Middle ear status at myringotomy was compared to middle ear immitance measurements in 76 ears. Clinical features examined included plane and mobility of the tympanic membrane, amount of effusion, and status of the middle ear mucosa. Middle ear effusion yielded the strongest relationship with immitance results. Plane and mobility of the tympanic membrane were not strongly related with clinical immitance data. Tympanometry and acoustic reflex threshold were found to be the best indicators of the presence of middle ear effusion.In attempting to validate the use of middle ear immitance data in the diagnosis of serous otitis media, researchers have typically taken one of 2 approaches. Either the immitance measurements are compared with otoscopic findings or the immitance data are compared to operative findings at myringotomy (9).Recent evidence suggests that agreement between tympanometry, one component of the immitance battery, and otoscopic examination is not as strong as once thought (17). When operative data have been used, middle ear immitance measurements are usually evaluated on the basis of the ability to predict the presence or absence of effusion in the middle ear (2, 3, 14, 15). Although not the only clinically significant finding from the viewpoint of the otolaryngologist, the presence of effusion is a relatively objective finding when compared to routine otoscopic examination.However, little information is available as to what other clinical features of serous otitis media might influence middle ear immitance measurement. The present investigation was designed to examine how other aspects of serous otitis media, including plane and mobility of the tympanic membrane as well as status of the middle ear mucosa, influence middle ear immitance data obtained before myringotomy.
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