PubMed Health⌕ Search

PubMed · 9329419

Minitympanometry in detecting middle ear fluid.

Abstract

OBJECTIVE: To assess the time needed to perform tympanometry, the success rate and the importance of the child's cooperation for the accuracy of minitympanometry in detecting middle ear fluid, and the relation between the static admittance of the tympanogram and the weight of the middle ear fluid. STUDY DESIGN: Two series of patients were enrolled. The first consisted of 206 consecutive children (mean age 4.7 years, range 1 month to 16 years) from the Outpatient Emergency Department of Pediatrics in the University of Oulu; the second group consisted of 162 children (age range 7 months to 8 years) who were referred to the Department of Otolaryngology for adenoidectomy, tympanostomy, or both procedures. In the first series the success rate and the time needed to complete a minitympanometric examination on each ear were recorded. In the second series, the tympanograms were evaluated according to the cooperation of the children at the time of the tympanometric examination, and the weight of the middle ear fluid was measured and compared with the static admittance of the minitympanometric curve. Sensitivity and specificity values were calculated separately for cooperative and uncooperative patients. RESULTS: In the first series, the mean time needed for tympanometry was 2.1 minutes (range 0.5 to 10 minutes), and 179 (86.9%) of the patients were cooperative. In the second series, the sensitivity and specificity calculated for tympanometry in detecting middle ear fluid were 79% and 93% among the cooperative children. In the uncooperative group, sensitivity and specificity were 71% and 38%, respectively. The weight of the middle ear fluid varied from 5 mg to 695 mg. There was a significant negative correlation (r = -0.66, p < 0.001) between the static admittance in minitympanometry and the weight of the middle ear fluid. CONCLUSION: Minitympanometry can be done quickly, it fails rarely, and in cooperative patients it is a better tool than has been earlier suggested, but it is useless in uncooperative children. The amount of middle ear fluid varies notably even among young children.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P Koivunen, O P Alho, M Uhari, M Niemelä, J Luotonen. 1997. Minitympanometry in detecting middle ear fluid.. https://pubmed.ncbi.nlm.nih.gov/9329419/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Bayesian estimation of intervention effect with pre- and post-misclassified binomial data.

We consider studies in which an enrolled subject tests positive on a fallible test. After an intervention, disease status is re-diagnosed with the same fallible instrument. Potential misclassification in the diagnostic test causes regression to the mean that biases inferences about the true intervention effect. The existing likelihood approach suffers in situations where either sensitivity or specificity is near 1. In such cases, common in many diagnostic tests, confidence interval coverage can often be below nominal for the likelihood approach. Another potential drawback of the maximum likelihood estimator (MLE) method is that it requires validation data to eliminate identification problems. We propose a Bayesian approach that offers improved performance in general, but substantially better performance than the MLE method in the realistic case of a highly accurate diagnostic test. We obtain this superior performance using no more information than that employed in the likelihood method. Our approach is also more flexible, doing without validation data if necessary, but accommodating multiple sources of information, if available, thereby systematically eliminating identification problems. We show via a simulation study that our Bayesian approach outperforms the MLE method, especially when the diagnostic test has high sensitivity, specificity, or both. We also consider a real data example for which the diagnostic test specificity is close to 1 (false positive probability close to 0).

Acoustic Impedance Tests↗

Abnormal electronystagmography in rheumatoid arthritis.

OBJECTIVE: Although sensorineural hearing loss has been widely investigated in those with rheumatoid arthritis, studies assessing the vestibular system in patients with rheumatoid arthritis are limited. The aim of this study was to assess the vestibular system in patients with rheumatoid arthritis. METHODS: The study consisted of 43 patients with rheumatoid arthritis and 30 healthy controls. Otorhinolaryngologic and neurotologic examinations, pure-tone audiometry, impedancemetry, electronystagmography including smooth pursuit, saccade, positional, and caloric tests were performed in all patients with rheumatoid arthritis and in controls. The erythrocyte sedimentation rate, C-reactive protein level, and rheumatoid factor level were evaluated in all patients with rheumatoid arthritis. RESULTS: Audiograms revealed sensorineural hearing loss in 12 patients (27.9%) with rheumatoid arthritis and in two controls (6.6%); the difference was statistically significant (P=.033). In those with rheumatoid arthritis, the results of electronystagmography revealed central abnormalities in nine patients (20.9%), peripheral abnormalities in three (6.9%), and mixed abnormalities in three (6.9%). Smooth pursuit and saccade tracing impairments were significantly higher in patients with rheumatoid arthritis (P>.05). Canal paresis in patients with rheumatoid arthritis were significantly higher than those in the control group (P=.039). No association was found between electronystagmographic abnormalities in patients with rheumatoid arthritis and age, sex, duration of disease, the results of laboratory testing, sensorineural hearing loss, or medication use. CONCLUSION: Our results suggest an association of rheumatoid arthritis with vestibular system dysfunction as well as auditory impairment.

Acoustic Impedance Tests↗

Reproducibility of sonotubometry as Eustachian tube ventilatory function test in healthy children.

OBJECTIVES: To devise a simple and reliable diagnostic procedure to test Eustachian tube function routinely in an ENT outpatient setting. One method to measure ET ventilatory function is sonotubometry. The reproducibility of a recently updated sonotubometry set-up was tested in healthy children. METHODS: The test population comprised 61 school children aged from 6 to 8 years. Only otologically healthy children were included. Health state was established by means of a 12-item questionnaire. To test reproducibility, sonotubometric testing took place in two sessions of 10 acts of swallowing each. Spearman's coefficient was used to test the correlation between the two sets of measurements. All testing took place at a primary school in a nearby village. RESULTS: Opening of the ET was recorded in at least one of the two measurement sessions in 82% of the children. The first and second sessions were highly correlated, with a Spearman's coefficient of 0.89. CONCLUSIONS: In otologically healthy children, opening of the ET was recorded frequently using the updated sonotubometry set-up. Measurement results had high reproducibility. Therefore, the test forms a useful method to assess ET ventilatory function in otologically healthy children. The performance of this updated version needs to be established in children with otological diseases.

Acoustic Impedance Tests↗