Open-ended tympanometric screening: A new concept.

We introduce the concept of open-ended, successive-day, tympanometric screening. In impedance screening of children for middle ear disorders, there is a serious risk of over-referral if decisions are made on the basis of a single tympanogram. Serial tympanometric studies of Australian aboriginal children show that, whereas the type B tympanogram is usually stable, type A and type C patterns are prone to vary from day to day, inviting inappropriate referral decisions unless the classifications are confirmed by tests on successive days.