns seems to be associated with normal ME function and different types of ME dysfunction
Describe the general strategies that can be used to adapt behavioral and physiological tests for assessing hearing in children with special needs.
- You need to say, “I was unable to test this child” rather than “this child is untestable”
- Can begin with electrophysiologic testing (ABR/OAE)
- If this testing is no concern, additional testing might not be needed
-If hearing is a concern, behavioral testing is critical - Accurate assessment of hearing level in children with developmental delay is crucial to optimize their rehabilitation, intervention, and follow up
- The cross-check procedures are necessary to complete the hearing evaluation and to confirm normal hearing in these children or the presence of hearing loss
- Every effort must be made to ensure the comprehensiveness and accuracy of all audiologic results
Sensitivity and specificity and how to calculate them.
Sensitivity
the ability of a test to correctly identify those with the disorder
True positive/total positive
Specificity
the ability of a test to correctly identify those without the disorder
True negative/total negative
Number of cases of a disease existing in a population during a specified time period
Proportion of the population that has the condition at a point in time
Prevalence
Prevalence
Number of cases of a disease existing in a population during a specified time period
Proportion of the population that has the condition at a point in time
Number of new cases identified over a given period of time, typically one year.
Reported as a fraction of the population at risk of developing the disease or condition of interest
Incidence
Number of new cases identified over a given period of time, typically one year.
Reported as a fraction of the population at risk of developing the disease or condition of interest
Incidence
