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Reference intervals for the evoked tympanic membrane displacement measurement: a non-invasive measure of intracranial pressure

Reference intervals for the evoked tympanic membrane displacement measurement: a non-invasive measure of intracranial pressure
Reference intervals for the evoked tympanic membrane displacement measurement: a non-invasive measure of intracranial pressure

OBJECTIVE: Evoked tympanic membrane displacement (TMD) is a non-invasive technique for assessing intracranial pressure (ICP). The aim of this study was to define reference intervals (RIs) in the healthy population.

APPROACH: Measurements were made in 154 healthy adults. Results were quantified by V m, which is the most frequently described TMD measurement. Distributions were determined for sitting and supine posture. Differences between right and left ears were explored using a Wilcoxon signed-rank test. Postural changes were used to assess pressure transfer between the cerebral spinal fluid (CSF) and the perilymph.

MAIN RESULTS: The range in which 95% of scores fall is  -283 to 722 nl (M  =  132 nl) left sitting, -232 to 623 nl (M  =  97 nl) right sitting, -543 to 717 nl (M  =  37 nl) left supine and  -584 to 504 nl (M  =  -15 nl) right supine. No significant difference was seen between the left and right ears in the sitting position; a significant difference was seen in the supine position. A significant effect of posture was seen for both the left and right ears. Postural changes indicated pressure transfer between the CSF and perilymph more often in the right ear (75.3%) than the left (61.9%). Pressure transfer could not be assumed in either ear for 13.4% of participants.

SIGNIFICANCE: We present the largest dataset of evoked TMD in healthy individuals and the first set of RIs for V m. A patient cohort with both invasive ICP and evoked TMD measurements is needed to validate the technique for clinical use.

Adult, Aged, Aged, 80 and over, Female, Healthy Volunteers, Humans, Intracranial Pressure, Male, Middle Aged, Posture, Reference Values, Tympanic Membrane, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
0967-3334
015008
Campbell-Bell, Cherith M.
6df96d49-a4c3-4cfb-add1-4d34ff1b1ba1
Birch, Anthony A.
755f2236-4c0c-49b5-9884-de4021acd42d
Vignali, Dario
9603c180-b663-45b8-883c-520820241e64
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d
Marchbanks, Robert J.
1ebe90b6-cb8a-4f9e-9585-4e264a951d7f
Campbell-Bell, Cherith M.
6df96d49-a4c3-4cfb-add1-4d34ff1b1ba1
Birch, Anthony A.
755f2236-4c0c-49b5-9884-de4021acd42d
Vignali, Dario
9603c180-b663-45b8-883c-520820241e64
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d
Marchbanks, Robert J.
1ebe90b6-cb8a-4f9e-9585-4e264a951d7f

Campbell-Bell, Cherith M., Birch, Anthony A., Vignali, Dario, Bulters, Diederik and Marchbanks, Robert J. (2018) Reference intervals for the evoked tympanic membrane displacement measurement: a non-invasive measure of intracranial pressure. Physiological Measurement, 39 (1), 015008. (doi:10.1088/1361-6579/aaa1d3).

Record type: Article

Abstract

OBJECTIVE: Evoked tympanic membrane displacement (TMD) is a non-invasive technique for assessing intracranial pressure (ICP). The aim of this study was to define reference intervals (RIs) in the healthy population.

APPROACH: Measurements were made in 154 healthy adults. Results were quantified by V m, which is the most frequently described TMD measurement. Distributions were determined for sitting and supine posture. Differences between right and left ears were explored using a Wilcoxon signed-rank test. Postural changes were used to assess pressure transfer between the cerebral spinal fluid (CSF) and the perilymph.

MAIN RESULTS: The range in which 95% of scores fall is  -283 to 722 nl (M  =  132 nl) left sitting, -232 to 623 nl (M  =  97 nl) right sitting, -543 to 717 nl (M  =  37 nl) left supine and  -584 to 504 nl (M  =  -15 nl) right supine. No significant difference was seen between the left and right ears in the sitting position; a significant difference was seen in the supine position. A significant effect of posture was seen for both the left and right ears. Postural changes indicated pressure transfer between the CSF and perilymph more often in the right ear (75.3%) than the left (61.9%). Pressure transfer could not be assumed in either ear for 13.4% of participants.

SIGNIFICANCE: We present the largest dataset of evoked TMD in healthy individuals and the first set of RIs for V m. A patient cohort with both invasive ICP and evoked TMD measurements is needed to validate the technique for clinical use.

Full text not available from this repository.

More information

Accepted/In Press date: 14 December 2017
e-pub ahead of print date: 14 December 2017
Published date: 31 January 2018
Keywords: Adult, Aged, Aged, 80 and over, Female, Healthy Volunteers, Humans, Intracranial Pressure, Male, Middle Aged, Posture, Reference Values, Tympanic Membrane, Young Adult, Journal Article, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 427686
URI: https://eprints.soton.ac.uk/id/eprint/427686
ISSN: 0967-3334
PURE UUID: 42e7bfa8-e0a4-4ea9-a51b-4fd840b8f88c
ORCID for Anthony A. Birch: ORCID iD orcid.org/0000-0002-2328-702X
ORCID for Dario Vignali: ORCID iD orcid.org/0000-0003-2612-6122

Catalogue record

Date deposited: 25 Jan 2019 17:30
Last modified: 14 Mar 2019 01:22

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