Prospective comparison of handheld pneumatic otoscopy, binocular microscopy, and tympanometry in identifying middle ear effusions in children

Rogers, Derek J.; Boseley, Mark E.; Adams, Mary Theresa; Makowski, Renee L.; Hohman, Marc H.

doi:10.1016/j.ijporl.2010.06.015

Cited by 43 publications

(27 citation statements)

References 20 publications

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“…Tests to predict MEE that are presently recommended in accepted clinical guidelines include pneumatic otoscopy and either 226‐Hz tympanometry or reflectometry when the results of pneumatic otoscopy are questionable 25. Although meta‐analysis has reported good sensitivity and specificity for pneumatic otoscopy in making predictions of MEE,27 it has produced variable inter‐ and intratester results 29, 34, 35. The performance of each WATF predictor is quantified in the present study by AUC and SYM values, which is not reported in the literature for pneumatic otoscopy.…”

Section: Discussionmentioning

confidence: 77%

“…Nevertheless, the WATF test has the option of obtaining pressurized responses if desired 45. In addition, pneumatic otoscopy is characterized by variability in interpretation,29, 34, 35 and tympanometry may not be suitable for detecting slight changes in middle‐ear mechanics that result from MEE because it tests at only a single frequency 42. The WATF test overcomes these limitations by providing an objective assessment of middle‐ear function across a broad frequency region (0.25–8 kHz) while also maintaining good test‐retest reliability46, 55 and a short test time 45.…”

Section: Discussionmentioning

confidence: 99%

“…Separate studies report sensitivity values from 85% to 91% and specificity from 58% to 89% 28–31. Although pneumatic otoscopy has potential in predicting MEE, interpretation of test results is characterized by highly variable outcomes26, 30, 32, 33 either across otoscopists34, 35 or across repeated tests by a single otoscopist 29…”

Section: Introductionmentioning

confidence: 99%

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Wideband acoustic transfer functions predict middle‐ear effusion

et al. 2012

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Objectives/Hypothesis Compare the accuracy of wideband acoustic transfer functions (WATFs) measured in the ear canal at ambient pressure to methods currently recommended by clinical guidelines for predicting middle-ear effusion (MEE). Study Design Cross-sectional validating diagnostic study among young children with and without MEE to investigate the ability of WATFs to predict MEE. Methods WATF measures were obtained in a MEE group of 44 children (53 ears, mean age 1.9 years) scheduled for middle-ear ventilation tube placement and a normal age-matched control group of 44 children (59 ears, mean age 1.8 years) with normal pneumatic otoscopic findings and no history of ear disease or middle-ear surgery. An otolaryngologist judged whether MEE was present or absent and rated tympanic-membrane (TM) mobility via pneumatic otoscopy. A likelihood-ratio classifier reduced WATF data (absorbance, admittance magnitude and phase) from 0.25 to 8 kHz to a single predictor of MEE status. Absorbance was compared to pneumatic otoscopy classifications of tympanic membrane (TM) mobility. Results Absorbance was reduced in ears with MEE compared to ears from the control group. Absorbance and admittance magnitude were the best single WATF predictors of MEE, but a predictor combining absorbance, admittance magnitude and phase was the most accurate. Absorbance varied systematically with TM mobility based on data from pneumatic otoscopy. Conclusions Results showed that absorbance is sensitive to middle-ear stiffness and MEE, and WATF predictions of MEE in young children are as accurate as that reported for methods recommended by the clinical guidelines.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Wideband acoustic transfer functions predict middle‐ear effusion

et al. 2012

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“…Para el examen de oídos, los participantes fueron estudiados por un especialista en Otorrinolaringología en el Hospital General de Agudos "Parmenio Piñero" mediante microotoscopía binocular, instrumento de alta sensibilidad en la detección de patologías otológicas. 28 El examen de audición fue llevado a cabo mediante audiometría tonal por juego (Audiómetro Kamplex® AD 229) en el Hospital de Rehabilitación "Manuel Rocca". En caso de dificultades con la colaboración del participante, se realizó una audiometría en campo libre o por refuerzo visual.…”

Section: Población Y Métodosunclassified

Retraso del desarrollo del lenguaje en niños de 24 meses en un centro de salud en la Ciudad de Buenos Aires

2018

Arch Argent Pediatr

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“…Although much is known about comparisons of diVerent models of tympanometer in measuring ear pressure [12] and about the correlation between tympanometry and other otoscopic and microscopic modalities in identifying middle ear eVusions [13], there is little research examining the basic accuracy of the tympanometer in measuring ear canal volume. This study examines the potential of the tympanometer as an objective experimental tool to assess the eVectiveness of cerumenolytics in laboratory and human studies.…”

Section: Introductionmentioning

confidence: 99%

Assessing the accuracy of tympanometric evaluation of external auditory canal volume: a scientific study using an ear canal model

Al‐Hussaini

Owens

Tomkinson

2011

Eur Arch Otorhinolaryngol

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Tympanometric evaluation is routinely used as part of the complete otological examination. During tympanometric examination, evaluation of middle ear pressure and ear canal volume is undertaken. Little is reported in relation to the accuracy and precision tympanometry evaluates external ear canal volume. This study examines the capability of the tympanometer to accurately evaluate external auditory canal volume in both simple and partially obstructed ear canal models and assesses its capability to be used in studies examining the effectiveness of cerumolytics. An ear canal model was designed using simple laboratory equipment, including a 5 ml calibrated clinical syringe (Becton Dickinson, Spain). The ear canal model was attached to the sensing probe of a Kamplex tympanometer (Interacoustics, Denmark). Three basic trials were undertaken: evaluation of the tympanometer in simple canal volume measurement, evaluation of the tympanometer in assessing canal volume with partial canal occlusion at different positions within the model, and evaluation of the tympanometer in assessing canal volume with varying degrees of canal occlusion. 1,290 individual test scenarios were completed over the three arms of the study. At volumes of 1.4 cm(3) or below, a perfect relationship was noted between the actual and tympanometric volumes in the simple model (Spearman's ρ = 1) with weakening degrees of agreement with increasing volume of the canal. Bland-Altman plotting confirmed the accuracy of this agreement. In the wax substitute models, tympanometry was observed to have a close relationship (Spearman's ρ > 0.99) with the actual volume present with worsening error above a volume of 1.4 cm(3). Bland-Altman plotting and precision calculations provided evidence of accuracy. Size and position of the wax substitute had no statistical effect on results [Wilcoxon rank-sum test (WRST) p > 0.99], nor did degree of partial obstruction (WRST p > 0.99). The Kamplex tympanometer accurately and precisely assesses ear canal volume in the scientific model in both simple and partially occluded wax substitute scenarios up to a volume of 1.4 cm(3). These findings suggest that the Kamplex tympanometer could be used as an effective objective tool in evaluating the efficacy of topical cerumolytics in both laboratory and human models.

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Prospective comparison of handheld pneumatic otoscopy, binocular microscopy, and tympanometry in identifying middle ear effusions in children

Cited by 43 publications

References 20 publications

Wideband acoustic transfer functions predict middle‐ear effusion

Wideband acoustic transfer functions predict middle‐ear effusion

Retraso del desarrollo del lenguaje en niños de 24 meses en un centro de salud en la Ciudad de Buenos Aires

Assessing the accuracy of tympanometric evaluation of external auditory canal volume: a scientific study using an ear canal model

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