Wideband acoustic immittance normative data: ethnicity, gender, aging, and instrumentation.

This article describes the effect of ethnicity, gender, aging, and instrumentation on wideband acoustic immittance (WAI). This is an important topic to investigate as the goal of any audiological test is optimize the test's sensitivity and specificity. One way to improve the test's sensitivity and specificity is to reduce the variability of the normative data. The impact of the aforementioned demographic characteristics on WAI norms has been reviewed, and where applicable its potential impact on clinical outcome has been discussed. Overall, differences observed between Caucasian and Chinese ethnic groups in adults population may warrant the use of ethnicity-specific norms especially for detection of otosclerosis; however, these differences in the school-aged children are not large enough to warrant the use of ethnicity-specific norms. It is important to explore whether the observed differences between Caucasian and Chinese ethnic groups is due to body-size indices and whether these differences can be replicated in other East Asian ethnic groups that share similar body-size indices. The differences observed between school-aged children and adults could also potentially impact clinical decision analysis. Therefore, use of age-specific norm is recommended. The differences in WAI between different systems are not clinically significant, and the use of instrument-specific norms does not result in improved test performance at least for the detection of otosclerosis. However, measuring WAI at ambient pressure (static) or at pressure corresponding to the peak (dynamic mode) could potentially impact the normative data and may prove to be clinically useful in cases of negative and positive middle ear pressure.