Accuracy of Tympanometry in the Diagnosis of Otitis Media with Effusion in Children's at Myringotomies

Abstract

Otitis media with effusion is a common cause of hearing impairment in children, required accurate diagnostic tools for timely intervention. Tympanometry is commonly used for assessing middle ear function, but its diagnostic accuracy compared to myringotomy, the gold standard, remains a topic of debate. Objective: To assess the diagnostic accuracy of tympanometry in identifying otitis media with effusion (OME) in children, using intraoperative findings during myringotomy as the gold standard. Methods: This observational cross-sectional study was carried out from January 2022 to June 2024 at the ENT Department, Hayatabad Medical Complex Peshawar. Ethical approval was obtained from Institutional Review Board (IRB) of the hospital, and written consent was obtained from parents or guardians of all children involved in the study. Total of 157 children aged 2 to 12 years, were included. Results:  Proportion of sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were determined. Type B tympanograms, suggestive of OME, were seen in 112 children (71.3%). Type A was observed in 25 children (15.9%) and type C in 20 children (12.7%). Myringotomy verified middle ear effusion in 120 children which is 76.4%. Within this group, 111 children presented with Type B tympanograms resulting in a true positive ratio of 92.5%. 9 cases (5.7%) were noticed with false positive results. Conclusion: Tympanometry stands as one of the top diagnostic instruments for OME identification in children. Their use, especially alongside otoscopy and audiometry, adds value in clinical practice.