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. 2015 Nov-Dec;81(6):610-5.
doi: 10.1016/j.bjorl.2015.08.008. Epub 2015 Sep 7.

Power reflectance testing in newborns and infants

Ticianna Garambone de Cerqueira Lima  1 , Helena Maria Gonçalves Becker  2 , Celso Gonçalves Becker  2 , Daniele Barreto da Cunha Ferreira  3 , Camilo Brandão de Resende  4 , Roberto Eustáquio Santos Guimarães  5
Affiliations

Power reflectance testing in newborns and infants

Ticianna Garambone de Cerqueira Lima et al. Braz J Otorhinolaryngol. 2015 Nov-Dec.

Abstract
in English, Portuguese

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 1000Hz ranged from 83% to 87.2%; there was agreement among these exams.

Conclusion: The outcome of power reflectance tests at 2000Hz and 3000Hz 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.

Introdução: A triagem auditiva neonatal nos permite identificar precocemente alterações auditivas. Entretanto, doenças da orelha média podem dificultar o diagnóstico.

Objetivo: Avaliar o exame de reflectância de potência como um indicador de doença de orelha média e compará-lo com a timpanometria.

Método: Estudo de casos em que foram avaliados 105 neonatos e lactentes que fizeram parte da triagem auditiva em 2013. Foram realizados os seguintes exames: emissões otoacústicas transientes, reflectância de potência e timpanometria.

Resultados: Na avaliação das emissões otoacústicas, cerca de 95% passaram. A especificidade da reflectância de potência em todas as frequências pesquisadas variou de 75,3% até 95,9% e da timpanometria em 1.000 Hz variou de 83% até 87,2% e houve concordância entre esses exames.

Conclusão: O resultado do exame de reflectância nas frequências de 2.000 Hz e 3.000 Hz apresentou correlação com os resultados da timpanometria e com as emissões otoacústicas, e foram estas as frequências mais adequadas para a determinação de doença de orelha média pela reflectância de potência. Observou-se que valores da reflectância de potência acima dos padrões sugerem presença de líquido em orelha média, portanto uma alteração condutiva.

Keywords: Hearing tests; Middle ear; Neonatal screening; Orelha média; Testes auditivos; Triagem neonatal.

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