Aithal Sreedevi, Aithal Venkatesh, Kei Joseph, Wilson Matthew
Department of Audiology, Townsville University Hospital, Townsville, Queensland, Australia.
Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.
J Am Acad Audiol. 2024 Jul;35(7-08):193-203. doi: 10.1055/s-0044-1791213. Epub 2024 Dec 18.
The objectives of the study were to (i) evaluate the effectiveness of wideband absorbance (WBA) at ambient pressure (WBA), tympanic peak pressure (WBA), and 0 daPa (WBA) to identify conductive hearing loss (CHL) in infants and (ii) compare the sensitivity and specificity of the three WBA tests with that of high-frequency tympanometry (HFT) and transient-evoked otoacoustic emissions (TEOAE).
A total of 31 ears with hearing thresholds no greater than 20 dB HL (reference group from 20 infants [mean age: 3.1 weeks]) and 47 ears with CHL from 31 infants (mean age: 3.4 weeks) were included in the study. Hearing threshold was determined using air-conduction tone-burst auditory brainstem response (TB-ABR) test, whereas CHL was determined using both air- and bone-conduction TB-ABR tests. HFT with a 1000-Hz probe tone, TEOAE, and WBA tests were conducted on all participants.
WBA WBA, and WBA of the CHL group were significantly lower than that of the reference group across a wide frequency range. Area under the receiver operating characteristic (AROC) curve for detecting CHL varied from 0.51 to 0.9 depending on the frequency. The highest AROC was obtained at 1.25 kHz for WBA (0.79), at 1.5 kHz for WBA (0.9) and at 1 kHz for WBA (0.80). The sensitivity and specificity were 0.98 and 0.45, respectively for HFT, and 1.0 and 0.6, respectively for TEOAE. In comparison, the WBA test had slightly lower sensitivity but higher specificity than the HFT and TEOAE tests.
WBA at 1.5 kHz can identify CHL in infants as good as, if not more accurately than, WBA or WBA WBA test had good balance of high sensitivity and specificity compared with HFT and TEOAE. The three WBA tests are useful tools for identifying CHL in infants under 6 weeks of age.
本研究的目的是：（i）评估常压下宽带吸收率（WBA）、鼓室峰压下宽带吸收率（WBA）和0 daPa下宽带吸收率（WBA）在识别婴儿传导性听力损失（CHL）方面的有效性；（ii）比较这三种WBA测试与高频鼓室图（HFT）和瞬态诱发耳声发射（TEOAE）的敏感性和特异性。
本研究共纳入了31只听力阈值不超过20 dB HL的耳朵（来自20名婴儿的参考组[平均年龄：3.1周]）和31名婴儿的47只患有CHL的耳朵（平均年龄：3.4周）。听力阈值通过气导短纯音听性脑干反应（TB-ABR）测试确定，而CHL通过气导和骨导TB-ABR测试确定。对所有参与者进行了1000 Hz探测音的HFT、TEOAE和WBA测试。
CHL组的WBA、WBA和WBA在很宽的频率范围内均显著低于参考组。根据频率不同，检测CHL的受试者工作特征曲线下面积（AROC）在0.51至0.9之间变化。WBA在1.25 kHz时获得的最高AROC为0.79，WBA在1.5 kHz时为0.9，WBA在1 kHz时为0.80。HFT的敏感性和特异性分别为0.98和0.45，TEOAE的敏感性和特异性分别为1.0和0.6。相比之下，WBA测试的敏感性略低于HFT和TEOAE测试，但特异性更高。
1.5 kHz的WBA在识别婴儿CHL方面的效果与WBA或WBA相当，即使不比它们更准确。与HFT和TEOAE相比，WBA测试在高敏感性和特异性之间具有良好的平衡。这三种WBA测试是识别6周龄以下婴儿CHL的有用工具。
