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Pediatr Infect Dis J. 2012 Oct;31(10):1003-6. doi: 10.1097/INF.0b013e31825cac94.

Tympanometry in discrimination of otoscopic diagnoses in young ambulatory children.

Author information

1
Department of Pediatrics, Turku University Hospital, Turku, Finland.

Abstract

BACKGROUND:

Tympanometry can indicate middle ear effusion in children referred for tympanostomy tube placement. In outpatient setting, objective adjunctive tools are needed to diagnose the otitis media spectrum.

METHODS:

We enrolled and followed 515 children aged 6-35 months at primary care level. We compared tympanometry with pneumatic otoscopy and evaluated the proportions of type A, C1, C2, Cs and B tympanograms in relation to specific otoscopic diagnoses in 2206 and 1006 examinations at symptomatic and asymptomatic visits, respectively.

RESULTS:

At symptomatic visits, different peaked tympanograms were associated with a healthy middle ear as follows: type A in 78%, type C1 in 62%, type C2 in 54% and type Cs in 18% of examinations. In contrast, any peaked tympanogram was related to healthy middle ear in 67% of examinations. Flat (type B) tympanogram was related to otitis media with effusion in 44% and to acute otitis media in 56% of examinations, respectively. At asymptomatic visits, the peaked tympanograms together were associated with a healthy middle ear in 87% of otoscopic examinations. Flat tympanogram indicated otitis media with effusion as well in 87% of examinations.

CONCLUSIONS:

Tympanometry is not a useful tool in detecting specific otoscopic diagnoses because it cannot distinguish between otitis media with effusion and acute otitis media. However, among outpatients all peaked tympanograms suggest a healthy middle ear and a flat tympanogram is useful in detecting any middle ear effusion. Thus, tympanometry can be used as an adjunctive tool, but accurate diagnosis requires careful pneumatic otoscopy.

PMID:
22592519
DOI:
10.1097/INF.0b013e31825cac94
[Indexed for MEDLINE]

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