Achados timpanométricos em neonatos com emissões otoacústicas presentes: medidas e interpretações
Timpanometria avalia condições funcionais da orelha média. Quando realizada em neonatos abaixo de quatro meses de idade pode gerar dúvidas. Sondas de alta freqüência têm sido investigadas na busca por resultados mais confiáveis. OBJETIVO: Descrever e analisar interpretações de características e medi...
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Published in: | Revista brasileira de otorrinolaringologia Vol. 73; no. 5; pp. 633 - 639 |
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01-10-2007
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Abstract | Timpanometria avalia condições funcionais da orelha média. Quando realizada em neonatos abaixo de quatro meses de idade pode gerar dúvidas. Sondas de alta freqüência têm sido investigadas na busca por resultados mais confiáveis. OBJETIVO: Descrever e analisar interpretações de características e medidas obtidas na timpanometria em neonatos com freqüências de 226, 678 e 1000Hz. MATERIAL E MÉTODO: Os 110 neonatos avaliados tinham idade entre 6 e 30 dias, não apresentaram fatores de risco e tinham emissões otoacústicas presentes. A timpanometria foi realizada com o analisador GSI-33-II, na Divisão de Educação e Reabilitação dos Distúrbios da Comunicação, São Paulo, em 2004. FORMA DE ESTUDO: Clínico prospectivo. RESULTADOS: Observou-se equilíbrio nas curvas pico único e pico duplo em 226Hz, maior ocorrência de assimétrica em 678Hz e de pico único em 1000 Hz. Houve significância de gênero na medida volume equivalente do meato acústico externo, em 226Hz, e na medida admitância acústica estática de pico compensado, em 1000Hz. O protocolo inglês apresentou quase 100% de normalidade em 678 e 1000Hz. CONCLUSÃO: A sonda de 1000Hz apresentou melhores resultados na caracterização da normalidade. O protocolo inglês mostrou-se eficiente em diminuir variabilidades das medidas. Os resultados podem ser usados como guia no diagnóstico da timpanometria.
Tympanometry is used in evaluating middle ear functional conditions. Before six months of age its results may be misleading. High frequency studies aim to provide more valid procedures. AIM: To describe and discuss tympanometric measurements and the interpretation in normal hearing neonates at 226, 678 and 1000Hz. METHOD: 110 neonates that were analyzed had normal otoacoustic emissions and no risk for hearing impairment. The age range was 6 to 30 days. Curves were obtained using the GSI-33-II, at the Divisão de Educação e Reabilitação dos Distúrbios da Comunicação, São Paulo, in 2004. STUDY DESIGN: Clinical prospective. RESULTS: There was a balance between single and double peak curves at 226Hz. Most of the curves were asymmetric at 678Hz, and single-peaked at 1000Hz. quantitative measurements showed a significant gender difference in the Equivalent Ear Canal Volume at 226Hz and on the Peak Compensated Static Acoustic Admittance at 1000Hz. The English protocol showed that almost 100% of ears were normal at 678 and 1000Hz. CONCLUSION: 1000Hz yielded superior results for characterizing normality. The English protocol was efficient to reduce the variability of tympanometric measurements. Data from this study may be used as a guide for diagnosis using tympanometry in neonates. |
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AbstractList | Timpanometria avalia condições funcionais da orelha média. Quando realizada em neonatos abaixo de quatro meses de idade pode gerar dúvidas. Sondas de alta freqüência têm sido investigadas na busca por resultados mais confiáveis. OBJETIVO: Descrever e analisar interpretações de características e medidas obtidas na timpanometria em neonatos com freqüências de 226, 678 e 1000Hz. MATERIAL E MÉTODO: Os 110 neonatos avaliados tinham idade entre 6 e 30 dias, não apresentaram fatores de risco e tinham emissões otoacústicas presentes. A timpanometria foi realizada com o analisador GSI-33-II, na Divisão de Educação e Reabilitação dos Distúrbios da Comunicação, São Paulo, em 2004. FORMA DE ESTUDO: Clínico prospectivo. RESULTADOS: Observou-se equilíbrio nas curvas pico único e pico duplo em 226Hz, maior ocorrência de assimétrica em 678Hz e de pico único em 1000 Hz. Houve significância de gênero na medida volume equivalente do meato acústico externo, em 226Hz, e na medida admitância acústica estática de pico compensado, em 1000Hz. O protocolo inglês apresentou quase 100% de normalidade em 678 e 1000Hz. CONCLUSÃO: A sonda de 1000Hz apresentou melhores resultados na caracterização da normalidade. O protocolo inglês mostrou-se eficiente em diminuir variabilidades das medidas. Os resultados podem ser usados como guia no diagnóstico da timpanometria.
Tympanometry is used in evaluating middle ear functional conditions. Before six months of age its results may be misleading. High frequency studies aim to provide more valid procedures. AIM: To describe and discuss tympanometric measurements and the interpretation in normal hearing neonates at 226, 678 and 1000Hz. METHOD: 110 neonates that were analyzed had normal otoacoustic emissions and no risk for hearing impairment. The age range was 6 to 30 days. Curves were obtained using the GSI-33-II, at the Divisão de Educação e Reabilitação dos Distúrbios da Comunicação, São Paulo, in 2004. STUDY DESIGN: Clinical prospective. RESULTS: There was a balance between single and double peak curves at 226Hz. Most of the curves were asymmetric at 678Hz, and single-peaked at 1000Hz. quantitative measurements showed a significant gender difference in the Equivalent Ear Canal Volume at 226Hz and on the Peak Compensated Static Acoustic Admittance at 1000Hz. The English protocol showed that almost 100% of ears were normal at 678 and 1000Hz. CONCLUSION: 1000Hz yielded superior results for characterizing normality. The English protocol was efficient to reduce the variability of tympanometric measurements. Data from this study may be used as a guide for diagnosis using tympanometry in neonates. |
Author | Lewis, Dóris Ruthi Novaes, Beatriz de Albuquerque C. C. Silva, Kilza de Arruda Lyra e Carvallo, Renata Mota Mamede |
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Cites_doi | 10.1056/NEJM197702242960802 10.1044/jshr.2802.265 10.3766/jaaa.14.1.4 10.1001/archotol.1970.04310040005002 10.3109/03005367509079122 10.1542/peds.106.4.798 10.3109/03005369609077925 10.1055/s-0040-1715757 10.1016/S0194-5998(99)70178-6 10.1121/1.407347 10.1001/archotol.1975.00780350040010 10.1542/peds.58.2.198 10.1001/archotol.1973.00780010479007 10.1097/00020840-200310000-00012 10.1542/peds.102.5.1161 10.1016/S0194-5998(99)70317-7 10.3109/01050398009076343 |
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References | Northern J (ref10) 2002 Rhodes MC (ref28) 1999; 120 Marchant CD (ref6) 1986; 109 Purdy SC (ref13); 10 Shurin PA (ref26) 1977; 296 Margolis RH (ref3) 2003; 14 Bennett MJ (ref22) 1975; 9 Sutton GJ (ref27) 1996; 30 McKinley AM (ref8) 1997; 8 Keith RW (ref29) 1973; 97 Paradise JL (ref5) 1976; 58 Margolis RH (ref12) 2001 Llly DJ (ref4) 1972 Hall III JW (ref16) 2000 Jerger J (ref20) 1970; 92 Keefe DH (ref25) 1993; 94 McKinley AM (ref17) 1997; 8 Sininger YS (ref2) 2003; 11 Keith RW (ref21) 1975; 101 Yoshinaga-Itano C (ref1) 1998; 102 Sutton G (ref14) 2002 Carvallo RMM (ref7) Koike KJ (ref18) 1999; 121 Fowler CG (ref11) 2002 Kei J (ref9) 2003; 14 (ref15) 2000; 106 Prieve BA (ref19) 2002 Sprague BH (ref23) 1985; 28 Weatherby M (ref24) 1980; 9 |
References_xml | – volume: 296 start-page: 412 year: 1977 ident: ref26 article-title: Tympanometry in the diagnosis of middle ear effusion publication-title: New Engl J Med doi: 10.1056/NEJM197702242960802 contributor: fullname: Shurin PA – volume: 28 start-page: 265 issn: 0022-4685 year: 1985 ident: ref23 article-title: Tympanometric and acoustic-reflex studies in neonates publication-title: J Speech Hear Res doi: 10.1044/jshr.2802.265 contributor: fullname: Sprague BH – start-page: 434 volume-title: Acoustic impedance at the tympanic membrane year: 1972 ident: ref4 contributor: fullname: Llly DJ – volume: 14 start-page: 20 issn: 1050-0545 year: 2003 ident: ref9 article-title: High-frequency (1000 Hz) tympanometry in normal neonates publication-title: J Am Acad Audiol doi: 10.3766/jaaa.14.1.4 contributor: fullname: Kei J – volume: 92 start-page: 311 issn: 0003-9977 year: 1970 ident: ref20 article-title: Clinical experience with impedance audiometry publication-title: Arch Otolaryngol doi: 10.1001/archotol.1970.04310040005002 contributor: fullname: Jerger J – volume: 9 start-page: 117 year: 1975 ident: ref22 article-title: Acoustic impedance bridge measurements with the neonate publication-title: Brit J Audiol doi: 10.3109/03005367509079122 contributor: fullname: Bennett MJ – volume: 106 start-page: 798 issn: 0031-4005 year: 2000 ident: ref15 article-title: Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs publication-title: Pediatrics doi: 10.1542/peds.106.4.798 – volume: 30 start-page: 9 issn: 0300-5364 year: 1996 ident: ref27 article-title: Tympanometry and otoacoustic emissions in a cohort of special care neonates publication-title: Br J Audiol doi: 10.3109/03005369609077925 contributor: fullname: Sutton GJ – volume: 10 start-page: 9 ident: ref13 article-title: High frequency tympanometry: a valid and reliable immittance test protocol for young infants? 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