| Objective:1.Clarify whether the 226 Hz tympanic chart in broadband acoustic reactance is consistent and unified with the 226 Hz tympanic chart in traditional acoustic reactance.2.Clear the value and range of Wideband absorbance(WBA)curve and Middle ear resonant frequency(RF)of hearing normal people,secretory otitis media and otosclerosis patients.The effects of age,sex and ear side on WBA and RF were analyzed.3.To clarify the diagnostic and differential diagnostic value of RF and WBA in hearing normal people,secretory otitis media and otosclerosis patients.Methods:1.A total of 77 subjects(154 ears in total)with normal hearing were selected from the Twelfth People’s Hospital of Guangzhou from October 2022 to February 2023 after specialist physical examination,pure tone threshold test,general acoustic reactance test and otoacoustic emission(OAE)examination,including 32 males and 45 females,aged14-49 years old,as the normal group.In the normal group,16 patients were divided into the juvenile group(14-17 years old)with an average age of 15.75 years.There were 39 students in the youth group(18-29 years old),with an average age of 22.56 years old.Twenty-two patients were in the young and middle-aged group(30-49 years old),with an average age of 30.01 years.2.A total of 13 cases(7 males and 6 females,aged 21-37 years)in the secretory otitis media group and 5 cases(2 males and 3 females)in the otosclerosis group were selected from the Twelfth People’s Hospital of Guangzhou during the same period.3.The above mentioned healthy people and patients in different age groups were all tested with the same wide-band acoustic reactance instrument to obtain the energy absorption rate(WBA)curve,middle ear resonance frequency(RF)and tympanum reactance map of 226 Hz.The mean and standard deviation of each measured value was calculated by statistical methods,and the WBA curve was drawn.Compare and analyze the difference of hearing normal people secretory otitis media patients and otosclerosis patients.Results:1.Pairwise comparison between the 226 Hz tympanic chart and the traditional 226 Hz tympanic chart in wide-band acoustic reactance was conducted through paired T-test analysis and it was found that there were significant differences in sound compliance value(P<0.05),significant differences in peak pressure points in tympanic chart(P<0.05),and no significant differences in equivalent external auditory canal volume(P>0.05).2.The influence of age,gender and ear measurement on middle ear resonance frequency(RF): The adolescent group,the youth group and the middle-aged and young people group in the normal hearing group were taken as the single factor,and the analysis of variance was performed,P>0.05,indicating that the homogeneity of variance was satisfied,indicating that there was no significant difference in middle ear resonance frequency(RF)between the teenagers,the young people and the middle-aged and young people.The paired T-test of RF measurements of male and female ear showed that there was no significant difference between male and female RF measurements(P>0.05).There was no significant difference between left ear RF and right ear RF(P>0.05).3.Normal hearing group,secretory otitis media group and otosclerosis group RF measurement values: normal hearing group was 924±173Hz,secretory otitis media group was 405±64Hz,otosclerosis group was 1312±131Hz.By variance analysis,P < 0.05 was found for all groups,suggesting significant differences in RF measurements among all groups.4.WBA curve test results of hearing normal people: absorption rate mainly concentrated in 1374～2911Hz.The lowest absorptance was 0.152 at 226 Hz,and then it rose steeply,reaching the first peak of 0.696 at 1374 Hz,then forming a plateau,reaching the second peak of 0.712 at 2911 Hz,and then falling rapidly,reaching the second low value of 0.394 at 6350 Hz.In the normal hearing group,the WBA curves of the three different age groups and different genders were basically consistent.The absorption rate at226 Hz,500Hz,1000 Hz,2000Hz,4000 Hz and 8000 Hz was selected,and age and gender were used as two factors for analysis of variance,and there was no statistical significance at each frequency(P>0.05).The WBA curves of the left and right ears were basically the same,and there was no statistical significance at each frequency(P > 0.05).5.Secretory otitis media group WBA curve test results: the whole was "low flat".The lowest absorption rate was 0.14 at 226 Hz,the first absorption rate was 0.277 at 866 Hz,and the second absorption rate was 0.421 at 2828 Hz.Compared with the normal hearing group,the two peak absorptivity points decreased significantly,and the corresponding frequencies of the two peak absorptivity points moved forward.The difference of energy absorption rate between the secretory otitis media group and the normal group was analyzed by selecting 10 frequency peaks within 226～8000Hz,suggesting that the energy absorption rate of secretory otitis media group with frequency above 500 Hz was significantly lower than that of the normal group,with statistical difference(P < 0.05).Further,515 Hz,545Hz and 561 Hz between 500 and 750 Hz were selected for comparative analysis,indicating that there was no significant difference at 515Hz(P > 0.05),while there was significant difference between 545 Hz and 561Hz(P < 0.05).The energy absorption rate of otitis media group with secretory frequency above 545 Hz was significantly lower than that of normal group.6.Otosclerosis WBA curve test results: the overall is "low flat-peak shape",the performance of the low frequency area is "low flat shape",to the high frequency area is "peak shape".The lowest absorptivity was 0.067 at 226 Hz,and the peak absorptivity was0.727 at 3268 Hz.Seven frequencies(226Hz,500 Hz,1000Hz,2000 Hz,2997Hz,4000 Hz,6000Hz)were selected from 226 to 6000 Hz to analyze the difference of energy absorption rate between otosclerosis group and normal hearing group under peak pressure.It indicates that except 2997 Hz,4000Hz and 6000 Hz,the other four frequencies have significant differences(P < 0.05).Continue to select the first two frequencies of 3000 Hz,namely 2828 Hz and 2911 Hz,for analysis,and both have significant differences(P < 0.05).The energy absorption rate of otosclerosis group was significantly lower than that of normal group in 226-2911 Hz range.Conclusion:1.There are significant differences in sound alignment value and peak pressure value between the 226 Hz tympanic reactance map and the traditional 226 Hz tympanic reactance map in broadband acoustic reactance,which may be caused by systematic errors between the two test techniques.2.There is no significant difference in the middle ear resonance frequency(RF)and WBA curves due to age(mainly adolescents,young adults and middle-aged and young adults),gender and ear type,and the influence of the above factors on RF and WBA curves should not be considered in clinical work.3.Middle ear resonance frequency(RF)has clinical diagnostic value in determining normal hearing,secretory otitis media and otosclerosis.4.The WBA curve of broadband acoustic transduction has differential diagnostic value in determining normal hearing persons,secretory otitis media and otosclerosis,and the WBA curve has diagnostic value in the amount of middle ear effusion. |
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