Survey of Wideband Acoustic Immittance Use by Clinical Audiologists.

PURPOSE: Wideband acoustic immittance (WAI) is a promising measure of middle-ear mechanics. In contrast to standard tympanometry, which is generally measured at a single stiffness-dominated low frequency, WAI detects mechanical effects on both the mass and stiffness properties of the middle ear across a wide range of frequencies, resulting in a more comprehensive assessment of middle-ear mechanics in healthy and pathological ears. Despite a plethora of research demonstrating the clinical utility of this measure, clinical adoption of WAI is still limited. This work explores audiologists' use and perceptions of WAI, with the goal of identifying the barriers to its clinical adoption. METHOD: A survey on the perception and use of WAI by clinical audiologists in the United States was developed and administered using the Research Electronic Data Capture application. The survey was distributed broadly across the United States. Participation was voluntary and anonymous, and no compensation was provided. RESULTS: Findings from 132 survey respondents across 32 states were included in the analyses. Overall, findings suggest the largest barriers to clinical adoption of WAI are lack of access to equipment that measures WAI and lack of training and/or confidence in measuring or interpreting WAI. CONCLUSIONS: Several barriers to clinical adoption of WAI were identified. However, findings also provide optimism in that audiologists utilizing WAI find it more useful than standard tympanometry, and most audiologists who do not currently use WAI are open to implementing the measure in their clinical practice. We proposed steps to address the highest priority issues and increase the clinical viability of WAI.

Limited Audiological Assessment Results in Children With Otitis Media With Effusion.

OBJECTIVES: Clinical practice guidelines predicate the need for evaluation of hearing in children with otitis media with effusion (OME). The objective of this work was to characterize the completeness of hearing assessment results in children with OME. DESIGN: Forty participants with OME completed two full audiological assessments, one in a clinical setting and a second in a research setting. An additional 14 participants without OME completed a single audiological assessment in the research setting as a control group. The success of various behavioral and objective audiometric tests in each setting was quantified and evaluated. RESULTS: Findings indicate that ear-specific behavioral audiometric information is substantially limited in children with OME, particularly in clinical settings. In contrast, objective testing including tympanometry and otoacoustic emission testing was largely successful. CONCLUSIONS: Ear-specific behavioral audiometric information is limited in children with OME and, consequently, consideration of these data for use as part of clinical decision making is also limited. Objective tests were more successful but are not direct measures of hearing.