Tympanometry, stapedius reflex and hearing impairment in children with otitis media with effusion

The study assessed the relationship between tympanometry, stapedius reflex and pure tone audiometric hearing impairment. A total of 581 audiograms and typanograms from 370 children aged between 3 and 10 years were studied. Only one ear was examined. Measurements of the pure tone air conduction thresholds (PTACT) were made: firstly as an average of the thresholds from 500, 1,000, and 2,000 Hz, secondly as an average of six frequencies from 250 Hz to 8 Hz. The mean PTACT were calculated for each year of age and for each type of tympanogram. Tympanograms were further subdivided by the presence or absence of the stapedius reflex. The sensitivity, specificity and predictive value of a type B tympanogram were investigated for different ages in relation to mean six frequency PTACT at 20, 25 and 30 dB HL. The results were used to show the accuracy of a type B tympanogram in detecting hearing impairment in children of different ages. The results suggest that tympanometry may be used to screen younger children with otitis media with effusion for hearing impairment, without the need for a pure tone audiogram.