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）的病理生理学基础。内耳的变化可通过听骨链活动度改变传导至中耳，宽带声导抗（wideband tympanometry）可通过测量多频声吸收值（以中耳吸收的声能表征）对其进行量化，甚至可在疾病早期阶段实现检测。针对内淋巴积水患者，在常压及峰值压力下通过声吸收指标分析中耳功能状态，有助于梅尼埃病的筛查。
研究目的：相较于健康对照组，明确有症状及无症状梅尼埃病患者的声吸收特征，以验证宽带声导抗检测梅尼埃病的临床效能。
研究方法：本研究为采用诊断对照设计的横断面研究，纳入健康对照组（n=30）、无症状组（n=21）及有症状组（n=9），对比三组受试者耳部在常压及峰值压力下的宽带声导抗检测结果。
研究结果：健康对照组耳部的峰值压力为0daPa，无症状组为−11 daPa，有症状组为−192 daPa，三组间差异具有统计学意义（经克鲁斯卡尔-沃利斯检验、曼-惠特尼检验及邦费罗尼校正后，p<0.05）。在常压及峰值压力下的低频段，有症状组、无症状组的声吸收值与健康对照组相比均存在显著差异，经同样统计学方法校正后p<0.05。
研究结论：宽带声导抗检测可有效识别梅尼埃病，且能够区分无症状与有症状的梅尼埃病患者，相较于健康个体，该检测结果具有显著的区分性。