{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:42:03Z","timestamp":1785404523745,"version":"3.56.0"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009232","name":"University of Debrecen","doi-asserted-by":"publisher","award":["GINOP-2.3.3-15-2016-00021"],"award-info":[{"award-number":["GINOP-2.3.3-15-2016-00021"]}],"id":[{"id":"10.13039\/501100009232","id-type":"DOI","asserted-by":"publisher"}]},{"award":["GINOP-2.3.3-15-2016-00021"],"award-info":[{"award-number":["GINOP-2.3.3-15-2016-00021"]}],"id":[{"id":"https:\/\/ror.org\/02xf66n48","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Background\/Objectives: This study evaluated the intra-session repeatability, reliability, and clinical consistency of resonance frequency derived from pressure-less acoustic immittance (PLAI), and compared the results with those obtained using conventional multifrequency tympanometry under identical clinical conditions. Methods: In this pilot methodological comparison study, resonance frequency (RF) measurements were obtained in 15 subjects (30 ears) using multifrequency tympanometry (MFT) and pressure-less acoustic immittance (PLAI). Three consecutive measurements were performed for each ear using both methods. Agreement between methods was evaluated using Bland\u2013Altman analysis. Within-method repeatability was assessed using range, coefficient of variation, repeatability coefficient, and intraclass correlation coefficients. Results: PLAI demonstrated lower intra-session variability than MFT. The mean within-series SD was 96.6 Hz for MFT and 10.5 Hz for PLAI. The coefficient of variation was 9.3% for MFT and 3.2% for PLAI, while intraclass correlation coefficients were 0.60 and 0.83, respectively. The repeatability coefficient was \u00b1367 Hz for MFT and \u00b147 Hz for PLAI. Bland\u2013Altman analysis revealed a systematic difference between the two methods, with a mean bias of 580.7 Hz and 95% limits of agreement between 247.5 Hz and 913.9 Hz, indicating that the two methods are not interchangeable. Conclusions: PLAI demonstrated higher repeatability than MFT. Its lower variability may support a more consistent clinical interpretation; PLAI-derived RF may therefore represent a stable method-specific parameter for middle ear assessment. However, RF values should be interpreted within method-specific frameworks.<\/jats:p>","DOI":"10.3390\/audiolres16040098","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:06:34Z","timestamp":1782875194000},"page":"98","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pressure-Less Acoustic Immittance-Derived Middle Ear Resonance Frequency: Repeatability and Comparison with Multifrequency Tympanometry"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3565-8274","authenticated-orcid":false,"given":"Zsuzsanna","family":"Piros","sequence":"first","affiliation":[{"name":"Szilv\u00e1ssy Judit Audiology Centre, Department of Otorhinolaryngology and Head and Neck Surgery, University of Debrecen Clinical Centre, Nagyerdei St. 98, H-4032 Debrecen, Hungary"},{"name":"Doctoral School of Nutrition and Food Sciences, University of Debrecen, H-4032 Debrecen, Hungary"},{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szil\u00e1rd Gyula","family":"Rezes","sequence":"additional","affiliation":[{"name":"Szilv\u00e1ssy Judit Audiology Centre, Department of Otorhinolaryngology and Head and Neck Surgery, University of Debrecen Clinical Centre, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-366X","authenticated-orcid":false,"given":"Rita","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Be\u00e1ta","family":"Lelesz","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8376-3940","authenticated-orcid":false,"given":"Gyula","family":"Ujlaki","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Juh\u00e1sz","sequence":"additional","affiliation":[{"name":"Doctoral School of Nutrition and Food Sciences, University of Debrecen, H-4032 Debrecen, Hungary"},{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Szilv\u00e1ssy","sequence":"additional","affiliation":[{"name":"Doctoral School of Nutrition and Food Sciences, University of Debrecen, H-4032 Debrecen, Hungary"},{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1097\/00003446-199008000-00007","article-title":"The Resonance Frequency of the External Auditory Canal in Children","volume":"11","author":"Dempster","year":"1990","journal-title":"Ear Hear."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1590\/2317-1782\/2014211IN","article-title":"Correlation between the Characteristics of Resonance and Aging of the External Ear","volume":"26","author":"Silva","year":"2014","journal-title":"CoDAS"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4081\/audiores.2016.147","article-title":"Decrease in Middle Ear Resonance Frequency During Pregnancy","volume":"6","author":"Dag","year":"2016","journal-title":"Audiol. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1080\/14992027.2022.2135033","article-title":"Measuring Resonance Frequency of the Middle Ear in School-Aged Children: Potential Applications for Detecting Middle Ear Dysfunction","volume":"62","author":"Downing","year":"2023","journal-title":"Int. J. Audiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Miladinovi\u0107, A., Bassi, F., Aj\u010devi\u0107, M., and Accardo, A. (2025). Age-Stratified Classification of Common Middle Ear Pathologies Using Pressure-Less Acoustic Immittance (PLAITM) and Machine Learning. Healthcare, 13.","DOI":"10.3390\/healthcare13151921"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1044\/1059-0889.0103.33","article-title":"Multifrequency Tympanometry: Current Clinical Application","volume":"1","author":"Hunter","year":"1992","journal-title":"Am. J. Audiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7874\/jao.2015.19.1.1","article-title":"Mass and Stiffness Impact on the Middle Ear and the Cochlear Partition","volume":"19","author":"Kim","year":"2015","journal-title":"J. Audiol. Otol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/00003446-199312000-00006","article-title":"Multifrequency Tympanometry in Normal Adults","volume":"14","author":"Margolis","year":"1993","journal-title":"Ear Hear."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3109\/00206090009073064","article-title":"Resonant Frequency Pattern in Multifrequency Tympanograms: Results in Normally-Hearing Subjects: Patr\u00f3n de Resonancia Frecuencial En Timpanogramas de Multifrecuencia: Resultados En Normoyentes","volume":"39","author":"Hocke","year":"2000","journal-title":"Audiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/00003446-198409000-00007","article-title":"Multiple Frequency, Multiple Component Tympanometry: New Approaches to an Old Diagnostic Problem","volume":"5","author":"Lilly","year":"1984","journal-title":"Ear Hear."},{"key":"ref_12","first-page":"53","article-title":"Multifrequency Tympanometry: Effects of Ear Canal Volume Compensation on Middle Ear Resonance","volume":"8","author":"Hanks","year":"1997","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3342\/kjorl-hns.2017.00605","article-title":"Clinical Applications of Wideband Tympanometry","volume":"60","author":"Park","year":"2017","journal-title":"Korean J. Otorhinolaryngol.-Head Neck Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-0043-1763295","article-title":"Implementation of Wideband Acoustic Immittance in Clinical Practice: Relationships among Audiologic and Otologic Findings","volume":"44","author":"Sanford","year":"2023","journal-title":"Semin. Hear."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1044\/2023_AJA-23-00228","article-title":"Survey of Wideband Acoustic Immittance Use by Clinical Audiologists","volume":"33","author":"Skretta","year":"2024","journal-title":"Am. J. Audiol."},{"key":"ref_16","unstructured":"Neuranix Srl (2026, June 24). PLAI\u00ae Methodology Used in Med\u00b7Wave\u00ae. Available online: https:\/\/neuranix.com\/wp-content\/uploads\/05_WP_PLAI-Methodology-used-in-med%E2%80%A2wave_def.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Polterauer-Neuling, D., Polterauer-Neuling, M., Zoth, P., and Molenda, C. (2026). Early Results from a Pressureless Middle Ear Diagnostic and Its Relation to the Types of Tympanometry Results. Audiol. Res., 16.","DOI":"10.3390\/audiolres16030062"}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/16\/4\/98\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:14:20Z","timestamp":1783484060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/16\/4\/98"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["audiolres16040098"],"URL":"https:\/\/doi.org\/10.3390\/audiolres16040098","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}