The clinical utility of wideband absorbance tympanometry in adults living with HIV
Date
2018
Authors
Sebothoma, Ben
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Abstract
Background: Studies suggest that wideband acoustic immittance (WAI) has higher sensitivity and specificity in the identification of middle ear pathologies than the tympanometry with 226Hz. However, most of the research on WAI emerges from the Western and Australian countries, primarily focusing on the paediatric population. There is limited scientific knowledge on WAI in adults, particularly those living with human immunodeficiency virus (HIV). Given that people living with HIV are known to be prone to various middle ear pathologies varying in severities (subtle to chronic) due to their weakened immune system, it was deemed valuable to investigate the clinical utility of wideband tympanometry in this population.
Purpose: The aim of this study was to evaluate the clinical utility of WAI in identifying middle ear pathologies in adults living with HIV.
Participants: A non-probability purposive sampling method was used to recruit 99 adults diagnosed with HIV who were between the ages of 18 and 72 years, with a mean age of 46 years. All participants were recruited from Elias Motsoaledi Local Municipality (EMLM), Sekhukhune district, Limpopo province and were attending Ndlovu medical centre for their treatments.
Method: A prospective quantitative, non-experimental, correlational design was employed. All participants underwent an audiological test battery which included case history information using a self-developed extracted sheet, video-otoscopy, tympanometry with 226Hz probe tone, wideband absorbance tympanometry using click stimulus, and pure tone audiometry. All measures were conducted in a sound treated room.
Data Analysis: Data was analysed through both descriptive and inferential statistics. Sensitivity and specificity were determined by receiver operative characteristics (ROC) analysis. All the analysis were conducted using IBM statistical Package for Social Sciences version 24
Results: The occurrence of middle ear pathologies in adults living with HIV was 11% (n=17) based on ENT diagnosis. A significantly lower occurrence of middle ear pathologies (11%, n=13) was obtained from tympanometry with 226Hz. The sensitivity and specificity of wideband absorbance tympanometry is generally high in the present study. The sensitivity of wideband absorbance tympanometry was higher (91%) than the sensitivity of tympanometry with 226Hz (23.5%) prone tone and clinical examination (30.8%), (p˂0.001) in identifying middle ear pathologies in adults living with HIV. The sensitivity of wideband absorbance tympanometry was significantly higher compared with the sensitivity of tympanometry with 226Hz probe tone and clinical examination in higher frequencies. However, there was a comparable specificity of wideband absorbance tympanometry (90%), with tympanometry with 226Hz (93.8%) and clinical examination 91.2%) across various frequencies.
Conclusion: Middle ear pathologies in adults living with HIV exist despite the use of HAART treatment. This study demonstrated the clinical utility of wideband absorbance tympanometry when assessing middle ear pathologies in adults living with HIV. Therefore, this study highlights the need to use wideband absorbance tympanometry, in combination with other middle ear measures such as video otoscopy, to accurately identify middle ear pathologies in adults living with HIV.
Description
A dissertation submitted to the Department of Speech Pathology and Audiology School of Human and Community Development Faculty of Humanities University of Witwatersrand, Johannesburg In fulfilment of the requirement of the degree Master of Arts in Audiology
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Citation
Sebothoma, Ben (2018) The clinical utility of wideband absorbance tympanometry in adults living with HIV, University of the Witwatersrand, Johannesburg, https://hdl.handle.net/10539/27193