Otitis media with effusion (OME) is a common treatable cause of hearing impairment in children. Although it is a self-limiting condition in the majority of cases, OME may become chronic to the extent that it affects child education and quality of life. Thus, early detection of this condition is a paramount issue for its treatment and improve the hearing of the effected child.
This study is aimed to evaluate the efficiency of tympanometry in the detection of fluid in the middle ear in comparison with myringotomy in children with OME as well as to evaluate the efficiency of otoendoscopy and to analyze the clinical data and predisposing factors for OME.
PATIENTS AND METHODS:
A total of 80 patients (160 ears) of children, with clinical features indicating OME were enrolled in this prospective study during the period from April 2018 to the end of March 2019. Patients were subjected to clinical assessment, and the middle ear examined with otoendoscopy and with tympanometry. The presence or absence of OME was confirmed by myringotomy. The sensitivity, specificity of otoendoscopy, and tympanometry were calculated.
The fluid was aspirated from the middle ear during myringotomy from 114 ears (71.15%) and the aspirate was serous in 54 ears (47.37%), mucoid in 60 ears (52.63%). Type B tympanometry was recorded in 108 ears with the rest 6 ears had other types of tympanometry (A or C). Thus, the sensitivity, specificity, and accuracy of tympanometry were 94.74%, 65.22%, and 86.25%, respectively. On the other hand, 98 ears with OME were detected depending on the changes in the middle ear observed by otoendoscopy. Therefore, the sensitivity, specificity, and accuracy of otoendoscopy were 85.96%, 60.87%, and 62.5% respectively.
Both tympanometry and otoendoscopy, in general, have a high sensitivity and low specificity in the detection of OME, with the priority to tympanometry over otoendoscopy. Therefore, the definitive diagnosis of OME should be confirmed during myringotomy, and examined by tympanometry to identify the type of curve result and to assess the middle ear pressure.