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Pneumatic otoscopy needed for accurate diagnosis of otitis media
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Tympanometry can assist in diagnosing otitis media, but it is not specific enough to be used alone, according to recently published data.
Kjell K. Helenius, MD, of the department of pediatrics at Turku University Hospital in Finland, and colleagues examined 514 children aged 6 to 35 months and compared tympanograms with pneumatic otoscopy results. The researchers evaluated the proportions of type A, C1, C2, Cs and B tympanograms in relation to specific otoscopic diagnoses in 2,206 symptomatic examinations and 1,006 asymptomatic visits.
Helenius and colleagues said for symptomatic visits, different peaked tympanograms were related to healthy ear types: type A in 78% of examinations; type C1 in 62%; type C2 in 54%; and type Cs in 18%. Any peaked tympanogram was related to a healthy middle ear in 67% of exams. Flat, or type B, tympanograms were associated with otitis media with effusion (OME) in 44% of the examinations or acute otitis media in 56% of the examinations.
According to the researchers, in asymptomatic visits, tympanograms together were related to a healthy middle ear in 87% of otoscopic examinations; flat tympanogram indicated OME in 87% of examinations, as well.
“The usefulness of tympanometry as an adjunctive diagnostic tool is emphasized by our findings that the success rate was not affected by cerumen, otoscopic diagnosis, or the child’s symptoms,” the researchers wrote. “On the other hand, the overall success rate of tympanometric examinations varies between physicians and may be modest at otitis-prone age.”
Disclosure: Dr. Helenius reports no relevant financial disclosures.
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