Center for Hearing Research, Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska, USA.
J Acoust Soc Am. 2021 Aug;150(2):969. doi: 10.1121/10.0005822.
The goal of this work was to estimate the middle-ear input impedance ( Z) from wideband acoustic immittance (WAI) measures and determine whether Z improves the clinical utility of WAI. The data used in this study were from a previously reported set of WAI measurements in ears with otitis media with effusion [OME; Merchant, Al-Salim, Tempero, Fitzpatrick, and Neely (2021). Ear Hear., published online]. Ears with OME were grouped based on effusion volume, which was confirmed during tube surgery. Z was estimated from the measured ear-canal impedance. An electrical-analog model of ear-canal acoustics and middle-ear mechanics was used to model the ear canal and Z. The model results fit the measured responses well for all conditions. A regression approach was used to classify the responses of different variable types to effusion volume groups and determine the specificity and sensitivity of the binary classifications. The Z magnitude increased with increasing effusion volume. The area under the receiver operating characteristic curve (AUC) was compared for binary decisions of the OME categories. The Z estimate resulted in a clinically meaningful improvement in the AUC for distinguishing healthy ears from ears with OME. Overall, these results suggest that Z estimation may provide useful information of potential clinical value to improve the diagnostic utility of WAI measurements for OME.
这项工作的目的是从宽频带声导抗（WAI）测量中估计中耳输入阻抗（Z），并确定 Z 是否能提高 WAI 的临床实用性。本研究使用的数据来自先前报道的一组中耳积液（OME；Merchant、Al-Salim、Tempero、Fitzpatrick 和 Neely，2021 年。Ear Hear.，在线发表）的 WAI 测量数据。OME 耳根据积液量进行分组，这是在管手术期间确认的。Z 是从测量的耳道阻抗中估计出来的。使用耳道声学和中耳力学的电模拟模型来模拟耳道和 Z。对于所有条件，模型结果都很好地拟合了测量的响应。回归方法用于对不同变量类型的响应进行分类，以确定积液体积组的分类的特异性和敏感性。Z 幅度随积液量的增加而增加。比较了区分健康耳和 OME 耳的 OME 类别的二值决策的接收者操作特征曲线（AUC）下面积。Z 估计可显著提高 AUC，从而有助于区分健康耳和 OME 耳，这表明 Z 估计可能为改善 WAI 测量对 OME 的诊断实用性提供有潜在临床价值的有用信息。
