An assessment of the validity of tympanometry compared to myringotomy performed under a nitrous oxide-free general anaesthetic

Abstract

To assess the validity of tympanometry as a test for the presence of middle ear effusion using a 'gold-standard' of myringotomy performed after a nitrous oxide-free general anaesthetic, we performed a prospective validity study comparing tympanometry traces obtained immediately pre-operatively from patients undergoing grommet insertion, with the otomicroscopic findings at myringotomy. Nitrous oxide was omitted from the anaesthetic gaseous mixture as it has been reported to displace middle ear effusions. One hundred and seventy-two patients (aged 1.5-15 years) with a clinically assessed 3 month history of middle ear effusion were included in the study. Sensitivity and specificity of a Jerger classification Type B tympanometric trace for the presence of middle ear effusion were 0.73 and 0.84, respectively. We conclude that tympanometry is a valid test in assessing the presence of middle ear effusion compared to a 'gold standard' of myringotomy performed after a nitrous oxide-free general anaesthetic.

Wideband energy reflectance findings in presence of normal tympanogram in children with Down's syndrome

“…Fishpool et al [16], for example, have shown that tympanometry has a 27% false negative rate (unable to detect cases with true OME) in children with confirmed OME using myringotomy and a 16% false positive rate (incorrectly identifying cases as having OME); these findings have been confirmed by several investigators [17,18]. This is in agreement with tympanometric findings reported previously for older children with DS [19].…”

Diagnosis of primary secretory otitis media in the cavalierKingCharles spaniel

“…In children, diagnosis and screening for SOM involves assessment of middle ear mechanical function. Diagnostic tests for SOM include otoscopy, pneumatic otoscopy and impedance audiometry …”

Tympanometric measures in ears with negative middle ear pressure, and tests of some common assumptions

“…In the diagnosis of middle ear effusion, the performance of a fl at tympanogram (type B in the Jerger classifi cation, Jerger, 1970) has been shown to be good (Sassen et al, 1994;Fishpool et al, 2009). However, as TPP is added to diagnostic criteria, the performance of tympanometry becomes poor.…”