Power reflectance testing in newborns and infants<b><sup>,</sup></b>

Lima, Ticianna Garambone de Cerqueira; Becker, Helena Maria Gonçalves; Becker, Celso Gonçalves; Ferreira, Daniele Barreto da Cunha; Resende, Camilo Brandão de; Guimarães, Roberto Eustáquio Santos

doi:10.1016/j.bjorl.2015.08.008

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Brazilian Journal of Otorhinolaryngology

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (6) • Nov-Dec 2015 • https://doi.org/10.1016/j.bjorl.2015.08.008 copy

Power reflectance testing in newborns and infants^☆ ☆ Please cite this article as: Lima TGC, Becker HMG, Becker CG, Ferreira DBC, de Resende CB, Guimarães RES. Power reflectance testing in newborns and infants. Braz J Otorhinolaryngol. 2015;81:610-5. ^,^{^☆☆} ☆☆ Institution: Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

Auditory screening in newborns allows for detection of hearing problems early in life. However, middle ear diseases can make the diagnosis more difficult.

OBJECTIVE:

To evaluate the power reflectance test as an indicator of the middle ear disease and to compare it to tympanometry.

METHODS:

Case study evaluating 105 newborns and infants who participated in the audiology screening in 2013. The following exams were performed: transient otoacoustic emissions, power reflectance, and tympanometry.

RESULTS:

In the optoacoustic emission evaluation, approximately 95% of the subjects passed the test. The specificity of power reflectance in all frequencies studied ranged from 75.3% to 95.9%, and that of tympanometry at 1000 Hz ranged from 83% to 87.2%; there was agreement among these exams.

CONCLUSION:

The outcome of power reflectance tests at 2000 Hz and 3000 Hz showed a correlation with tympanometry and otoacoustic emissions, and these were the most appropriate frequencies to determine middle ear disease through power reflectance measurement. It was also observed that values of power reflectance above reference levels suggested the presence of fluid in the middle ear, and thus a conductive hearing loss.

Keywords:
Hearing tests; Middle ear; Neonatal screening

	Frequency	Passed the test		Failed the test
		n	%	n	%
Right side	1000 Hz	91	86.7	14	13.3
	2000 Hz	77	73.3	28	26.7
	3000 Hz	89	84.8	16	15.2
	4000 Hz	95	90.5	10	8.5
Left side	1000 Hz	78	74.3	27	25.7
	2000 Hz	74	70.5	31	29.5
	3000 Hz	91	86.7	14	13.3
	4000 Hz	99	94.3	6	5.7

PR	Frequency	n	Kappa	95% CI	Classification	p-Value
Right side	1000 Hz	98	0.18	0.00–0.40	–	0.251
	2000 Hz	98	0.20	0.01–0.44	Low	0.047
	3000 Hz	98	0.17	0.00–0.45	–	0.126
	4000 Hz	98	0.13	0.00–0.45	–	0.201
Left side	1000 Hz	100	0.12	0.00–0.34	–	0.144
	2000 Hz	100	0.31	0.10–0.52	Reasonable	0.002
	3000 Hz	100	0.35	0.09–0.62	Reasonable	0.005
	4000 Hz	100	0.23	0.00–0.54	–	0.059

Tests	PR (1000 Hz)	PR (2000 Hz)	PR (3000 Hz)	PR (4000 Hz)
Right side
Tympanometry	0.01	0.29	0.22	0.16
Confidence interval	(0–0.15)	(0.12–0.47)	(0.02–0.42)	(0–0.36)

Left side
Tympanometry	0.04	0.32	0.37	0.17
Confidence interval	(0–0.20)	(0.15–0.49)	(0.18–0.56)	(0–0.35)

Side	Specificity
Right	87.2% (78.4–92.9)
Left	83.0% (73.5–89.7)

Side	Frequency	Specificity
Right	1000 Hz	86.6% (77.8–92.4)
	2000 Hz	75.3% (65.3–83.2)
	3000 Hz	85.9% (77.1–91.8)
	4000 Hz	90.9% (83.0–95.5)
Left	1000 Hz	76.3% (66.4–84.1)
	2000 Hz	76.0% (66.0–83.9)
	3000 Hz	90.7% (82.7–95.4)
	4000 Hz	95.9% (89.3–98.7)

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail:ticigarambone@gmail.com (T.G.C. Lima).