Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics
2.2. Participants
2.3. Inclusion Criteria
2.4. Exclusion Criteria
2.5. Procedures
2.5.1. Otorhinolaryngological Evaluation
2.5.2. Otoscopy
2.5.3. Pure-Tone Audiometry
2.5.4. Logoaudiometry
2.5.5. Wideband Tympanometry (Ambient and Peak Pressure)
2.5.6. TEOAEs and DPOAEs (Ambient and Peak Pressure)
2.6. Statistical Analyses
3. Results
3.1. Sample Characterization
3.2. Pure-Tone Audiometry
3.3. Tympanometry (226 Hz and Wideband)
3.4. TEOAEs and DPOAEs
4. Discussion
4.1. Pure-Tone Audiometry
4.2. Tympanometry (226 Hz and Wideband)
4.3. TEOAEs and DPOAEs
4.4. Limitations and Future Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Age (Years) | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sex | F | M | F | M | F | M | F | M | F | M | F | M | F | M | F | M | |
Structures removed in surgery | Pharyngeal and palatine tonsils | 0 | 2 | 0 | 1 | 0 | 1 | 1 | 3 | 0 | 2 | 0 | 1 | 1 | 0 | 0 | 0 |
Pharyngeal tonsils | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
Frequency (Hz) | Group | n | Mean (dB HL) | Median | SD | Min | Max | p-Value |
---|---|---|---|---|---|---|---|---|
250 | G1 | 30 | 8.17 | 10 | 5.94 | −5 | 20 | 0.889 |
G2 | 30 | 8.00 | 10 | 4.66 | 0 | 20 | ||
500 | G1 | 30 | 6.67 | 5 | 5.14 | −5 | 15 | 0.086 |
G2 | 30 | 5.00 | 5 | 4.35 | −5 | 15 | ||
1000 | G1 | 30 | 4.33 | 5 | 4.50 | −5 | 15 | * 0.014 |
G2 | 30 | 1.83 | 0 | 3.07 | −5 | 10 | ||
2000 | G1 | 30 | 4.83 | 5 | 4.45 | −5 | 15 | * 0.037 |
G2 | 30 | 2.83 | 5 | 3.39 | −5 | 10 | ||
3000 | G1 | 30 | 5.17 | 5 | 3.82 | 0 | 10 | * <0.001 |
G2 | 30 | 1.83 | 0 | 3.59 | −5 | 10 | ||
4000 | G1 | 30 | 3.17 | 5 | 4.64 | −5 | 15 | 0.119 |
G2 | 30 | 1.67 | 0 | 5.14 | −5 | 15 | ||
6000 | G1 | 30 | 5.67 | 5 | 6.12 | −10 | 15 | 0.202 |
G2 | 30 | 7.33 | 5 | 6.12 | 0 | 20 | ||
8000 | G1 | 30 | 4.67 | 5 | 5.71 | −5 | 20 | 0.778 |
G2 | 30 | 5.00 | 5 | 6.57 | −10 | 15 |
Test | Classification | G1 | G2 | Total | p-Value | |||
---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | |||
Pure tone audiometry | Altered | 0 | 0% | 0 | 0% | 0 | 0% | -x- |
Normal | 30 | 100% | 30 | 100% | 60 | 100% | ||
Tympanometry | Altered | 4 | 13.3% | 0 | 0% | 4 | 6.7% | * 0.038 |
Normal | 26 | 86.7% | 30 | 100% | 56 | 93.3% | ||
Reflex IPSI 500 | Absent | 7 | 23.3% | 5 | 16.7% | 12 | 20.0% | 0.519 |
Present | 23 | 76.7% | 25 | 83.3% | 48 | 80.0% | ||
Reflex IPSI 1000 | Absent | 5 | 16.7% | 3 | 10.0% | 8 | 13.3% | 0.448 |
Present | 25 | 83.3% | 27 | 90.0% | 52 | 86.7% | ||
Reflex IPSI 2000 | Absent | 6 | 20.0% | 3 | 10.0% | 9 | 15.0% | 0.278 |
Present | 24 | 80.0% | 27 | 90.0% | 51 | 85.0% | ||
Reflex IPSI 4000 | Absent | 11 | 36.7% | 8 | 26.7% | 19 | 31.7% | 0.405 |
Present | 19 | 63.3% | 22 | 73.3% | 41 | 68.3% | ||
Reflex CONTRA 500 | Absent | 21 | 70.0% | 19 | 63.3% | 40 | 66.7% | 0.584 |
Present | 9 | 30.0% | 11 | 36.7% | 20 | 33.3% | ||
Reflex CONTRA 1000 | Absent | 20 | 66.7% | 20 | 66.7% | 40 | 66.7% | 1.000 |
Present | 10 | 33.3% | 10 | 33.3% | 20 | 33.3% | ||
Reflex CONTRA 2000 | Absent | 10 | 33.3% | 12 | 40.0% | 22 | 36.7% | 0.592 |
Present | 20 | 66.7% | 18 | 60.0% | 38 | 63.3% | ||
Reflex CONTRA 3000 | Absent | 14 | 51.9% | 13 | 48.1% | 27 | 50.0% | 0.785 |
Present | 13 | 48.1% | 14 | 51.9% | 27 | 50.0% | ||
Reflex CONTRA 4000 | Absent | 13 | 43.3% | 14 | 46.7% | 27 | 45.0% | 0.795 |
Present | 17 | 56.7% | 16 | 53.3% | 33 | 55.0% |
Frequency (Hz) | Group | n | Mean (dB HL) | Median | SD | Min | Max | p-Value |
---|---|---|---|---|---|---|---|---|
226 PP | G1 | 30 | 0.101 | 0.094 | 0.050 | 0.001 | 0.212 | 0.057 |
G2 | 30 | 0.121 | 0.116 | 0.056 | 0.047 | 0.259 | ||
257 PP | G1 | 30 | 0.107 | 0.099 | 0.052 | 0.003 | 0.222 | 0.060 |
G2 | 30 | 0.128 | 0.123 | 0.059 | 0.050 | 0.273 | ||
324 PP | G1 | 30 | 0.136 | 0.119 | 0.062 | 0.029 | 0.288 | 0.055 |
G2 | 30 | 0.162 | 0.152 | 0.075 | 0.055 | 0.345 | ||
408 PP | G1 | 30 | 0.187 | 0.155 | 0.078 | 0.088 | 0.375 | 0.055 |
G2 | 30 | 0.221 | 0.209 | 0.101 | 0.069 | 0.434 | ||
500 PP | G1 | 30 | 0.240 | 0.203 | 0.097 | 0.103 | 0.451 | * 0.031 |
G2 | 30 | 0.284 | 0.264 | 0.125 | 0.093 | 0.512 | ||
630 PP | G1 | 30 | 0.338 | 0.307 | 0.131 | 0.135 | 0.670 | * 0.047 |
G2 | 30 | 0.390 | 0.382 | 0.155 | 0.134 | 0.670 | ||
749 PP | G1 | 30 | 0.440 | 0.420 | 0.155 | 0.186 | 0.714 | * 0.046 |
G2 | 30 | 0.498 | 0.486 | 0.176 | 0.196 | 0.766 | ||
1000 PP | G1 | 30 | 0.598 | 0.603 | 0.169 | 0.249 | 0.862 | 0.159 |
G2 | 30 | 0.639 | 0.637 | 0.153 | 0.389 | 0.933 | ||
1260 PP | G1 | 30 | 0.653 | 0.684 | 0.131 | 0.260 | 0.840 | 0.644 |
G2 | 30 | 0.667 | 0.683 | 0.128 | 0.444 | 0.978 | ||
1587 PP | G1 | 30 | 0.667 | 0.697 | 0.127 | 0.351 | 0.846 | 0.729 |
G2 | 30 | 0.676 | 0.733 | 0.149 | 0.352 | 0.909 | ||
2000 PP | G1 | 30 | 0.652 | 0.654 | 0.168 | 0.331 | 0.932 | 0.973 |
G2 | 30 | 0.653 | 0.726 | 0.221 | 0.085 | 0.947 | ||
2520 PP | G1 | 30 | 0.729 | 0.733 | 0.204 | 0.324 | 0.992 | 0.590 |
G2 | 30 | 0.752 | 0.790 | 0.196 | 0.343 | 0.989 | ||
3175 PP | G1 | 30 | 0.767 | 0.798 | 0.176 | 0.348 | 0.989 | 0.629 |
G2 | 30 | 0.744 | 0.784 | 0.203 | 0.303 | 0.990 | ||
4000 PP | G1 | 30 | 0.728 | 0.763 | 0.174 | 0.291 | 0.949 | 0.302 |
G2 | 30 | 0.677 | 0.725 | 0.166 | 0.250 | 0.968 | ||
5040 PP | G1 | 30 | 0.561 | 0.551 | 0.177 | 0.272 | 0.947 | 0.754 |
G2 | 30 | 0.545 | 0.555 | 0.186 | 0.199 | 0.880 | ||
6350 PP | G1 | 30 | 0.311 | 0.283 | 0.116 | 0.161 | 0.545 | 0.869 |
G2 | 30 | 0.305 | 0.284 | 0.146 | 0.104 | 0.670 | ||
8000 PP | G1 | 30 | 0.230 | 0.187 | 0.132 | 0.066 | 0.584 | 0.450 |
G2 | 30 | 0.258 | 0.207 | 0.157 | 0.054 | 0.589 |
Frequency (Hz) Condition | Group | n | Mean | Median | SD | Min | Max | p-Value |
---|---|---|---|---|---|---|---|---|
Amplitude (dBSPL) 1000 PP | G1 | 29 | 14.29 | 13.9 | 5.35 | 4.6 | 29.8 | * 0.015 |
G2 | 29 | 12.11 | 11.8 | 6.39 | −1.3 | 30.5 | ||
2000 PP | G1 | 29 | 12.81 | 13.2 | 3.75 | 0 | 18.1 | 0.074 |
G2 | 29 | 11.08 | 11.9 | 4.05 | 0.7 | 17.1 | ||
3000 PP | G1 | 29 | 7.40 | 8.1 | 5.03 | −4 | 18.1 | 0.233 |
G2 | 29 | 6.61 | 7.3 | 4.60 | −3.6 | 18 | ||
4000 PP | G1 | 29 | 1.01 | 3.3 | 5.07 | −10.7 | 10 | 0.325 |
G2 | 29 | 0.33 | 1.8 | 5.67 | −10.8 | 9.8 | ||
5000 PP | G1 | 29 | −7.53 | −7.,1 | 5.12 | −20 | 1.5 | 0.284 |
G2 | 29 | −8.28 | −8 | 5.52 | −17 | 2.1 | ||
1000 AP | G1 | 29 | 14.10 | 13.8 | 5.60 | 2.5 | 29.2 | * 0.002 |
G2 | 29 | 11.79 | 11.6 | 6.30 | 0.7 | 30.5 | ||
2000 AP | G1 | 29 | 13.21 | 13.4 | 3.80 | 6.9 | 23.1 | 0.511 |
G2 | 29 | 17.89 | 12.2 | 38.55 | −0.7 | 217.3 | ||
3000 AP | G1 | 29 | 7.49 | 7.9 | 4.99 | −6.4 | 18.2 | 0.095 |
G2 | 29 | 6.56 | 7.1 | 4.73 | −3.1 | 18.9 | ||
4000 AP | G1 | 29 | 1.10 | 2.9 | 5.20 | −11 | 10.3 | 0.129 |
G2 | 29 | 0.12 | 1.5 | 5.93 | −12.1 | 9.6 | ||
5000 AP | G1 | 29 | −7.58 | −7 | 5.47 | −19.4 | 2 | 0.534 |
G2 | 29 | −8.01 | −7 | 5.39 | −17 | 1.9 |
Frequency (Hz) Condition | Group | n | Mean | Median | SD | Min | Max | p-Value |
---|---|---|---|---|---|---|---|---|
Amplitude (dBSPL) 500 PP | G1 | 30 | 6.55 | 7.15 | 6.98 | −5.7 | 20.1 | 0.168 |
G2 | 30 | 8.70 | 8.75 | 6.67 | −4.3 | 18.2 | ||
1000 PP | G1 | 30 | 12.80 | 13.55 | 4.72 | 4.7 | 22.3 | 0.557 |
G2 | 30 | 13.15 | 13.8 | 4.78 | 2.3 | 23.5 | ||
1500 PP | G1 | 30 | 15.04 | 15.4 | 5.31 | 4.1 | 25.2 | 0.897 |
G2 | 30 | 15.11 | 16.5 | 5.30 | 2.9 | 24 | ||
2000 PP | G1 | 30 | 12.44 | 12.45 | 4.99 | 2.5 | 22.3 | 0.286 |
G2 | 30 | 13.08 | 13.25 | 4.38 | 3.8 | 20.6 | ||
3000 PP | G1 | 30 | 10.24 | 10.35 | 4.47 | 1 | 19 | 0.662 |
G2 | 30 | 10.52 | 11.7 | 4.24 | 2.4 | 17.4 | ||
4000 PP | G1 | 30 | 11.46 | 12.65 | 4.70 | 1.4 | 19.5 | 0.613 |
G2 | 30 | 11.09 | 12.45 | 5.35 | 0 | 19.2 | ||
5000 PP | G1 | 30 | 10.44 | 11.4 | 5.60 | −4.9 | 18.4 | 0.210 |
G2 | 30 | 9.01 | 10.05 | 6.52 | −5 | 18.5 | ||
6000 PP | G1 | 30 | 8.08 | 8.35 | 4.73 | −1.9 | 17.2 | 0.137 |
G2 | 30 | 6.09 | 7.55 | 7.25 | −9.4 | 16.8 | ||
7000 PP | G1 | 30 | 8.43 | 10.25 | 6.21 | −8.8 | 19 | 0.169 |
G2 | 30 | 6.26 | 9.8 | 8.79 | −10.5 | 16.2 | ||
8000 PP | G1 | 29 | −0.59 | −0.3 | 7.93 | −18.5 | 17.1 | 0.081 |
G2 | 30 | −3.60 | 0.95 | 11.39 | −22.7 | 12.8 | ||
9000 PP | G1 | 30 | −2.76 | −1.7 | 8.47 | −18.7 | 12.4 | 0.054 |
G2 | 29 | −6.64 | −4.3 | 11.37 | −37.1 | 9.4 | ||
10,000 PP | G1 | 30 | −3.26 | −3.4 | 9.07 | −21.9 | 19.4 | 0.061 |
G2 | 30 | −6.71 | −6.15 | 8.79 | −22.3 | 8.6 | ||
500 AP | G1 | 29 | 6.65 | 8.2 | 6.59 | −11.6 | 18.5 | 0.241 |
G2 | 29 | 8.72 | 9.9 | 7.21 | −16.1 | 17.6 | ||
1000 AP | G1 | 29 | 11.74 | 12.1 | 7.41 | −6.7 | 24.4 | 0.160 |
G2 | 29 | 13.66 | 13.9 | 5.31 | 2.8 | 25.1 | ||
1500 AP | G1 | 29 | 13.91 | 14.7 | 7.66 | −6.8 | 26.7 | 0.118 |
G2 | 29 | 16.20 | 17.2 | 4.85 | 5.1 | 24.3 | ||
2000 AP | G1 | 29 | 15.24 | 12.8 | 17.64 | −9.6 | 10.9 | 0.631 |
G2 | 29 | 13.67 | 13.9 | 4.36 | 3.8 | 21.4 | ||
3000 AP | G1 | 29 | 10.73 | 10.5 | 6.30 | −2.2 | 26.3 | 0.227 |
G2 | 29 | 12.22 | 11.5 | 5.14 | 2.3 | 25.6 | ||
4000 AP | G1 | 29 | 12.37 | 13.3 | 5.89 | 1.4 | 32.9 | 0.877 |
G2 | 29 | 12.19 | 13 | 6.21 | 0.2 | 30.2 | ||
5000 AP | G1 | 29 | 11.97 | 11.9 | 6.49 | 1.1 | 36.6 | 0.206 |
G2 | 29 | 10.22 | 10 | 6.54 | −6.4 | 21.8 | ||
6000 AP | G1 | 29 | 9.95 | 8.6 | 7.38 | 0.9 | 41.6 | 0.818 |
G2 | 29 | 10.87 | 9.8 | 21.11 | −13.1 | 113.5 | ||
7000 AP | G1 | 29 | 9.35 | 10.7 | 7.55 | −8.9 | 29 | 0.314 |
G2 | 29 | 7.84 | 12 | 9.23 | −14.9 | 20 | ||
8000 AP | G1 | 29 | 2.16 | 3.6 | 10.66 | −16.9 | 419 | * 0.048 |
G2 | 29 | −2.22 | 2.1 | 10.81 | −25.5 | 12.8 | ||
9000 AP | G1 | 29 | −1.13 | −2.2 | 10.82 | −21.2 | 37.3 | * 0.020 |
G2 | 29 | −5.98 | −3.4 | 10.60 | −28.2 | 9.6 | ||
10,000 AP | G1 | 29 | −2.26 | −2.4 | 11.92 | −29.1 | 2.5 | 0.077 |
G2 | 29 | −5.94 | −3.6 | 9.09 | −22.6 | 8 |
Frequency (Hz) Condition | Group | n | Mean | Median | SD | Min | Max | p-Value |
---|---|---|---|---|---|---|---|---|
S/R (dB) 500 PP | G1 | 30 | 6.33 | 7.4 | 5.43 | −8.8 | 12.3 | 0.262 |
G2 | 30 | 4.49 | 5.45 | 6.86 | −9.3 | 15 | ||
1000 PP | G1 | 30 | 16.11 | 14.85 | 5.41 | 7.5 | 27 | * 0.017 |
G2 | 30 | 19.79 | 18.95 | 7.81 | 0.3 | 34.2 | ||
1500 PP | G1 | 30 | 23.14 | 22.25 | 5.21 | 14.7 | 34.3 | * 0.002 |
G2 | 30 | 26.90 | 27.25 | 6.75 | 12 | 41 | ||
2000 PP | G1 | 30 | 23.11 | 22.6 | 6.01 | 10.2 | 34 | * <0.001 |
G2 | 30 | 27.24 | 27.2 | 5.28 | 16.5 | 40.4 | ||
3000 PP | G1 | 30 | 24.56 | 23.9 | 5.05 | 14.4 | 35.3 | * <0.001 |
G2 | 30 | 28.92 | 29.1 | 4.41 | 19.4 | 36 | ||
4000 PP | G1 | 30 | 39.87 | 31 | 56.84 | 15.8 | 339.1 | 0.491 |
G2 | 30 | 32.85 | 33.4 | 6.45 | 16.9 | 42.3 | ||
5000 PP | G1 | 29 | 33.72 | 34.4 | 7.18 | 14.1 | 46.3 | 0.291 |
G2 | 30 | 35.46 | 37.75 | 6.96 | 19 | 45.1 | ||
6000 PP | G1 | 30 | 33.68 | 33.65 | 6.00 | 21 | 48.1 | 0.523 |
G2 | 30 | 34.78 | 36.7 | 8.04 | 18.1 | 44.3 | ||
7000 PP | G1 | 30 | 32.03 | 32.25 | 7.38 | 15.9 | 47.6 | 0.610 |
G2 | 30 | 33.02 | 35.75 | 8.79 | 16.7 | 42.9 | ||
8000 PP | G1 | 30 | 24.66 | 23 | 8.24 | 6.4 | 41.9 | 0.582 |
G2 | 30 | 23.43 | 24.55 | 12.05 | −3.2 | 42.3 | ||
9000 PP | G1 | 30 | 23.40 | 23.2 | 7.17 | 13.6 | 41 | 0.161 |
G2 | 30 | 20.45 | 21.35 | 12.08 | −7.1 | 36.3 | ||
10,000 PP | G1 | 30 | 18.41 | 17.1 | 8.33 | 5.9 | 44.7 | 0.475 |
G2 | 30 | 17.07 | 16.3 | 9.20 | 0.5 | 32.4 | ||
500 AP | G1 | 29 | 6.45 | 8.4 | 6.08 | −16.3 | 12.6 | 0.358 |
G2 | 29 | 4.98 | 5.9 | 7.49 | −16.1 | 19.2 | ||
1000 AP | G1 | 29 | 15.85 | 16.3 | 5.62 | −0.9 | 25.9 | * 0.035 |
G2 | 29 | 19.20 | 20.5 | 8.34 | 1.9 | 35.2 | ||
1500 AP | G1 | 29 | 22.12 | 23.4 | 7.04 | 3.4 | 33.3 | * 0.020 |
G2 | 29 | 26.54 | 25.7 | 6.96 | 13.4 | 37.8 | ||
2000 AP | G1 | 29 | 22.87 | 23.6 | 6.22 | 0.9 | 32 | * <0.001 |
G2 | 29 | 28.19 | 28.6 | 5.16 | 15.3 | 38.8 | ||
3000 AP | G1 | 29 | 25.21 | 24.3 | 5.49 | 16.3 | 34.1 | * <0.001 |
G2 | 29 | 29.04 | 29.6 | 4.87 | 17.4 | 39.3 | ||
4000 AP | G1 | 29 | 30.43 | 30.6 | 5.59 | 16.8 | 39.9 | * 0.023 |
G2 | 29 | 32.33 | 33.3 | 5.84 | 20.9 | 41.6 | ||
5000 AP | G1 | 29 | 35.10 | 35.7 | 5.73 | 21.8 | 44.9 | 0.752 |
G2 | 29 | 35.58 | 36.5 | 7.64 | 19.3 | 46.3 | ||
6000 AP | G1 | 29 | 34.79 | 35.2 | 5.65 | 25.1 | 46.6 | 0.869 |
G2 | 29 | 35.08 | 35.7 | 7.19 | 18.4 | 44.9 | ||
7000 AP | G1 | 29 | 33.14 | 34.8 | 7.36 | 13.6 | 46.5 | 0.709 |
G2 | 29 | 33.77 | 37.1 | 8.83 | 14.3 | 44.4 | ||
8000 AP | G1 | 29 | 26.50 | 27.5 | 8.12 | 12.2 | 42.1 | 0.450 |
G2 | 29 | 24.80 | 27.1 | 11.84 | −3.5 | 41.1 | ||
9000 AP | G1 | 29 | 23.91 | 25.7 | 7.68 | 9.4 | 37.5 | 0.221 |
G2 | 29 | 21.31 | 22.8 | 11.83 | −4.9 | 36.9 | ||
10,000 AP | G1 | 29 | 17.51 | 16.2 | 10.25 | −9.3 | 43.1 | 0.693 |
G2 | 29 | 16.73 | 19.3 | 9.95 | 0.3 | 31.1 |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Sanches, A.B.; Sanfins, M.D.; Skarzynski, P.H.; Skarżyńska, M.B.; Penatti, H.C.; Donadon, C.; Souza, I.P.d.; Silva, I.V.d.; Colella-Santos, M.F. Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils. Brain Sci. 2024, 14, 598. https://doi.org/10.3390/brainsci14060598
Sanches AB, Sanfins MD, Skarzynski PH, Skarżyńska MB, Penatti HC, Donadon C, Souza IPd, Silva IVd, Colella-Santos MF. Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils. Brain Sciences. 2024; 14(6):598. https://doi.org/10.3390/brainsci14060598
Chicago/Turabian StyleSanches, Aline Buratti, Milaine Dominici Sanfins, Piotr Henryk Skarzynski, Magdalena Beata Skarżyńska, Henrique Costa Penatti, Caroline Donadon, Ingrid Pereira de Souza, Ingridy Vitoria da Silva, and Maria Francisca Colella-Santos. 2024. "Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils" Brain Sciences 14, no. 6: 598. https://doi.org/10.3390/brainsci14060598