Wideband Power Reflectance and Power Transmittance as Tools for Assessing Middle-Ear Function

Hearing screening programs using otoacoustic emissions can have high false positive rates, due to temporary middle-ear and outer-ear disorders. This is especially the case for newborns, infants, and young children. Standard tympanometry is limited, uncomfortable, and unreliable in young ears. By incorporating wideband acoustic power flow measurements into hearing screening (using the same equipment), middle-ear and outer-ear disorders can be detected, thus allowing for rescreening rather than more expensive audiological referrals. Wideband acoustic power flow is described in detail and four case examples are provided for adults and children. Science is much like a game of leapfrog. Each new advance introduces new obstacles and new opportunities for further advances. A case in point is the development of improved hearing screening procedures using evoked otoacoustic emissions, which has many advantages over earlier methods. Reliable objective measurements are obtained rapidly and conveniently.