LM103 - Assessment and Interpretation of Wideband Tympanometry in Children with Middle-Ear Dysfunction

Abstract:
Wideband tympanometry (WBT) has been demonstrated to effectively characterize middle-ear effusion volume in children with otitis media with effusion (OME) with high sensitivity and specificity. However, many clinicians hesitate to utilize WBT due to a lack of confidence in interpreting findings and understanding their implications on hearing. This session aims to enhance clinicians' understanding of WBT fundamentals and provide guidelines for analyzing WBT variations in children with OME. By equipping audiologists with resources for interpreting and documenting WBT, we hope to encourage greater adoption of WBT in clinical practice, ultimately improving timely identification and treatment of OME in pediatric populations.

Summary:
Wideband tympanometry (WBT) measures the mechanical status of the ear in response to a wideband sound stimulus. This presentation focuses on absorbance, a key outcome of WBT that reflects the middle ear's ability to absorb sound across different frequencies. Numerous studies have highlighted the diagnostic advantages of WBT, particularly in pediatric cases of otitis media with effusion (OME), where it quantifies effusion volume and predicts associated conductive hearing loss (Merchant et al., 2021; Sanford et al., 2023). WBT is particularly valuable when behavioral audiometric data are limited or unavailable, enhancing the clinical management of OME and related hearing loss in children (Merchant et al., 2024).

Despite these benefits, WBT remains underutilized in clinical practice. A recent survey indicated that over 40% of audiologists in the U.S. cite insufficient training and a lack of confidence in WBT measurement and interpretation as the primary barriers to its integration into diagnostic protocols (Al-Salim, Skretta, & Merchant, 2024). This finding underscores the need for training initiatives to bolster clinician confidence and expertise to successfully integrate this measurement into their clinical repertoire.

This session will provide an overview of middle-ear mechanics and how various pathologies, particularly OME, impact these mechanics as reflected in WBT measurements. Participants will receive practical strategies and resources for interpreting WBT absorbance data in pediatric OME cases. Case studies will illustrate WBT absorbance findings collected using the GSI TympStar Pro and Interacoustics Titan devices, which are immittance devices commonly found in clinical settings. This training will empower audiologists to better understand the relationship between OME episodes and hearing status in children by quantifying effusion volume through WBT absorbance.

Additionally, we will discuss how to translate WBT interpretations into clinical documentation, including report templates and electronic medical record smart phrases. With increased education on WBT and accessible resources for integration, audiologists will be better equipped to apply this measurement reliably, ultimately advancing care standards for children with OME.

Brief Summary of Clinical Takeaways:
The clinical takeaway for this session will be how to measure and interpret wideband tympanometry in children with middle-ear dysfunction.