Tympanometric Examination Research Articles

Impacts of ventriculoperitoneal shunt on hearing threshold and speech discrimination among hydrocephalic children

Purpose: The purpose of this study was to determine the prevalence of hearing loss (HL) in children with hydrocephalus (HCP) and to assess the impact of the ventriculoperitoneal (VP) shunt on their hearing threshold and speech discrimination percentage. Methodology: This was a case–control study. A total of 20 children who experienced HCP and 20 healthy controls were recruited. All participants in the study were subjected to a systematic clinical examination including otomicroscopic, audiometric (Pure-tone audiometry and speech audiometry), and tympanometric examination before and after VP shunt. Results: The mean age ± standard deviation for the HCP children and the control group was 5.4 ± 0.994 and 5.8 ± 1.196 years, respectively. The prevalence of HL in hydrocephalic children was 40%, and they had raising mild-to-moderate sensorineural HL. Children with HCP (preoperative) had a statistically significantly higher pure-tone threshold at 250, 500, 1000, 2000, and 4000 Hz than the control group. They also had a statistically significantly lower speech discrimination percentage than the control group. There was a statistically significant difference between the preoperative and the postoperative groups in pure-tone thresholds at 250, 500, 1000, and 2000 Hz. There is also a statistically significant difference between the preoperative and the postoperative groups in speech discrimination percentage. Conclusion: Early diagnosis in children with HCP is important. The results of the current study add further evidence of hearing impairment in hydrocephalic children and improvement in hearing after shunt operation. Auditory assessment is highly recommended for all hydrocephalic children as a routine examination.

Correlation between Serum Interleukin-17 level and Serum Reactive Oxygen Species levels among Children experiencing Otitis Media with Effusion.

Introduction The detection of inflammatory mediators in the serum of children with have otitis media with effusion (OME) and their correspondence with clinical considerations may enable the use of a modern nonsurgical curative treatment for OME. Objective To determine the relation between interleukin-17 (IL-17) serum level and reactive oxygen species (ROS) serum levels in children suffering from OME and to disclose if any variation occurs in the level of IL-17 Will affect the ROS and antioxidant equilibrium in the serum, which indicates the entire body's reaction to OME. Methods The present study was a case-control study. A total of 24 children experienced OME, and 24 healthy controls were recruited. All participants in the study were subjected to a systematic clinical investigation including otoscopic, audiometric, and tympanometric examination. Also, venous blood samples were collected from all children to determine the levels of IL-17 and ROS.Results The mean ± standard deviation (SD) age ranges of the patients and the control group were 6.8 ± 2.7 and 6.2 ± 3.4 years, respectively. A stylistically significant difference in the levels of serum nitric oxide (NO), catalase (CT), myeloperoxidase (MPO), and malondialdehyde (MDA) ( p < 0.05) was detected between OME and control patients. No significant difference was found in serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GPX) between OME and control patients. The serum levels of MDA, NO, and MPO positively correlated with the serum levels of IL-17 in OME patients. Conclusion In the present study, there is a reasonable role of the IL-17 pathway in OME pathogenesis through an increase in ROS levels.

Efficacy and feasibility of 226 Hz and 1000 Hz tympanometry in healthy pediatric patients

Objectives: Tympanometric evaluation of middle ear with 226 Hertz (Hz) frequency probe has been widely used in patients with suspected middle ear and Eustachian tube disorders. However most of the recent studies were demonstrated that tympanometric examination with 1000 Hz frequency probe was superior to 226 Hz frequency probe examination to detect middle ear disorders affecting middle ear admittance especially for infants. The objective(s) of this study was to compare the reliability and feasibility of 226 Hz and 1000 Hz tympanometric results in normal hearing healthy pediatric group of patients.Methods: In this study, we evaluated normal healthy pediatric patients with 226 and 1000 Hz frequency probe tympanometry for the aim of comparing efficacy and detecting the rate of false negative tympanometric findings in these subjects. Forty-nine (98 ears) healthy pediatric patients (25 males and 24 females) were enrolled in the study and all of the patients were younger than 18 years of age. Oto-microscopic examination was performed to all of the patients as a gold standard.Results: The mean age was 9.3 ± 4.46 years old with a range from 3 to 17 years. The mean values of 226 Hz tympanometric measurement of right ears for ear volume, compliance, pressure and gradient were 74 ± 28.10, 59 ± 38.96, -46 ± 92.38 and 36 ±3 3.22, respectively; these values for the left ears were 84 ± 65.94, 51 ± 31.00, -57 ± 102.05 and 30 ± 23.35, respectively. The mean values of 1000 Hz tympanometric measurement of right ears for ear volume, compliance and pressure were 78 ± 23.03, 172 ± 85.04 and -22 ± 110.70, respectively; these values for the left ears were 64 ± 32.05, 147 ± 104.70, and 0 ± 98.20, respectively.Conclusions: We found that there was no superiority of the usage of 1000 Hz tympanometry to 226 Hz tympanometry in normal hearing healthy pediatric patients who were equal or older than 3 years of age.

Video head impulse test in children with otitis media with effusion and dizziness

ObjectiveThe objectives of the study were to evaluate the vestibular impairment in children with otitis media with effusion (OME) and dizziness by using vHIT test, and to compare their results with healthy children. MethodsThe study population consisted of 30 pediatric patients with OME and dizziness and 30 healthy children, age between 4 and 15. Otoscopic and tympanometric examination and vHIT testing were performed to all subjects. vHIT test parameters were compared between pediatric patients with OME and dizziness and healthy children. Additionally, the differences of the mean vHIT gains between tympanogram types, otoscopic findings and the presence of saccades were analyzed. ResultsThe mean vHIT gains and gain asymmetry values of patients with OME and dizziness and healthy children were comparable. No significant difference was observed between the mean vHIT gains of patients with type B and type C2 tympanogram. Covert saccades were observed in 57% of the patients with OME and dizziness. None of the patients had over saccades and none of the healthy children had saccades. ConclusionOur study is a preliminary study analyzing the vestibular impairment in children with OME and dizziness using vHIT test. Based on our results, it can be assumed that the children with OME and dizziness usually don't have a great vestibular impairment that can be detected with vHIT test. The covert saccades detected in this patient group are accepted as a sign of slight vestibular impairment.

Noise-dose estimated with and without pre-cochlear amplification.

Amplification from natural ear canal resonance has been documented as highly variable across individuals. However, individual variability in total pre-cochlear amplification (i.e., combined external and middle ear mechanisms) remains understudied in relevance to noise-induced hearing loss (NIHL). It is well-known that more noise means more risk of hearing loss, yet the current risk-models do not consider individually variable pre-cochlear amplification, also referred to as the transfer function of the open ear (TFOE). The present study principally documented individual TFOE variability and explored the feasibility and accuracy of simple proxy metrics, which could be used to estimate TFOE. Participants' TFOE values were used to estimate their NIHL risk in hypothetical free-field exposures. Forty-eight adult participants (42 female, 6 male, ages 21-60 years) met inclusion criteria of 2 healthy pinnae and ear canals (<10% cerumen occlusion) and type-A tympanometric examination. Participants underwent otoscopy, tympanometry, pinna size measurement, real-ear-to-coupler-difference, and TFOE measurement. TFOE ranged from 5 to 15 dB-A (mean = 10 dB-A); given that NIHL risk is estimated to double in either 3 or 5 dB-A increments, the observed variability could explain a substantial portion of individual vulnerability to NIHL. A simple regression model with eardrum compliance (ml) was correlated with individual TFOE (p < 0.05). TFOE variability has the potential to substantially explain why two individuals with the same noise-exposure can develop significantly different degrees of NIHL. Eardrum compliance (ml) was a correlated proxy measurement of TFOE in this principally adult, female dataset; additional research is needed to confirm this relationship in a unique, heterogeneous dataset.

Возможности широкополосной тимпанометрии в дифференциальной диагностике некоторых форм тугоухости

Today acoustic impedansometry is one of the main methods of diagnostics of the state of acoustic analyzer both in adults and in children, it is represented by various techniques of analysis of external and middle ear structures: the change of sounding tone frequency, the tests of auditory tube function. However, the same type of tympanometric curve may describe several pathological conditions, sometimes this type does not fall under the existing classification suggested by Jerger in 1970, which results in low diagnostic value of this acoustic analyzer examination method and sometimes even causes misdiagnosis. Besides, the classical variant of tympanometric examination, predominantly at the sounding tone frequency of 226 and 1000 Hz, has a great number of limiting factors, especially during the first year of the child’s life. All these factors complicate hearing disorders diagnostics and results in the distortion of the results and, subsequently, incorrect treatment, establishment of disability group, etc. Special attention is paid to children’s practice as this category of patients is the most difficult. It should be noted that early rehabilitation intervention, its quality, and further control are extremely important for speech skills training and further integration into society.

The effect of thyroid autoantibody positivity on the functions of internal ear.

The objective of the study is to investigate if any significant difference exists in hearing thresholds and tympanometric examination results among patients whose thyroid antibody positivity was detected approximately 1year or at least 5years ago. Study population aged less than 40years consisted of 17 patients who had thyroid antibody positivities for an average of 1year (first group), 15 patients who were followed up for at least 5years for thyroid antibody positivity (second group), and 18 volunteers (third group). Tympanometric examination results, stapes reflex, SRT, SD, and pure tone values were examined. When the second group and the third group were compared, significant results were obtained at hearing frequencies between 500 and 4000Hz. When the first group and the third group were compared, only at 1000Hz threshold significant results were obtained. During evaluation of hearing frequencies between 250 and 8000Hz, significant results were not observed between the second group and the first group. When the first and the second groups were compared with the control group, significant results were obtained as for tympanometric examination findings and significant results were not observed between the second group and the first group. A significant difference was not detected as for the results of stapes reflex. Since thyroid antibody positivity affects the functions of internal ear, these patients should be more closely monitored. Since these effects become deeper in line with increased exposure to autoantibody positivity, variations in auditory responses should be more attentively monitored.

Functions of the inner ear in psoriatic arthritis.

This study aimed to investigate whether there is a negative impact as a result of psoriatic arthritis disease of the inner ear function. Twenty-four successive patients and 38 healthy volunteers, younger than 60 years of age, who were followed up for at least for one year in the outpatient clinics of physical therapy and rehabilitation with the diagnosis of PsA according to CASPAR criteria (17) and who did not complain of any hearing impairment were included in the study. Distortion-product otoacoustic emission (DPOAE) values between 1kHz and 4kHz, tympanometric examination results, stapes reflex values, speech reception threshold (SRT) and speech discrimination (SD) values, pure-tone values between 250 and 8000Hz and high-frequency values between 10,000, 12,500 and 16,000Hz were analyzed. Statistical comparisons between both groups were performed using chi-square test and Mann-Whitney U test. p<0.05 was accepted as the level of statistical significance. Our study population consisted of 24 [9 male (37.5%) and 15 female (62.5%)] patients with a mean age of 47.21±11.28 (range, 28-59) years and 38 [16 male (42.1%) and 22 female (57.9%)] healthy volunteers with a mean age of 44.39±8.12 (range, 29-59) years as the control group. Mean duration of arthritis was 7.62±4.88 years. In the evaluation of hearing frequencies of the patients between 4000 and 6000Hz, a statistically significant difference was found relative to the control group (p<005). DPOAE values of the patients were analyzed within the 1000-4000Hz interval. When compared with the control group, a statistically significant difference was found at 3000 and 4000Hz (p<005). Our study provides strong evidence suggesting the necessity of monitorization of these patients regarding sensorineural hearing loss so as to take measures against the development of hearing loss during early stage, which may be another disability in patients with PsA, which is itself a potential cause of severe disability.

Therapeutic Proposal to Clinical Treatment for Tympanometric Improvement in Patients with Otitis Media Secretory

Objectives: Serous otitis media is very frequent in children, especially those between 3 and 6 years of age. The diagnosis of otitis media is often difficult. Otomicroscopy and tympanometry can improve diagnostic quality by the indication of fluid in the middle ear and thereby improve the quality of treatment. The aim of this ongoing study is to describe the variations in tympanometry in patients undergoing clinical treatment alone. Methods: This was a prospective study of 25 patients diagnosed with secretory otitis media, treated with oral antibiotics, nasal corticosteroid spray, and nasal N-acetylcystein from January 2013 to January 2014 in the Otorhinolaryngology Department, Juiz de Fora University Medical School, Brazil. The inclusion criteria were age between 2 and 12 years and altered otoscopy and tympanometric examination. The exclusion criteria were antibiotic use during the previous month and history of chronic otologic disorder or congenital abnormalities. All were evaluated by tympanometry in the week of diagnosis and after treatment, at 30 days from the first review. Results: A total of 25 patients, of which 11 (44%) were girls, and 14 (56%) were boys (3 to 15 years old). Of the 50 ears assessed in the first week of diagnosis, 28 (56%) had curve B and 20 (40%) had curve C. At the last evaluation, only 8 ears (16%) remained with curve B. 12 (24%) had curve C and 30 (60%) had curve A. Conclusions: Treatment with corticosteroids via nasal spray combined with oral antibiotics and nasal N-acetylcysteine can be a good therapeutic option for the treatment of secretory otitis media.

Parental role in the diagnostics of otitis media: Can parents be taught to use tympanometry reliably?

ObjectiveTympanometry can be used to detect middle ear effusion (MEE). As the need for rearrangement of clinical resources at the primary care level increases, it is important to determine whether layman parents could be taught to use the tympanometer reliably, aiming to reduce unnecessary physician visits during respiratory tract infections. MethodsFrom our AOM treatment trial we enrolled 78 children (age 6–35 months) who had persistent MEE, parents were voluntary and willing to use a tympanometer at home, the child was sufficiently co-operative, and parents learned technically the use of the tympanometer. At home, parents were asked to perform daily bilateral tympanometry on their child. We included those parental tympanometric examinations, to which the corresponding tympanometric examination, within one day by a study physician was available. Parental tympanometric examinations were compared to the pneumatic otoscopy by a study physician which served as the diagnostic standard. ResultsThis study involved 78 children and a total of 432 parental tympanometric examinations. From these 432 examinations, parents obtained an interpretable tympanogram in 83% (359/432) and physicians in 91% (393/432) (absolute rate difference 8%, 95% CI 3–12%). Both obtained an interpretable tympanogram from the same ear in 75% (326/432) of the tympanometric examinations. Of these 326 interpretable examinations, parents and physicians were in accordance with either a peaked or a flat tympanogram in 88% of examinations (288/326) (kappa-value 0.77). When the tympanogram was peaked, pneumatic otoscopy indicated healthy middle ear in 72% (122/169) of parental and in 69% (149/217) of study physicians’ tympanometric examinations (absolute rate difference 4%, 95% CI −6% to 13%). When the tympanogram was flat, pneumatic otoscopy indicated any MEE in 92% of parental (174/190) and in 96% (169/176) of study physicians’ tympanometric examinations (absolute rate difference 4%, 95% CI −9% to 1%). ConclusionThis study showed that layman parents are able to use tympanometry technically successfully, and that the parental tympanometric examinations are as reliable as those obtained by study physicians.

Effectiveness of pandemic influenza A/H1N1 vaccine for prevention of otitis media in children

Our aim was to evaluate effectiveness of pandemic influenza A/H1N1 vaccine in preventing acute otitis media (AOM) and/or otitis media with effusion (OME), in a randomized, prospective and single-blind study conducted in the children aged of 6-60 months. This study was done between December 1, 2009 and April 30, 2010 during the pandemia between June 2009 and May 2010. On the healthy children, vaccinated against pandemic influenza A/H1N1 and age-matched unvaccinated controls, the rate of AOM, OME, and any otitis media (OM) attack (sum of AOM and OME attacks) confirmed by otoscopic and tympanometric examination, and their associations with risk factors were looked for. Otoscopic and tympanometric evaluation was done twice within the follow-up period of 4-8 weeks. Totally 46 vaccinated and 46 unvaccinated healthy children were enrolled. No difference in rates of AOM, OME, or OM was found between vaccinated and unvaccinated children. But logistic regression analysis revealed that unvaccinated children had 2.9-folds more risk for OME and OM, but not for AOM. Further, male gender and bottle feeding and/or using pacifier revealed significant relationships with AOM. We conclude that pandemic influenza A/H1N1 vaccine prevented OME rather than AOM attacks in children with 6-60 months of age.

An unusual dark pigmentation on the tympanic membrane

To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss. A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality. Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.

Assessing the accuracy of tympanometric evaluation of external auditory canal volume: a scientific study using an ear canal model

Tympanometric evaluation is routinely used as part of the complete otological examination. During tympanometric examination, evaluation of middle ear pressure and ear canal volume is undertaken. Little is reported in relation to the accuracy and precision tympanometry evaluates external ear canal volume. This study examines the capability of the tympanometer to accurately evaluate external auditory canal volume in both simple and partially obstructed ear canal models and assesses its capability to be used in studies examining the effectiveness of cerumolytics. An ear canal model was designed using simple laboratory equipment, including a 5ml calibrated clinical syringe (Becton Dickinson, Spain). The ear canal model was attached to the sensing probe of a Kamplex tympanometer (Interacoustics, Denmark). Three basic trials were undertaken: evaluation of the tympanometer in simple canal volume measurement, evaluation of the tympanometer in assessing canal volume with partial canal occlusion at different positions within the model, and evaluation of the tympanometer in assessing canal volume with varying degrees of canal occlusion. 1,290 individual test scenarios were completed over the three arms of the study. At volumes of 1.4cm(3) or below, a perfect relationship was noted between the actual and tympanometric volumes in the simple model (Spearman's ρ=1) with weakening degrees of agreement with increasing volume of the canal. Bland-Altman plotting confirmed the accuracy of this agreement. In the wax substitute models, tympanometry was observed to have a close relationship (Spearman's ρ>0.99) with the actual volume present with worsening error above a volume of 1.4cm(3). Bland-Altman plotting and precision calculations provided evidence of accuracy. Size and position of the wax substitute had no statistical effect on results [Wilcoxon rank-sum test (WRST) p>0.99], nor did degree of partial obstruction (WRST p>0.99). The Kamplex tympanometer accurately and precisely assesses ear canal volume in the scientific model in both simple and partially occluded wax substitute scenarios up to a volume of 1.4cm(3). These findings suggest that the Kamplex tympanometer could be used as an effective objective tool in evaluating the efficacy of topical cerumolytics in both laboratory and human models.

Transient evoked otoacoustic emissions in young children with otitis media with effusion before and after surgery

Otitis media with effusion (OME) is one of the commonest causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to clinical trials and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAE), can be applied. The aim of this study is to evaluate the parameters of TEOAE in young children with OME prior and after surgery. Prospective study included 50 children with OME, both sexes, aged 2-5 years. Preoperatively tympanometric examination was performed and TEOAE were recorded. Surgery was performed under general anesthesia and included myringotomy with/without ventilation tube insertion. Measurements of TEOAEs (correlation percentage, signal to noise ratio and amplitude) were repeated on the first and six day postoperatively as well as 6 weeks and 6 months postoperatively. The preoperative TEOAEs were not recorded in 93.5%, with values of all TEOAE parameters being the most affected on highest frequencies. Significant changes of all TEOAE parameters were found 6 weeks postoperatively with further improvement 6 months postoperatively. Statistically highly significant difference of TEOAE between examinees with and without inserted ventilation tubes was established only in regard to preoperative results. In small children with OME, application of TEOAEs in follow-up of surgical effects is a method of choice for hearing screening due to its objectivity, simplicity and ease of use even after insertion of ventilation tubes. Follow-ups of TEOAE correlation percentage and signal to noise ratio reflect the condition earlier than follow-ups of TEOAE amplitude.

Otoacoustic emissions in children with otitis media with effusion

Otoacoustic emissions (OAE) are transmitted from the cochlea to the ear canal via the middle ear and the transmission properties of the middle ear directly influence OAE characteristics. The purpose of this study was to establish the mechanisms of changes occurred in middle ear by tympanometric, audiometric and OAE examination. Audiometric and tympanometric examination were performed and otoacoustic emissions were recorded from 22 normal ears and 52 ears with middle ear effusions and repeated 3 months later. Results of the air conduction in study group were significantly different from the control group and we found significant recovery in 3 months. When we analysed the DPOAE evaluation results in our study, some of the DPOAE parameters were found to be different between the control and the study group at low frequencies. Changes in the amplitude, especially at low frequencies, were statistically significant after 3 months. The results of this study revealed that measurement of otoacoustic emissions, especially distortion product otoacoustic emissions, is helpful in evaluating the condition of middle ear during the treatment.

Parental suspicion of hearing loss in children with otitis media with effusion

This study aimed to evaluate the parental suspicion of hearing loss in children with otitis media with effusion (OME). As part of a population-based survey in a screening programme among 6- to 7-year-old Chinese children in Hong Kong, OME cases and controls were studied for the value of parental observations in the prediction of OME and hearing test results. Prior to the otoscopic and tympanometric examination of the children on school premises, a self-administered binary-choice question was sent to the parents asking whether there was any suspicion of hearing impairment. Positive screens and randomly selected negative screens were seen in a hospital clinic for the confirmation of case and control status 2 to 3 weeks after the school screening. Aural examination under microscopy, repeated tympanometry and stapedial reflex testing, and pure-tone audiometry (PTA) were conducted, and 117 cases and 159 controls were included in this study. The average PTA conductive threshold levels in the individual children with OME ranged from 3.8 dB to 40.0 dB with a group mean of 17.0 dB in the better-hearing ears. Parental suspicion of hearing deficit was significantly associated with OME (p<0.001) but not PTA findings (p=0.686). The sensitivity of parent-suspected hearing impairment to detect OME however was very low (19.7%). In other words, if we had relied on parental suspicion as the first screening, at least 80% of the OME cases would have been missed. We conclude that the parental suspicion of hearing loss is inadequate for the identification of mild hearing loss as caused by OME. Health education is recommended to improve parental awareness of the disease.

Tympanometric ear examination for the diagnosis of hearing impairment in Saudi children

Tympanometric ear examination for the diagnosis of hearing impairment in Saudi children

Otologic and audiologic evaluation of human immunodeficiency virus-infected patients

To quantify the incidence of ear disease in patients infected with human immunodeficiency virus (HIV). This is a descriptive case series of HIV-positive patients, with data collected using an otologic questionnaire. otologic examination, audiologic evaluation, and chart review. The study was performed at an urban University Hospital's outpatient Infectious Disease and Otolaryngology clinics. A consecutive sample of 50 HIV-infected patients volunteered for this study. Ten subjects refused. Almost all patients received public assistance for medical care. Descriptive results were tabulated. Audiometric data were analyzed for ear, Centers for Disease Control (CDC) group, otologic complaint, and age effects. Data were compared with established norms. Twenty-three men and 27 women with a mean age of 40 years and mean duration of HIV disease of 3.5 years were studied. Eighteen percent of patients were in category CDC-A, 38% in CDC-B, and 44% in CDC-C. Otologic complaints were more prevalent than expected: 34% of patients reported aural fullness, 32% dizziness, 29% hearing loss, 26% tinnitus, 23% otalgia, and 5% otorrhea. Results of the neuro-otologic examination were abnormal in 33%. Tympanometric examination was abnormal in 21%. A significant degree of high-frequency sensorineural hearing loss was observed. CDC-B and CDC-C patients had worse hearing than CDC-A patients at 3 frequencies. Patients who complained of hearing loss had significantly worse otoacoustic emission results and hearing results than patients who did not, at all frequencies except 1,000 Hz. Patients in their 30s had better hearing in the speech frequencies than did all other patients. Ear disease affects up to 33% of HIV-infected patients. Otitis media is a frequent finding. Sensorineural hearing loss is more severe in patients with more severe HIV infection. Patients with ear complaints have demonstrable otopathology. Continuation of this preliminary descriptive work is necessary.

Minitympanometry in detecting middle ear fluid

To assess the time needed to perform tympanometry, the success rate and the importance of the child's cooperation for the accuracy of minitympanometry in detecting middle ear fluid, and the relation between the static admittance of the tympanogram and the weight of the middle ear fluid. Two series of patients were enrolled. The first consisted of 206 consecutive children (mean age 4.7 years, range 1 month to 16 years) from the Outpatient Emergency Department of Pediatrics in the University of Oulu; the second group consisted of 162 children (age range 7 months to 8 years) who were referred to the Department of Otolaryngology for adenoidectomy, tympanostomy, or both procedures. In the first series the success rate and the time needed to complete a minitympanometric examination on each ear were recorded. In the second series, the tympanograms were evaluated according to the cooperation of the children at the time of the tympanometric examination, and the weight of the middle ear fluid was measured and compared with the static admittance of the minitympanometric curve. Sensitivity and specificity values were calculated separately for cooperative and uncooperative patients. In the first series, the mean time needed for tympanometry was 2.1 minutes (range 0.5 to 10 minutes), and 179 (86.9%) of the patients were cooperative. In the second series, the sensitivity and specificity calculated for tympanometry in detecting middle ear fluid were 79% and 93% among the cooperative children. In the uncooperative group, sensitivity and specificity were 71% and 38%, respectively. The weight of the middle ear fluid varied from 5 mg to 695 mg. There was a significant negative correlation (r = -0.66, p < 0.001) between the static admittance in minitympanometry and the weight of the middle ear fluid. Minitympanometry can be done quickly, it fails rarely, and in cooperative patients it is a better tool than has been earlier suggested, but it is useless in uncooperative children. The amount of middle ear fluid varies notably even among young children.

Tympanometric examination of preschool children in eleven public institutions of Yokosuka City

Tympanometric examination of preschool children in eleven public institutions of Yokosuka City