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Tympanometric Detection of Middle Ear Effusion in Infants and Young Children
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1976
Year
OtorhinolaryngologyTympanometric DetectionMiddle Ear EffusionAuditory ScienceRadiologyMiddle Ear StatusVestibular SystemPediatric OtolaryngologyAudiologyClinical PediatricsHuman HearingHearing LossPediatricsOtolaryngologyYoung ChildrenArtsMedicineHearing DetectionAnesthesiology
Tympanometry was performed on 280 infants and young children aged 10 days to 5 years, and the resulting tympanograms were compared with otoscopic examinations and, in 107 cases, with myringotomy findings. Seven tympanometric curve types were defined, with low compliance curves strongly indicating middle‑ear effusion, normal compliance rarely indicating effusion in children older than 7 months, and intermediate compliance correlating variably; in infants under 7 months many effusions produced normal curves, yet tympanometry remains a simple, rapid, objective, and valid test that improves effusion detection and diagnostic accuracy.
Tympanometry, a test of middle ear status new to clinical pediatrics, was carried out on 280 subjects, 10 days through 5 years of age. The tympanograms obtained were compared with otoscopic findings and, in 107 of the subjects, with findings at myringotomy. Seven distinct tympanometric curve types were identified and defined, based on their degree of correlation with the presence or absence of middle ear effusion. In subjects 7 months of age and older, curves suggesting normal (high) tympanic membrane compliance in combination with atmospheric or near-atmospheric middle ear air pressure were rarely associated with effusion. Conversely, curves suggesting low tympanic membrane compliance were highly correlated with the presence of effusion. Curves suggesting intermediate compliance or reduced middle ear air pressure were also correlated with effusion, but the degree of correlation was dependent on the shape of the curve. In infants less than 7 months of age, many of the ears with effusion had "normal" tympanograms, presumably because external auditory canal walls in such infants tend to be highly distensible. Tympanometry is a simple, rapid, atraumatic, valid, and objective test, easily administered by paraprofessional personnel. Its use can result in improved detection of middle ear effusion and other middle ear abnormalities, and also appears to promote improvement in diagnostic acumen.