Publication: The analysis multifrequency tympanometry among Malay children aged 1-4 years old
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Date
2025-08
Authors
Adnan, Nur Afiqah
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Abstract
Tympanometry using 226 Hz probe tone is commonly employed as an excellent noninvasive test with high sensitivity and specificity used to assess middle ear function. To increase sensitivity in detecting middle ear pathology, multifrequency tympanometry is recommended. This study investigated multifrequency tympanometry (226 Hz, 678 Hz, and 1000 Hz) in Malay children aged 1–4 years to evaluate middle ear function and to provide preliminary reference values for this population. Using a cross-sectional design, 38 children (76 ears) were recruited from daycare centers and audiology clinics in Kelantan, Malaysia. All participants underwent hearing screening including otoscopy, DPOAE, and screening acoustic reflex testing followed by multifrequency tympanometry. The results of tympanometric parameters showed excellent test–retest reliability across all probe frequencies (226 Hz, 678 Hz and 1000 Hz), as indicated by intraclass correlation coefficients (ICCs). The tympanometry parameters included ear canal volume (ECV), static admittance (SA), tympanometric peak pressure (TPP) and Tympanometric width (TW). Using 226 Hz, ICCs ranged from 0.765 to 0.976, using 678 Hz ICCs ranged from 0.903 to 0.998 and 1000 ranged from 0.821 to 0.979. The Kruskal–Wallis tests showed that ear canal volume (ECV) and static admittance (SA) changed significantly across probe frequencies. Specifically, ECV was higher at 678 Hz compared to 226 Hz, and SA values were significantly different between all frequency pairs. In contrast, tympanometric peak pressure (TPP) did not show any significant differences across frequencies. Correlation using Spearman’s correlation analyses showed that in Malay toddlers aged 1–4 years, ECV and SA slightly increased with age, with the strongest correlation for SA at 678 Hz. In contrast, age had little effect on TPP and TW, as these showed weak and non-significant negative correlations. Indicating the increase in ECV and SA with Age suggests that as Malay toddlers grow, their ear canal size and middle ear compliance also increase. This reflects normal anatomical and physiological development of the middle ear system during early childhood. These findings support the clinical value of tympanometry parameters in identifying middle ear characteristics in young children and provide preliminary reference data specific to the Malay paediatric population. However, larger studies involving diverse ethnic groups are needed to establish comprehensive normative standards