Tympanometry with otoendoscopy helps diagnose Acute Otitis Media and OME: Study
Tympanometry plus otoendoscopy together greatly increase the chances of detecting acute otitis media (AOM) and otitis media with effusion (OME), describe Mohd. Aftab and colleagues from the Department of ENT and HNS, SRN Hospital, Prayagraj, Uttar Pradesh, India.
The research has recently been published in the Indian Journal of Otolaryngology and Head & Neck Surgery.
The tympanic membrane (TM) undergoes a number of pathological changes in middle ear disease which can be detected by a video-otoendoscope. Middle ear disease is also accompanied by changes in middle ear pressure which can be assessed by tympanometry.
Hence, the authors conducted the present prospective study in a tertiary health care centre in North India, where they examined a total of 75 patients with AOM or OME , all of whom were selected from the population visiting the ENT Outpatient Department. They were included over 1 year where each patient was followed up for 21 days.
The objectives of this study were to find the correlation between video-otoendoscopy and tympanometry in acute middle ear infections and to deduce which of the two is more efficient and reliable for early diagnosis.
Detailed history and clinical examination with videootoendoscope and tympanometry was done on each visit. Each TM was graded using OMGRADE scale. Symptoms and clinical findings consistent with acute otitis media were given a clinical score (CO Score).
The results were collected and correlation between video-otoendoscopy and tympanometry was determined and their individual sensitivity, specificity and diagnostic accuracy was calculated.
The sensitivity, specificity and diagnostic accuracy for tympanometry and video-otoendoscopy was calculated individually for each of the 4 visits and positive correlation between the 2 was found.
The findings showed that -
a. Tympanometry had a higher overall sensitivity than video-otoendoscopy.
b. While, video-otoendoscopy showed a higher specificity than Tympanometry.
c. Otoendoscopy is good for ruling out AOM/OME but cannot rule out persisting Middle Ear Effusion and Tympanometry is a better tool for detecting MEE but cannot differentiate well between AOM and OME.
Therefore, the authors concluded that " tympanometry plus otoendoscopy together greatly increase the chances of detecting AOM and OME."