Correlation between video-otoscopic images and tympanograms of patients with acute middle ear infection

Abstract

Objective: The tympanic membrane undergoes several changes in appearance in acute middle ear infection, which may be caused by a pressure change in the middle ear cavity. The tympanic membrane can be visualized through video-otoscopy, and the middle ear pressure can be detected through tympanometry. The objectives of this study were to assess the correlation between video-otoscopic images and tympanograms and to determine which of these tools can be used in diagnosing acute middle ear infection most efficiently and at an earlier stage. Materials and Methods: The study period was from April 2005 to August 2014, 900 patients, 1247 cases (693 males, 554 females), and 1951 infected ears were examined. Patients were encouraged to follow-up at our outpatient clinic where matched video-otoscopic images and tympanograms were obtained independently at each visit. A total of 4827 matched results were collected and their correlations were statistically analyzed using Pearson's Chi-square and logistic regression tests. Results:P< 0.05, determined using Pearson's Chi-square test, indicated a statistically significant correlation between video-otoscopic images and tympanograms. Furthermore, in 7.2% of the cases, video-otoscopy could be used to diagnose acute middle ear infection 1–2 visits earlier than tympanometry could, which was also confirmed by logistic regression tests. Conclusions: Handheld otoscopes coupled with video-otoscopes are more efficient than tympanometers in diagnosing any patient with a suspected acute middle ear infection. Video-otoscopy provides an opportunity for immediately observing the condition of the tympanic membrane, which is helpful for clinicians and patients.