Analysis of wideband tympanometry in Ménière’s disease

Abstract Introduction: Endolymphatic hydrops is the pathophysiological substrate of Ménière’s disease. The changes in the inner ear, transmitted to the middle ear through changes in the ossicular chain mobility, can be quantified by wideband tympanometry, through the measurement of the acoustic absorbance at multiple frequencies, represented by the sound energy absorbed by the middle ear, even at its early stages. Studying the behavior of the middle ear through the absorbance in patients with endolymphatic hydrops under ambient pressure and under peak pressure can be useful for detecting Ménière’s disease. Objective: To characterize acoustic absorbance behavior in subjects with symptomatic and asymptomatic Ménière’s disease compared to controls, in order to verify the ability of wideband tympanometry to detect Ménière’s disease. Methods: We carried out a cross-sectional study with a diagnostic approach comparing the findings of wideband tympanometry at ambient pressure and peak pressure between the ears of the control group (n = 30), the asymptomatic group (n = 21) and the symptomatic group (n = 9). Results: Different peak pressure values were found between the ears of the control group (0daPa), the asymptomatic group (−11 daPa) and the symptomatic group (−192 daPa), with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction. Different absorbance values were found between the ears of the symptomatic group and the asymptomatic group compared to the control group for low frequencies at ambient pressure and peak pressure, with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction. Conclusions: The Wideband Tympanometry test was capable of identifying the presence of Ménières disease, and to differentiate between asymptomatic and symptomatic patients, when comparing them with healthy individuals.

【摘要 引言】内淋巴积水（endolymphatic hydrops）是梅尼埃病（Ménière’s disease）的病理生理基础。内耳的病理变化可通过听骨链活动度改变传导至中耳，而宽鼓室导抗图（wideband tympanometry）可通过测量多频率下的声吸光度——即中耳吸收的声能——对其进行量化，甚至可在疾病早期阶段实现检测。针对环境压力与峰值压力下内淋巴积水患者的中耳声吸光度特征展开研究，有助于梅尼埃病的检出。

【研究目的】本研究旨在对比有症状、无症状梅尼埃病患者与健康对照组的声吸光度特征，以验证宽鼓室导抗图对梅尼埃病的检出能力。

【研究方法】本研究采用诊断性横断面研究设计，纳入对照组（n=30）、无症状组（n=21）及有症状组（n=9）的受试耳部，对比三组在环境压力与峰值压力下的宽鼓室导抗图检测结果。

【研究结果】对照组耳部的峰值压力为0daPa，无症状组为-11daPa，有症状组为-192daPa，三组间差异具有统计学意义（经克朗斯卡尔-沃利斯检验（Kruskal-Wallis test）、曼-惠特尼U检验（Mann Whitney test）及邦费罗尼校正（Bonferroni correction）后，p<0.05）。在环境压力与峰值压力下的低频频段中，有症状组、无症状组的声吸光度与对照组相比差异均具有统计学意义（经克朗斯卡尔-沃利斯检验、曼-惠特尼U检验及邦费罗尼校正后，p<0.05）。

【研究结论】宽鼓室导抗图检测可有效识别梅尼埃病的存在，并可区分无症状与有症状的梅尼埃病患者，与健康人群对比差异显著。