Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School and Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
Copenhagen Hearing & Balance Centre, Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Ear Hear. 2022 Mar/Apr;43(2):563-576. doi: 10.1097/AUD.0000000000001117.
Absorbance measured using wideband tympanometry (WBT) has been shown to be sensitive to changes in middle and inner ear mechanics, with potential to diagnose various mechanical ear pathologies. However, artifacts in absorbance due to measurement noise can obscure information related to pathologies and increase intermeasurement variability. Published reports frequently present absorbance that has undergone smoothing to minimize artifact; however, smoothing changes the true absorbance and can destroy important narrow-band characteristics such as peaks and notches at different frequencies. Because these characteristics can be unique to specific pathologies, preserving them is important for diagnostic purposes. Here, we identify the cause of artifacts in absorbance and develop a technique to mitigate artifacts while preserving the underlying WBT information.
A newly developed Research Platform for the Interacoustics Titan device allowed us to study raw microphone recordings and corresponding absorbances obtained by WBT measurements. We investigated WBT measurements from normal hearing ears and ears with middle and inner ear pathologies for the presence of artifact and noise. Furthermore, it was used to develop an artifact mitigation procedure and to evaluate its effectiveness in mitigating artifacts without distorting the true WBT information.
We observed various types of noise that can plague WBT measurements and that contribute to artifacts in computed absorbances, particularly intermittent low-frequency noise. We developed an artifact mitigation procedure that incorporates a high-pass filter and a Tukey window. This artifact mitigation resolved the artifacts from low-frequency noise while preserving characteristics in absorbance in both normal hearing ears and ears with pathology. Furthermore, the artifact mitigation reduced intermeasurement variability.
Unlike smoothing algorithms used in the past, our artifact mitigation specifically removes artifacts caused by noise. It does not change frequency response characteristics, such as narrow-band peaks and notches in absorbance at different frequencies that can be important for diagnosis. Also, by reducing intermeasurement variability, the artifact mitigation can improve the test-retest reliability of these measurements.
宽频鼓室导抗(WBT)测量的吸光度对中耳和内耳力学变化敏感,具有诊断各种机械性耳病的潜力。然而,由于测量噪声引起的吸光度伪影会掩盖与病变相关的信息,并增加测量间的变异性。已发表的报告经常呈现经过平滑处理以最小化伪影的吸光度;然而,平滑处理会改变真实的吸光度,并破坏不同频率处的峰和切迹等重要的窄带特征。由于这些特征可能是特定病变所特有的,因此保留这些特征对于诊断目的很重要。在这里,我们确定了吸光度伪影的原因,并开发了一种在保留底层 WBT 信息的同时减轻伪影的技术。
新开发的 Interacoustics Titan 研究平台允许我们研究正常听力耳和中耳及内耳病变耳的原始麦克风记录和相应的 WBT 测量吸光度。我们研究了 WBT 测量结果中存在的伪影和噪声。此外,它被用于开发一种减轻伪影的程序,并评估其在不扭曲真实 WBT 信息的情况下减轻伪影的有效性。
我们观察到各种类型的噪声会干扰 WBT 测量并导致计算吸光度中的伪影,特别是间歇性低频噪声。我们开发了一种包含高通滤波器和 Tukey 窗口的伪影减轻程序。这种伪影减轻程序消除了低频噪声引起的伪影,同时保留了正常听力耳和病变耳中吸光度的特征。此外,伪影减轻还降低了测量间的变异性。
与过去使用的平滑算法不同,我们的伪影减轻程序专门去除由噪声引起的伪影。它不会改变频率响应特征,例如不同频率处吸光度的窄带峰和切迹,这些特征对于诊断很重要。此外,通过降低测量间的变异性,伪影减轻可以提高这些测量的测试-重测可靠性。