Introduction: Otoacoustic emissions are
sounds that result from energy generated in
the cochlea. Because they are transmitted from
the cochlea to the ear canal where they can be
measured, middle ear pathology can influence
their characteristics.
Objective: The objective of the study was to
evaluate the influence of middle ear disorders
on the expression of distortion product
otoacoustic emissions (DPOAE) in children.
Material and methods: This prospective
study included a sample of 51 children, 26
males (51%) and 25 females (49%), aged 4 to
14 years (mean age of 7.1 years), examined
during the period of January to May 2017. A
total of 15 children with otitis media with effusion
(OME) and type B tympanogram were
included, 21 children with Eustachian tube
dysfunction and type C tympanogram, without
middle ear fluid, and 15 normal hearing
children with type A tympanogram as a control

Results: In children with type B tympanogram,
the lowest mean DPOAE amplitude
was -15 dB SPL at frequency of 4000 Hz. In
cases with type C tympanogram, the lowest
mean DPOAE amplitude was -0.5 dB SPL,
and in type A tympanogram 6.7 dB SPL. In
children with OME, only 7% of all points
per octave were accepted (p<0.00001),
DPOAE were absent in 85.8% of tested frequencies
(p = 0.0259), and pure tone average
was 26 dB HL.
Conclusion: Expression of DPOAE is significantly
affected not only with presence of
middle ear fluid, but also in cases of negative
middle ear pressure without hearing


otitis media with effusion, otoacoustic emissions, expression

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