Effect of contralateral stimulation on acoustic reflectance measurements

Pichelli, Tathiany Silva; Soares, Jordana Costa; Cibin, Bruna Carla; Carvallo, Renata Mota Mamede

doi:10.1016/j.bjorl.2015.07.004

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Brazilian Journal of Otorhinolaryngology

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (5) • Sep-Oct 2015 • https://doi.org/10.1016/j.bjorl.2015.07.004 copy

Effect of contralateral stimulation on acoustic reflectance measurements^☆ ☆ Please cite this article as: Pichelli TS, Soares JC, Cibin BC, Carvallo RMM. Effect of contralateral stimulation on acoustic reflectance measurements. Braz J Otorhinolaryngol. 2015;81:466-72. ^☆☆ ☆☆ Institution: Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

Acoustic reflectance is an important tool in the assessment of middle ear afflictions, and the method is considered advantageous in relation to tympanometry. There has been a growing interest in the study of contralateral acoustic stimulation and its effect on the activation of the efferent auditory pathway. Studies have shown that the introduction of simultaneous stimulation in the contralateral ear generates alterations in auditory response patterns.

OBJECTIVE:

To investigate the influence of contralateral stimulation on acoustic reflectance measurements.

METHODS:

Case study of 30 subjects with normal hearing, of both genders, aged 18-30 years. The test and retest acoustic reflectance was conducted in the frequency range 200-6000 Hz. The procedure was repeated with the simultaneous presence of contralateral white noise at 30 dBNS.

RESULTS:

The analysis of the conditions of test, retest, and test with contralateral noise showed statistical difference at the frequency of 2 kHz (p = 0.011 and p = 0.002 in test and retest, respectively) in the right ear.

CONCLUSION:

The activation of the auditory efferent pathways through contralateral acoustic stimulation produces alterations in response patterns of acoustic reflectance, increasing sound reflection and modifying middle ear acoustical energy transfer.

Keywords:
Hearing; Middle ear; Acoustic reflex; Hearing tests

Chirp reflectance RE		Mean	Median	Standard deviation	CV	Min	Max	n	CI
250 Hz	Test	91.81	93.26	5.40	6%	78.42	100.00	30	1.93
	Retest	91.64	93.29	6.25	7%	75.46	99.39	30	2.24
	With noise	91.93	93.05	5.60	6%	76.12	100.00	30	2.01

500 Hz	Test	79.01	79.88	13.37	17%	48.51	99.22	30	4.78
	Retest	79.28	79.95	13.02	16%	50.24	98.81	30	4.66
	With noise	78.79	78.81	12.83	16%	47.46	100.00	30	4.59

750 Hz	Test	61.48	60.71	17.84	29%	23.94	89.06	30	6.38
	Retest	61.29	59.78	17.72	29%	23.99	88.08	30	6.34
	With noise	61.43	60.78	17.97	29%	25.11	88.34	30	6.43

1 kHz	Test	47.32	46.85	18.10	38%	9.09	79.81	30	6.48
	Retest	47.37	47.35	17.73	37%	9.08	80.22	30	6.34
	With noise	47.59	47.05	18.02	38%	8.34	82.08	30	6.45

1.5 kHz	Test	39.96	40.65	15.80	40%	1.66	64.35	30	5.65
	Retest	39.86	41.23	15.86	40%	2.07	65.28	30	5.68
	With noise	39.85	41.09	15.81	40%	3.01	64.80	30	5.66

2 kHz	Test	40.27	45.48	17.62	44%	3.85	75.57	30	6.30
	Retest	40.30	45.61	17.91	44%	4.01	75.46	30	6.41
	With noise	41.10	45.19	17.65	43%	4.66	75.43	30	6.32

3 kHz	Test	36.68	40.06	18.73	51%	3.27	75.51	30	6.70
	Retest	36.70	39.34	18.83	51%	3.28	75.18	30	6.74
	With noise	37.01	38.14	18.72	51%	3.37	75.99	30	6.70

4 kHz	Test	45.56	47.09	17.16	38%	4.16	79.37	30	6.14
	Retest	45.96	47.12	16.83	37%	4.00	79.57	30	6.02
	With noise	45.65	46.70	16.98	37%	5.55	80.46	30	6.08

6 kHz	Test	74.50	77.02	19.32	26%	31.56	105.45	30	6.91
	Retest	74.95	78.35	19.57	26%	33.00	107.95	30	7.00
	With noise	75.05	78.40	19.64	26%	33.51	109.65	30	7.03

Chirp reflectance LE		Mean	Median	Standard deviation	CV	Min	Max	n	CI
250 Hz	Test	92.15	93.21	6.80	7%	70.95	100.00	30	2.43
	Retest	91.54	92.29	7.29	8%	72.70	100.00	30	2.61
	With noise	90.66	93.06	8.01	9%	66.98	100.00	30	2.87

500 Hz	Test	81.90	82.49	10.90	13%	56.09	100.00	30	3.90
	Retest	81.95	81.20	10.65	13%	56.12	98.78	30	3.81
	With noise	81.96	82.23	11.15	14%	55.98	100.00	30	3.99

750 Hz	Test	64.83	66.56	16.23	25%	23.91	93.91	30	5.81
	Retest	64.92	66.56	16.39	25%	23.24	93.43	30	5.87
	With noise	64.83	64.82	16.12	25%	24.44	92.96	30	5.77

1 kHz	Test	53.24	53.28	17.73	33%	11.11	85.28	30	6.34
	Retest	53.22	54.80	18.32	34%	10.78	84.79	30	6.55
	With noise	53.51	53.37	18.22	34%	9.67	85.58	30	6.52

1.5 kHz	Test	44.66	48.37	15.65	35%	9.97	68.72	30	5.60
	Retest	45.18	48.28	15.48	34%	11.20	71.86	30	5.54
	With noise	44.84	49.86	16.27	36%	14.47	71.92	30	5.82

2 kHz	Test	40.80	42.73	14.54	36%	9.43	69.17	30	5.20
	Retest	41.18	42.53	14.33	35%	10.30	69.11	30	5.13
	With noise	41.43	43.98	14.77	36%	8.69	70.00	30	5.29

3 kHz	Test	29.35	27.85	15.32	52%	5.16	59.20	30	5.48
	Retest	29.28	27.64	15.12	52%	4.99	58.19	30	5.41
	With noise	29.74	27.47	15.43	52%	6.30	59.52	30	5.52

4 kHz	Test	35.08	28.29	16.75	48%	10.24	77.98	30	5.99
	Retest	34.95	28.24	16.97	49%	10.73	77.78	30	6.07
	With noise	35.07	29.26	17.01	48%	12.12	77.87	30	6.09

6 kHz	Test	72.79	72.64	18.32	25%	33.21	100.07	30	6.56
	Retest	73.02	73.21	18.29	25%	35.86	100.00	30	6.54
	With noise	73.25	73.58	18.38	25%	32.34	100.00	30	6.58

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
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[1] * Corresponding author. E-mail:tpichelli@gmail.com (T.S. Pichelli).