BACKGROUND: Tympanometry can indicate middle ear effusion in children referred for tympanostomy tube placement. In outpatient setting, objective adjunctive tools are needed to diagnose the otitis media spectrum. METHODS: We enrolled and followed 515 children aged 6-35 months at primary care level. We compared tympanometry with pneumatic otoscopy and evaluated the proportions of type A, C1, C2, Cs and B tympanograms in relation to specific otoscopic diagnoses in 2206 and 1006 examinations at symptomatic and asymptomatic visits, respectively. RESULTS: At symptomatic visits, different peaked tympanograms were associated with a healthy middle ear as follows: type A in 78%, type C1 in 62%, type C2 in 54% and type Cs in 18% of examinations. In contrast, any peaked tympanogram was related to healthy middle ear in 67% of examinations. Flat (type B) tympanogram was related to otitis media with effusion in 44% and to acute otitis media in 56% of examinations, respectively. At asymptomatic visits, the peaked tympanograms together were associated with a healthy middle ear in 87% of otoscopic examinations. Flat tympanogram indicated otitis media with effusion as well in 87% of examinations. CONCLUSIONS: Tympanometry is not a useful tool in detecting specific otoscopic diagnoses because it cannot distinguish between otitis media with effusion and acute otitis media. However, among outpatients all peaked tympanograms suggest a healthy middle ear and a flat tympanogram is useful in detecting any middle ear effusion. Thus, tympanometry can be used as an adjunctive tool, but accurate diagnosis requires careful pneumatic otoscopy.
BACKGROUND: Tympanometry can indicate middle ear effusion in children referred for tympanostomy tube placement. In outpatient setting, objective adjunctive tools are needed to diagnose the otitis media spectrum. METHODS: We enrolled and followed 515 children aged 6-35 months at primary care level. We compared tympanometry with pneumatic otoscopy and evaluated the proportions of type A, C1, C2, Cs and B tympanograms in relation to specific otoscopic diagnoses in 2206 and 1006 examinations at symptomatic and asymptomatic visits, respectively. RESULTS: At symptomatic visits, different peaked tympanograms were associated with a healthy middle ear as follows: type A in 78%, type C1 in 62%, type C2 in 54% and type Cs in 18% of examinations. In contrast, any peaked tympanogram was related to healthy middle ear in 67% of examinations. Flat (type B) tympanogram was related to otitis media with effusion in 44% and to acute otitis media in 56% of examinations, respectively. At asymptomatic visits, the peaked tympanograms together were associated with a healthy middle ear in 87% of otoscopic examinations. Flat tympanogram indicated otitis media with effusion as well in 87% of examinations. CONCLUSIONS: Tympanometry is not a useful tool in detecting specific otoscopic diagnoses because it cannot distinguish between otitis media with effusion and acute otitis media. However, among outpatients all peaked tympanograms suggest a healthy middle ear and a flat tympanogram is useful in detecting any middle ear effusion. Thus, tympanometry can be used as an adjunctive tool, but accurate diagnosis requires careful pneumatic otoscopy.
Authors: Guillermo L Monroy; Paritosh Pande; Ryan M Nolan; Ryan L Shelton; Ryan G Porter; Michael A Novak; Darold R Spillman; Eric J Chaney; Daniel T McCormick; Stephen A Boppart Journal: J Biomed Opt Date: 2017-12 Impact factor: 3.170
Authors: Guillermo L Monroy; Paritosh Pande; Ryan L Shelton; Ryan M Nolan; Darold R Spillman; Ryan G Porter; Michael A Novak; Stephen A Boppart Journal: J Biophotonics Date: 2016-03-24 Impact factor: 3.207
Authors: Miia K Laine; Paula A Tähtinen; Olli Ruuskanen; Eliisa Löyttyniemi; Aino Ruohola Journal: Scand J Prim Health Care Date: 2015-04-07 Impact factor: 2.581
Authors: Miia K Laine; Paula A Tähtinen; Olli Ruuskanen; Eliisa Löyttyniemi; Aino Ruohola Journal: Scand J Prim Health Care Date: 2015-12-14 Impact factor: 2.581