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Clinical comparison of tympanic membrane displacement with invasive intracranial pressure measurements

Lookup NU author(s): Dr Kathryn Banister, Emeritus Professor David Mendelow, Dr Iain Chambers


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A non-invasive method of assessing intracranial pressure (ICP) would be of benefit to patients with abnormal cerebral pathology that could give rise to changes in ICP In particular, it would assist the regular monitoring of hydrocephalus patients. This study evaluated a technique using tympanic membrane displacement (TMD) measurements, which has been reported to provide a reliable, non-invasive measure of ICP. A group of 135 hydrocephalus patients was studied, as well as 13 patients with benign intracranial hypertension and a control group of 77 volunteers. TMD measurements were carried out using the Marchbanks measurement system analyser and compared between the groups. In 36 patients, invasive measurements of ICP carried out at the same time were compared with the TMD values. A highly significant relationship was found between TMD and ICP but intersubject variability was high and the predictive value of the technique low. Taking the normal range of ICP to be 10-15 mmHg, the predictive limits of the regression are an order of magnitude wider than this and therefore Vm cannot be used as a surrogate for ICP. In conclusion, TMD measurements do not provide a reliable non-invasive measure of ICP in patients with shunted hydrocephalus.

Publication metadata

Author(s): Shimbles S, Dodd C, Banister K, Mendelow AD, Chambers IR

Publication type: Article

Publication status: Published

Journal: Physiological Measurement

Year: 2005

Volume: 26

Issue: 6

Pages: 1085-1092

ISSN (print): 0967-3334

ISSN (electronic): 1361-6579

Publisher: Institute of Physics Publishing Ltd.


DOI: 10.1088/0967-3334/26/6/017


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