A longitudinal study of the detection of otitis media in the first two years of life.

A number (210) of children were followed longitudinally through the first two years of life with pneumatic otoscopy and electroacoustic immitance, tympanometry, at every physician encounter. Tympanometry proved to have a high predictive value (86%) for detecting normal ears but relatively poor predictive value (58%) for detecting abnormal ears when utilized as a routine screening procedure with every clinic visit. In part the tympanometrically abnormal ears which appeared normal in otoscopic exam were temporally related to recent episodes of otitis and concurrent upper respiratory congestion, but many were unrelated to detectable middle ear pathology. These observations detract from the utility of tympanometry as a screening tool for middle ear pathology.