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Tympanometric pattern classification in relation to middle ear effusions.

Q C Beery, W S Andrus, C D Bluestone

    The Annals of Otology, Rhinology, and Laryngology
    |January 1, 1975
    PubMed
    Summary
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    Tympanometry reliably indicates middle ear effusion in children. A specific tympanometric pattern at 660 Hz is pathognomonic, achieving 93% prediction accuracy for effusion.

    Area of Science:

    • Otolaryngology
    • Pediatric Medicine
    • Diagnostic Audiology

    Background:

    • Recurrent acute otitis media and persistent middle ear effusion are common in children.
    • Accurate diagnosis of middle ear effusion is crucial for appropriate management.
    • Otoadmittance tympanometry offers a non-invasive method for assessing middle ear status.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of tympanometry in identifying middle ear effusion in children.
    • To develop and refine criteria for tympanometric evaluation of middle ear effusion.
    • To compare the efficacy of different tympanometric frequencies (220 Hz vs. 660 Hz).

    Main Methods:

    • Tympanometric evaluation using an otoadmittance meter and X-Y plotter was conducted on 129 ears of 70 children.

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  • Myringotomy was performed post-tympanometry to confirm the presence or absence of middle ear effusion.
  • Susceptance and conductance tracings at 220 Hz and 660 Hz were analyzed, along with middle ear pressure and peak otoadmittance values.

    • Main Results:

    • High negative middle ear pressure was not a consistently reliable indicator of effusion.
    • Tympanometry demonstrated reliable predictive capability for middle ear effusion.
    • A combination of pattern classification and susceptance criteria achieved 93% accuracy in predicting effusion.
    • A specific tympanometric pattern at 660 Hz (B660) was found to be pathognomonic of effusion.
    • Otoadmittance at 660 Hz generally proved a better indicator of effusion than at 220 Hz.

    Conclusions:

    • Tympanometry is a reliable diagnostic tool for detecting middle ear effusion in children.
    • Specific tympanometric patterns, particularly at 660 Hz, can accurately identify middle ear effusion.
    • Otoadmittance measurements at 660 Hz offer superior diagnostic value compared to 220 Hz for middle ear effusion.