A comparison of audiometry and audiometry with tympanometry to determine middle ear status in school-age children.

Otitis media with effusion is the most common cause of fluctuating hearing loss in children. Pure-tone audiometry is the current mandated standard to determine hearing loss in public-school children in most states. Students who fail pure tone audiometry are at risk for otitis media with effusion because it is asymptomatic. Tympanometry, which assesses middle ear status, is used to detect hidden otitis media with effusion. This longitudinal study evaluated pure tone audiometry and tympanometry in preschool and elementary children (n = 141). Results found 12 children (23 ears) who failed either a second threshold or tympanometry. The study also showed that a greater number of ears were identified with otitis media with effusion (n = 19) by using pure tone audiometry and tympanometry than byusing pure tone audiometry alone (n = 4).