CN114699069A - Eustachian tube openness test system - Google Patents
Eustachian tube openness test system Download PDFInfo
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- CN114699069A CN114699069A CN202210096232.6A CN202210096232A CN114699069A CN 114699069 A CN114699069 A CN 114699069A CN 202210096232 A CN202210096232 A CN 202210096232A CN 114699069 A CN114699069 A CN 114699069A
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- 210000002388 eustachian tube Anatomy 0.000 title claims abstract description 85
- 238000012360 testing method Methods 0.000 title claims abstract description 38
- 238000000034 method Methods 0.000 claims abstract description 38
- 238000001514 detection method Methods 0.000 claims abstract description 23
- 210000000613 ear canal Anatomy 0.000 claims abstract description 18
- 210000001989 nasopharynx Anatomy 0.000 claims abstract description 6
- 238000005259 measurement Methods 0.000 claims description 14
- 239000000523 sample Substances 0.000 claims description 9
- 238000007789 sealing Methods 0.000 claims description 5
- 230000005236 sound signal Effects 0.000 claims description 5
- 230000009747 swallowing Effects 0.000 claims description 4
- 238000012545 processing Methods 0.000 claims description 3
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 3
- 230000003447 ipsilateral effect Effects 0.000 claims description 2
- 238000012076 audiometry Methods 0.000 claims 1
- 238000010998 test method Methods 0.000 abstract description 5
- 238000003745 diagnosis Methods 0.000 abstract description 3
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 206010033078 Otitis media Diseases 0.000 description 13
- 208000005923 otitis media with effusion Diseases 0.000 description 10
- 208000024036 serous otitis media Diseases 0.000 description 10
- 210000005069 ears Anatomy 0.000 description 6
- 210000000959 ear middle Anatomy 0.000 description 4
- 230000007423 decrease Effects 0.000 description 3
- 238000007689 inspection Methods 0.000 description 3
- 230000003248 secreting effect Effects 0.000 description 3
- 241000167880 Hirundinidae Species 0.000 description 2
- 230000005540 biological transmission Effects 0.000 description 2
- 239000003153 chemical reaction reagent Substances 0.000 description 2
- 230000000875 corresponding effect Effects 0.000 description 2
- 238000009826 distribution Methods 0.000 description 2
- 238000002474 experimental method Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 206010015543 Eustachian tube dysfunction Diseases 0.000 description 1
- 238000003556 assay Methods 0.000 description 1
- 230000002596 correlated effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 210000003128 head Anatomy 0.000 description 1
- 238000000691 measurement method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 238000011160 research Methods 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
- 230000000152 swallowing effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/12—Audiometering
- A61B5/121—Audiometering evaluating hearing capacity
- A61B5/125—Audiometering evaluating hearing capacity objective methods
- A61B5/126—Audiometering evaluating hearing capacity objective methods measuring compliance or mechanical impedance of the tympanic membrane
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/12—Audiometering
- A61B5/121—Audiometering evaluating hearing capacity
- A61B5/125—Audiometering evaluating hearing capacity objective methods
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- Acoustics & Sound (AREA)
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- Otolaryngology (AREA)
- Heart & Thoracic Surgery (AREA)
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Abstract
The invention discloses a eustachian tube openness testing system, and mainly relates to the technical field of eustachian tube testing. Comprises a eustachian tube sound measuring method device and a eustachian tube pressure measuring meter (TMM) which are used together, and sound measuring method detection is carried out under the condition of nasopharynx pressurization. The selected nasopharyngeal pressures of 30mbar, 40mbar and 50mbar are provided by TMM equipment, acoustic detection is respectively carried out on the basis of the three pressure values, each pressure value is tested for 1-3 times, Sound Pressure (SPL) detected by a microphone of an external auditory canal is a result, and the open ET is defined as that the SPL is more than or equal to 5dB for at least one time. The invention has the beneficial effects that: a new test method is provided for evaluating the function of the Eustachian Tube (ET), and the diagnosis accuracy of the ET function is improved.
Description
Technical Field
The invention relates to the technical field of eustachian tube detection, in particular to a eustachian tube openness testing system.
Background
The eustachian tube, also known as the eustachian tube, has a very important dark channel in the upper part of the anterior wall of the tympanic cavity. One end of the tube enters the tympanic cavity from the front wall, and the other end enters the nasopharynx, which is a channel for communicating the tympanic cavity and the nasopharynx, so the tube is called a eustachian tube. The Eustachian Tube (ET) function is dynamically changed and comprises an active opening function and a passive opening function, and a plurality of eustachian tube function detection methods are developed at present, but no detection method can realize 100% of the eustachian tube opening rate.
Disclosure of Invention
The invention aims to provide a eustachian tube patency test system, which provides a new test method for evaluating the function of an Eustachian Tube (ET) and improves the diagnosis accuracy of the ET function.
In order to achieve the purpose, the invention is realized by the following technical scheme:
a eustachian tube patency test system comprises a eustachian tube acoustic testing device and a eustachian tube pressure gauge;
the eustachian tube acoustic measurement equipment comprises an acoustic measurement host, a loudspeaker and a microphone probe, wherein a sound processing system for acquiring sound information from the microphone probe is matched and sleeved in the acoustic measurement host;
the eustachian tube pressure gauge comprises a pressure measuring host, a computer host, a nose adapter and a pressure receiver, wherein the pressure receiver is connected with the pressure measuring host through a data line, the pressure measuring host is connected with the nose adapter through a pressure conveying pipe and provides set pressure for the nose adapter, and a TMM system is sleeved in the computer host;
step 1, connecting and starting a nostril at the same side and an external auditory canal by using eustachian tube acoustic testing equipment, wherein the method comprises the steps of placing and sealing a loudspeaker in a front nostril at one side, placing and sealing a microphone probe in the external auditory canal at the same side, outputting 7KHz narrow-band noise by the loudspeaker, and outputting 123dB SPL (maximum output noise);
and 2, connecting the nostril at the other side and the external auditory canal by using a eustachian tube pressure gauge, wherein the nasogastric tube pressure gauge is placed in the other nostril and is sealed without air leakage.
And 3, carrying out acoustic measurement detection while pressurizing the nasopharynx, wherein the pressure is provided by a TMM system, the detection pressure is regulated to 30mbar, 40mbar and 50mbar, the acoustic measurement detection is respectively carried out based on the three pressure values, each pressure value is tested for 1-3 times, the Sound Pressure (SPL) detected by a microphone of an external auditory canal is a result, and the open ET is defined as that the SPL is not less than 5dB once.
Further, the step 1 of connecting and starting the ipsilateral nostril and the external auditory canal by using the eustachian tube acoustic measurement device further comprises calibrating the received sound signal based on the calibration target value.
Further, the calibration target values include 50dB SPL, 55dB SPL.
Further, the pressure test of the step 3 comprises that the subject holds 10ml of water and holds the breath, and swallows after closing an air inlet below the single-foot nasal adapter; immediately after the end of swallowing, sound detection is stopped, and as a result, Sound Pressure (SPL) is detected by a microphone in the external auditory canal.
Further, a printing apparatus inherent to the eustachian tube sounding apparatus for outputting the data result of the sound pressure method in a printed manner is also included.
Compared with the prior art, the invention has the beneficial effects that:
the acoustic detection method is combined with nasopharyngeal pressure to carry out ET function detection, sound signal transmission is more sensitive than pressure transmission, whether the Eustachian Tube (ET) is normally opened or not is more favorably found, a new detection method, namely the acoustic pressure method, is obtained by combining the acoustic detection method and the nasopharyngeal pressure, whether the ET is opened or not is more accurately judged, and therefore a more instructive data conclusion can be provided for diagnosis of related diseases.
Drawings
FIG. 1 is a schematic diagram of the application of the present system.
Fig. 2 is data of sound test and sound pressure test in example 1 of the present invention. Wherein A is the data of the sound measuring method, B is the data of the sound pressure method, and the duration time of the sound intensity of B is obviously prolonged compared with A.
FIG. 3 is a graph showing the distribution of R value and SPL value in example 2 of the present invention.
Wherein, A is the median value of R value at 30mbar, 40mbar and 50mbar pressure of 0.935, 0.795 and 0.660 respectively, and there is a significant difference between two (P is 0.000); b is 18, 22, 26dB median acoustic pressure at 30mbar, 40mbar and 50mbar, respectively, with significant statistical difference between each two (P0.000).
FIG. 4 is a graph showing the correlation between the R value and SPL value and the nasopharyngeal pressure in example 2 of the present invention.
Where a is a decrease in R value with increasing nasopharyngeal pressure, with clear correlation (R ═ 0.298, p ═ 0.000); b is the decrease of SPL with increasing nasopharyngeal pressure, showing a normal weak correlation (r 0.251, p 0.000).
FIG. 5 shows the results of TMM harmonic sounding in example 2 of the present invention, which results were from TMM harmonic sounding tests in the same ear, without R values for A1 and B1, and R1 for C1; however, the SPL of A2, B2 and C2 were 20, 30 and 40dB respectively, which is the corresponding result of the sonography at 30, 40 and 50mbar pressure.
FIG. 6 shows the ET patency of secretory otitis media detected by the sonography in example 2 of the present invention.
FIG. 7 is a schematic view of the invention showing the flow of air and sound waves through the eustachian tube into the middle ear and transmitted to the external auditory meatus.
Detailed Description
The invention will be further illustrated with reference to the following specific examples. It should be understood that these examples are for illustrative purposes only and are not intended to limit the scope of the present invention. Further, it should be understood that various changes or modifications of the present invention may be made by those skilled in the art after reading the teaching of the present invention, and these equivalents also fall within the scope of the present application.
The instruments, reagents, materials and the like used in the following examples are conventional instruments, reagents, materials and the like in the prior art and are commercially available in a normal manner unless otherwise specified. Unless otherwise specified, the experimental methods, detection methods, and the like described in the following examples are conventional experimental methods, detection methods, and the like in the prior art.
Example 1: eustachian tube openness test system and implementation
As in fig. 1, the system comprises:
eustachian tube sounding equipment: specifically eustachian tube comprehensive inspection instrument JK-05A (RION co., ltd., kokuunji, Tokyo, Japan); the system comprises a sound measurement host, a loudspeaker and a microphone probe, wherein a sound processing system used for acquiring sound information of the microphone probe is matched in the sound measurement host.
Eustachian tube pressure gauge: the eustachian tube pressure measuring instrument comprises a pressure measuring host, a computer host, a nose adapter and a pressure receiver, wherein the pressure receiver is connected with the pressure measuring host through a data line, the pressure measuring host is connected with the nose adapter through a pressure conveying pipe and provides set pressure for the nose adapter, and a TMM system is matched and sleeved in the computer host.
A printing apparatus.
The specific operation and detection process is as follows:
the subject takes the seat, is 1.5 meters away from the experimental facility and can not touch the inspection facility. Firstly, a loudspeaker of a eustachian tube function comprehensive inspection instrument JK-05A is placed in a front nostril at one side and sealed to emit narrow-band noise of 7KHz (the narrow-band noise refers to a type of noise with a narrow frequency band range, and the frequency bandwidth of a system is far less than that of the system with the central frequency), and the maximum output noise is 123dB SPL (the dB SPL is a physical unit of sound intensity); a microphone probe is placed on the external auditory canal on the same side and is sealed, a sound signal is detected by utilizing a 50dB SPL baseline automatically calibrated by the system, and a start button is pressed to detect whether the sound pressure baseline of the external auditory canal is 0 or not. Then, the TMM software is turned on, the pressure button of the TMM is adjusted to the standard pressure (30, 40 and 50mbar) required by the examination, the subject is ordered to suck 10ml of water and clench the dental articulations, the pressure delivery pipe of the Tubomanometer is connected with a single-foot nose adapter with the proper size, the other anterior nares is placed and sealed without air leakage, the horizontal position is kept, the head is kept in the right position (the lower jaw is parallel to the ground), the breath is held, the air inlet below the single-foot nose adapter is sealed by fingers, and the patient swallows by clenching the dental articulations with strength. After swallowing, detection of JK-05A is stopped, and the Sound Pressure (SPL) detected by the microphone in the external auditory canal is used as a result, and the detection result is printed and stored.
The sound pressure method and the sound measuring method have the same detection result as sound pressure, and according to the previous research result, the condition that the peak value of the sound pressure of the external auditory canal is more than 5dB of a base line is defined as ET open. Each ear in this study was tested continuously for 3 nasopharyngeal pressures, 30, 40, 50mbar, etc., each pressure being tested 1-3 times differently, as long as more than one SPL ≧ 5dB is defined as ET patency.
Using the system and method described above, 2 tests were immediately repeated at each pressure for 20 lateral ears, with the external auditory meatus sound pressure for 3 tests for 20 lateral ears being greater than 5 dB. In addition, because ET passively opens under nasopharyngeal pressure, ET opening duration of the sound pressure method is far longer than that of the sound measurement method, so that the waveforms of sound signals measured by external auditory canals are greatly different (as shown in figure 2).
Example 2: auditory tube test contrast test is carried out by respectively using acoustic method, TMM method and the system
This example incorporates 53 normal healthy volunteers (106 ears) and 37 patients with otitis media secretory (47 ears) with the basic information shown in table 1. All subjects were tested for eustachian tube function by ETDQ-7) (eustachian tube dysfunction), sonography, TMM and sound pressure. All subjects successfully completed all tests.
All subjects respectively carry out tests such as a sound testing method, a TMM (TMM) method and a sound pressure method in sequence, and after each test is finished, rest is carried out for 15 minutes, so that the detection result is prevented from being influenced by fatigue. All tests were performed by two experienced, skilled operators.
Watch (A)Basic information of healthy subject group and secretory otitis media group
1) Eustachian tube test results for healthy subjects
The ET open ratio measured by the sonography, TMM and sound pressure methods is shown in table 2. The ET opening rate detected by the sound pressure method at 30mbar nasopharynx pressure (30 mbar by the sound pressure method) is 93.4 percent, which is higher than that detected by the sound pressure method (P is 0.005) and TMM (P is 0.000) at 30mbar, and the difference with the ET opening rate detected by the TMM at 40 and 50mbar has no statistical significance (P is more than 0.05). The sound pressure method found 98.1% open ET at 40 and 50mbar, higher than other test methods, with a significant difference from TMM 40mbar (P0.033) but not with TMM 50mbar (P0.733). In 21 negative audiometrically, ET patency by TMM and acoustic pressure at standard nasopharyngeal pressure (30, 40, 50mbar) is shown in Table 3. No ET patency was found in the 2-sided ear by all test methods.
Both the R value of TMM and the SPL value of the sound pressure method are non-normal distributions (FIG. 3). There was a significant difference between each two R values for TMM at 30, 40, 50mbar (P ═ 0.000); similarly, the sound pressure method also has a significant difference between SPL values of 30, 40, 50mbar (P ═ 0.000). Both R and SPL values correlated with nasopharyngeal pressure (fig. 4). The R value gradually decreases along with the increase of the nasopharyngeal pressure, and the R value is obviously and weakly related to the nasopharyngeal pressure (R is-0.298, and P is 0.000); while SPL values increase with increasing nasopharyngeal pressure, there is a clear positive-weak correlation between SPL values and nasopharyngeal pressure (r 0.251, P0.000). The results of TMM and tonometry of the same subject were compared at 30, 40, 50mbar (figure 5).
The SPL values of 20-side ears measured repeatedly under the sound pressure method have better consistency (ICC is 0.776, and the 95% ICC value is 0.672-0.857).
TABLE 3 results of sonographic negative 21-lateral ear TMM and tonometry
2) Sound pressure method test result of secretory otitis media group
The 47 sided secretory otitis media in this study was tested by the sound pressure method and the results are detailed in table 4. ET patency increases with increasing nasopharyngeal pressure (fig. 6), as does acoustic pressure. The ET opening measured by the sound pressure method is obviously higher than that measured by the TMM at the corresponding pressure (P <0.05) at the pressures of 30, 40 and 50mbar, and the ET opening is shown in tables 3-5. The ET patency rate under dry swallowing activity, as tested by sonography for 47-sided secretory otitis media, was only 19.10% (9 ears), significantly lower than that measured by sonotonometry or TMM at each pressure (P < 0.05).
Sound pressure method test result of ear secretory otitis media of table 447
TABLE 5 test ET patency comparison of Acoustic pressure method and TMM
3) Comparison of Sound pressure results in healthy subjects with patients with secretory otitis media
The sound pressure of a healthy subject as a control group and the sound pressure of a secretory otitis media group are shown in table 6, and the sound pressure of the secretory otitis media group at 30mbar, 40mbar and 50mbar is obviously lower than that of a normal control group; also, the ET patency at 30, 40, 50mbar was significantly lower in the otitis media with secretory group than in the normal control group (Table 7).
TABLE 6 comparison of Sound pressure of control group with that of secretory otitis media group
TABLE 7 comparison of ET patency rates for the control and otitis media with secretory assays
And (4) conclusion:
the sound pressure method is a proper mixed ET function test method, has the functions of simultaneously detecting the active and passive opening of ET, and has high sensitivity for detecting the opening of ET. The sound pressure method for detecting ET openness is superior to the sound detection method and TMM, the sound pressure intensity of the sound pressure method is increased along with the increase of nasopharyngeal pressure, the sound pressure intensity is related to ET openness degree, and the sound pressure method can be used for quantifying ET function. The repeated measurement consistency of the sound pressure method test is good, and the method can be widely used for clinical detection. In conclusion, the sound pressure method for evaluating the ET function has a good clinical application prospect.
Claims (5)
1. A eustachian tube patency test system is characterized by comprising eustachian tube acoustic testing equipment and a eustachian tube pressure gauge;
the eustachian tube acoustic measurement equipment comprises an acoustic measurement host, a loudspeaker and a microphone probe, wherein a sound processing system for acquiring sound information from the microphone probe is matched and sleeved in the acoustic measurement host;
the eustachian tube pressure gauge comprises a pressure measuring host, a computer host, a nose adapter and a pressure receiver, wherein the pressure receiver is connected with the pressure measuring host through a data line, the pressure measuring host is connected with the nose adapter through a pressure conveying pipe and provides set pressure for the nose adapter, and a TMM system is sleeved in the computer host;
step 1, connecting and starting a nostril at the same side and an external auditory canal by using eustachian tube acoustic testing equipment, wherein the method comprises the steps of placing and sealing a loudspeaker in a front nostril at one side, placing and sealing a microphone probe in the external auditory canal at the same side, outputting 7KHz narrow-band noise by the loudspeaker, and outputting 123dB SPL (maximum output noise);
and 2, connecting the nostril at the other side and the external auditory canal by using a eustachian tube pressure measuring instrument, namely placing the nasal adapter in the other nostril and sealing the nostril without air leakage.
And 3, performing acoustic measurement while pressurizing nasopharynx, wherein the pressure is provided by TMM, adjusting the test pressure to 30mbar, 40mbar and 50mbar, respectively performing acoustic measurement test based on the three pressure values, wherein each pressure value is tested for 1-3 times, Sound Pressure (SPL) detected by a microphone of an external auditory canal is a result, and the ET opening is defined as that the SPL is more than or equal to 5dB at least once.
2. The eustachian tube patency test system according to claim 1, wherein the eustachian tube sounding device is used to connect and activate the ipsilateral naris and external auditory canal in step 1, further comprising calibrating the received sound signal based on a calibration target value.
3. The eustachian tube patency test system according to claim 2, wherein the calibration target values include 50dB SPL, 55dB SPL.
4. The eustachian tube patency test system according to claim 1, wherein the pressure test of step 3 comprises letting the subject hold 10ml of water and hold their breath, closing the air inlet under the single foot nasoscope and swallowing immediately; after swallowing, the detection is stopped, and the Sound Pressure (SPL) is detected by the microphone in the external auditory canal as a result.
5. The eustachian tube patency test system according to claim 1, further comprising a printing device inherent to the eustachian tube audiometry device for printingly outputting data results of an acoustic pressure method.
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2342072C1 (en) * | 2007-07-09 | 2008-12-27 | Александр Владимирович Староха | Diagnostics method of acoustical pipe diseases |
| CN101766474A (en) * | 2009-01-07 | 2010-07-07 | 陈舒华 | Auditory-tube-function detecting device and detecting method thereof |
| CN105686847A (en) * | 2016-04-07 | 2016-06-22 | 广西医科大学 | Eustachian tube sonic-detection-method digital inspection tester and measuring method thereof |
| US20180161527A1 (en) * | 2016-12-14 | 2018-06-14 | Tyler A. Janz | Eustachian tube dilation device |
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2022
- 2022-01-26 CN CN202210096232.6A patent/CN114699069A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2342072C1 (en) * | 2007-07-09 | 2008-12-27 | Александр Владимирович Староха | Diagnostics method of acoustical pipe diseases |
| CN101766474A (en) * | 2009-01-07 | 2010-07-07 | 陈舒华 | Auditory-tube-function detecting device and detecting method thereof |
| CN105686847A (en) * | 2016-04-07 | 2016-06-22 | 广西医科大学 | Eustachian tube sonic-detection-method digital inspection tester and measuring method thereof |
| US20180161527A1 (en) * | 2016-12-14 | 2018-06-14 | Tyler A. Janz | Eustachian tube dilation device |
Non-Patent Citations (1)
| Title |
|---|
| KAIAN RUAN, ET AL: "Comparison of sonotubometry, impedance, tubo-tympano-aerography, and tubomanometry to test eustachian tube function", ELSESVIER, 31 December 2020 (2020-12-31), pages 1 - 7 * |
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