Tympanometric screening for Otitis media of paediatric patients with respiratory tract infection in rural setting a prospective observational study

Abstract

Introduction: Early identification of hearing impairment in childhood is imperative, as even a mild hearing loss can have long term consequence on the development of the Central Nervous System. Many children develop transient, fluctuant deafness due to Middle ear effusion, especially during episodes of Common cold. In this research we try to develop a Screening protocol using Impedance Audiometry for early identification of Middle ear effusions. Materials and Methods: Children between 7 months to 6 years of ages, with no previous history of hearing impairment or ear disease, who were suffering from Upper respiratory tract infection (Common cold) were selected as targets of screening. These children were then subjected to a Screening Tympanometry. A simple, quick and accurate method of screening for Middle ear fluid was “Peak” or “No peak” approach was employed to judge the curves. If a curve was obtained (similar to Jerger's classification-type “A”) child was deemed to have “Pass”. A type “B” curve was deemed highly positive and was labelled “Fail+” and any other trace like type “C” or just reduced type “A” or “As” labelled just “Fail”. Otoscopic and endoscopic examination and diligent search was carried out for signs of Middle ear effusion and confirmation was done. This was cross checked by 2 authors (First and third author) and findings confirmed. Results: Dervan child screening protocol is 91.67% (92%) sensitive and 94.23 (94%) specific is detection of Middle ear effusions. Conclusion: Dervan child Middle ear effusion protocol can be used in a cost efficient, scalable and sustainable method of screening children for Middle ear effusion. Tympanometry in selected high risk population is an accurate and reliable test for detection of Middle ear effusion