Diagnostic value of tympanometry in infants in clinical practice
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1Department of Vaccines, National Public Health Institute, Helsinki, Finland.
Insights
Tympanometry is a valuable tool for diagnosing otitis media in infants. This study shows high accuracy and success rates, especially in younger children, aiding clinical practice.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Diagnostic Imaging
Background:
- Otitis media is a common infant infection.
- Accurate diagnosis is crucial for effective treatment.
- Tympanometry is a non-invasive diagnostic method.
Purpose of the Study:
- To evaluate the diagnostic accuracy of tympanometry for otitis media in infants.
- To assess the success rate of tympanometry across different infant age groups.
Main Methods:
- Evaluated 121 visits from 58 infants (2-11 months) in the Finnish Otitis Media Vaccine Trial.
- Used tympanometry and pneumatic otoscopy for infant ear examinations.
- Verified otitis media diagnoses via myringotomy in 74% of cases.
Main Results:
- Tympanometry was technically successful in 94% of infant ears.
- Higher success rates were observed in infants under 7 months (P < 0.05).
- Tympanometry demonstrated high sensitivity (0.70) and specificity (0.98) for middle ear fluid detection, with excellent predictive values (PPV 0.93, NPV 0.94).
Conclusions:
- Tympanometry is a highly accurate and successful diagnostic aid for otitis media in infants.
- Its effectiveness supports its use in routine clinical practice for accurate diagnosis.
- Predictive values remain high across different infant age groups.
Abstract:
One hundred and twenty-one visits of 58 infants (2-11 months of age) were evaluated in the Finnish Otitis Media Vaccine Trial. Infants were examined with tympanometry (Grason-Stadler GSI 38 Autotymp) and pneumatic otoscopy by one study doctor. Diagnosis of otitis media was verified by myringotomy in 74% of cases. Tympanometry was technically successful in 94% of ears. The success rate was statistically significantly higher (P < 0.05) among infants less than 7 months of age than those above 7 months. The sensitivity of tympanometry (type B) to detect ears with middle ear fluid was 0.70 and the specificity 0.98 with a positive predictive value of 0.93 and negative predictive value of 0.94. The sensitivity was somewhat lower in the younger age group (0.61); specificity and positive and negative predictive values were good in both age groups. The high success rate and high negative and positive predictive values of tympanometry make it a useful aid for assuring the correct diagnosis of otitis media in infants in routine clinical practice.
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