The relationship between preoperative tympanograms and intraoperative ear examination results in children
Steffen Knopke1, Ekpemi Irune2, Heidi Olze3
1Department of Otorhinolaryngology, Campus Virchow-Klinikum, University Hospital Charité, Augustenburger Platz 1, 13353, Berlin, Germany. steffen.knopke@charite.de.
Insights
Preoperative tympanometry alone is insufficient for middle ear surgery decisions. Intraoperative findings revealed air-filled middle ears in 18.4% of cases with flat tympanograms, highlighting the need for comprehensive patient assessment.
Area of Science:
- Audiology
- Otolaryngology
- Pediatric Medicine
Background:
- Tympanometry is a key audiological test for middle ear pathology.
- Clinical examination and patient history are crucial before middle ear procedures like paracentesis or tympanostomy tube insertion.
Purpose of the Study:
- To assess the correlation between preoperative tympanometry results and intraoperative middle ear findings.
- To determine if tympanometry alone can reliably predict intraoperative conditions.
Main Methods:
- Retrospective analysis of 654 ears from 333 patients (average age 3.7 years) undergoing paracentesis or tympanostomy tube insertion.
- Comparison of preoperative tympanogram data with intraoperative ear examination findings.
Main Results:
- A significant discrepancy was observed: 18.4% of ears with a flat tympanogram showed an air-filled middle ear during surgery (p < 0.01).
- This indicates tympanometry is not a sole predictor of intraoperative middle ear status.
Conclusions:
- Tympanometry results should not be the exclusive basis for surgical intervention in middle ear conditions.
- Treatment decisions require integrating tympanometry findings with clinical symptomatology and patient history.
Abstract:
The tympanogram is an objective audiological method in adults and children which is often used in the evaluation of middle ear pathology. This should be alongside a thorough patient history and clinical examination prior to the decision to carry out a paracentesis or tympanostomy tube insertion. The goal of the study was to evaluate the relationship between the preoperative tympanogram and intraoperative ear examination results or middle ear findings. The retrospective study included 654 ears in 333 patients who underwent paracentesis with or without tympanostomy tube insertion between January and December 2011. The study cohort consisted of 206 male and 127 female patients with an average age of 3.7 ± 2.5 years. The results of the preoperative tympanogram were compared to those of the intraoperative ear findings. In 18.4 % of ears with a flat tympanogram, an air-filled middle ear was found intraoperatively (p < 0.01). Thus, tympanometry results cannot serve as the only indication for surgical intervention. A decision to treat should always be based on the merits of the symptomatology of the patient in conjunction with tympanometry findings.
