The Use of Tympanometry and Pneumatic Otoscopy for Predicting Middle Ear Disease

TLDR

Otitis media affects about 70 % of children and is the most frequently diagnosed condition by pediatricians. The study aimed to evaluate how well otoscopy and multifrequency tympanometry diagnose otitis media in children, with plans for larger future studies. Twenty‑one children aged 1–10 underwent pre‑myringotomy testing with pneumatic otoscopy, conventional 226‑Hz tympanometry, and multifrequency tympanometry to assess sensitivity and specificity against the gold‑standard myringotomy. Pneumatic otoscopy and tympanometry agreed 80–100 % of the time, and 678‑Hz and 1000‑Hz tympanometry detected abnormalities more frequently, supporting routine use of MFT in children with otitis media history or abnormal 226‑Hz tympanograms.

Abstract

Purpose: Otitis media is the most common condition diagnosed by pediatricians and is estimated to affect approximately 70% of the pediatric population. The goal of this study was to evaluate the effectiveness of otoscopy and multifrequency tympanometry (MFT) for diagnosis of otitis media in children. Method: Twenty-one children, age 1 to 10 years, who were seeking medical treatment for suspected middle ear disease were selected to participate. Data were collected prior to myringotomy to determine the sensitivity and specificity rates of the following otologic and audiologic measures: (a) pneumatic otoscopy, (b) conventional tympanometry, and (c) MFT. For this study, the "gold standard," myringotomy, was used along with pneumatic otoscopy to determine the effectiveness, sensitivity, and specificity of conventional 226-Hz tympanometry, 678-Hz tympanometry, and 1000-Hz tympanometry to predict middle ear disease. Results: The diagnoses provided with pneumatic otoscopy and tympanometry were both similar, agreeing in diagnosis 80%–100% of the time. The diagnoses from 678-Hz and 1000-Hz tympanometry were nearly equal and proved to detect abnormality at a higher rate. Conclusions: MFT is recommended on a routine basis with children having a history of otitis media, or else abnormal or notched 226-Hz tympanograms. Further research with a larger sample size will illuminate the possible predictive potential of MFT in otitis media.