Wideband energy reflectance measurements: effects of negative middle ear pressure and application of a pressure compensation procedure

Click on the DOI link to access the article (may not be free).The wideband energy reflectance (ER) technique has become popular as a tool for evaluating middle ear function. Negative middle ear pressure (MEP) is a prevalent form of middle ear dysfunction, which may impact application of ER measurements in differential diagnosis. A negative MEP may be countervailed by application of an equivalent negative ear canal pressure. The present study examined ER in the same ears under normal and experimentally induced negative MEP conditions. Thirty-five subjects produced at least one negative MEP each ( 40 to 225 daPa). Negative MEP significantly altered ER in a frequency-specific manner that varied with MEP magnitude. ER increased for low-to mid-frequencies with the largest change (similar to 0.20 to 0.40) occurring between 1 and 1.5 kHz. ER decreased for frequencies above 3 kHz with the largest change (similar to-0.10 to -0.25) observed between 4.5 and 5.5 kHz. Magnitude of changes increased as MEP became more negative, as did the frequencies at which maximum changes occurred, and the frequency at which enhancement transitioned to reduction. Ear canal pressure compensation restored ER to near baseline values. This suggests that the compensation procedure adequately mitigates the effects of negative MEP on ER. Theoretical issues and clinical implications are discussed. (C) 2013 Acoustical Society of America.This study was partially funded by Wichita State University in the form of an Ollie A. and J. O. Heskett Graduate Fellowship awarded (2009) to M. D. S. and a University Research/Creative Projects Award granted (2009) to X.M.S