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The relationship between preoperative tympanograms and intraoperative ear examination results in children

  • Otology
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Abstract

The tympanogram is an objective audiological method in adults and children which is often used in the evaluation of middle ear pathology. This should be alongside a thorough patient history and clinical examination prior to the decision to carry out a paracentesis or tympanostomy tube insertion. The goal of the study was to evaluate the relationship between the preoperative tympanogram and intraoperative ear examination results or middle ear findings. The retrospective study included 654 ears in 333 patients who underwent paracentesis with or without tympanostomy tube insertion between January and December 2011. The study cohort consisted of 206 male and 127 female patients with an average age of 3.7 ± 2.5 years. The results of the preoperative tympanogram were compared to those of the intraoperative ear findings. In 18.4 % of ears with a flat tympanogram, an air-filled middle ear was found intraoperatively (p < 0.01). Thus, tympanometry results cannot serve as the only indication for surgical intervention. A decision to treat should always be based on the merits of the symptomatology of the patient in conjunction with tympanometry findings.

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References

  1. Browning GG, Rovers MM, Williamson I, Lous J, Burton MJ (2010) Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev CD001801

  2. Harmes KM, Blackwood RA, Burrows HL, Cooke JM, Van Harrison R, Passamani PP (2013) Otitis media: diagnosis and treatment. Am Fam Phys 88:435–440

    Google Scholar 

  3. Tos M (1984) Epidemiology and natural history of secretory otitis. Am J Otol 5:459–462

    CAS  PubMed  Google Scholar 

  4. Rosenfeld RM, Kay D (2003) Natural history of untreated otitis media. Laryngoscope 113:1645–1657

    Article  PubMed  Google Scholar 

  5. Bluestone CD, Beery QC, Paradise JL (1973) Audiometry and tympanometry in relation to middle ear effusions in children. Laryngoscope 83:594–604

    Article  CAS  PubMed  Google Scholar 

  6. Bluestone CD (2004) Studies in otitis media: Children’s Hospital of Pittsburgh-University of Pittsburgh progress report–2004. Laryngoscope 114:1–26

    Article  PubMed  Google Scholar 

  7. German society for ORL (2011) Guidelines chronic otitis media with effusion according to the German society for ORL

  8. Jerger J (1970) Clinical experience with impedance audiometry. Arch Otolaryngol 92:311–324

    Article  CAS  PubMed  Google Scholar 

  9. Fiellau-Nikolajsen M (1983) Tympanometric prediction of the magnitude of hearing loss in preschool-children with secretory otitis media. Scand Audiol Suppl 17:68–72

    CAS  PubMed  Google Scholar 

  10. Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS et al (2013) Clinical practice guideline: tympanostomy tubes in children. Otolaryngol Head Neck Surg 149:S1–S35

    Article  PubMed  Google Scholar 

  11. Federal Republic of Germany (1990) German Social Code Book VIII—Child and Youth welfare § 7 para. 1

  12. Bast F, Frank A, Schrom T (2013) Balloon dilatation of the Eustachian tube: postoperative validation of patient satisfaction. ORL J Otorhinolaryngol Relat Spec 75:361–365

    Article  CAS  PubMed  Google Scholar 

  13. Mandel EM, Swarts JD, Casselbrant ML, Tekely KK, Richert BC, Seroky JT et al (2013) Eustachian tube function as a predictor of the recurrence of middle ear effusion in children. Laryngoscope 123:2285–2290

    Article  PubMed Central  PubMed  Google Scholar 

  14. Martino E, Di Thaden R, Krombach GA, Westhofen M (2004) Function tests for the Eustachian tube. Current knowledge. HNO 52:1029–1039

    Article  CAS  PubMed  Google Scholar 

  15. Poe DS, Pyykkö I (2011) Measurements of Eustachian tube dilation by video endoscopy. Otol Neurotol 32:794–798

    Article  PubMed  Google Scholar 

  16. Zehlicke T, Just T, Specht O, Schmidt W, Sass W, Moss C et al (2011) Tensometry—development of a measurement technique of the tube function in a temporal bone model. Laryngorhinootologie 90:26–29

    Article  CAS  PubMed  Google Scholar 

  17. Parlea E, Georgescu M, Calarasu R (2012) Tympanometry as a predictor factor in the evolution of otitis media with effusion. J Med Life 5:452–454

    CAS  PubMed  Google Scholar 

  18. Kujala T, Alho O-P, Luotonen J, Kristo A, Uhari M, Renko M et al (2012) Tympanostomy with and without adenoidectomy for the prevention of recurrences of acute otitis media: a randomized controlled trial. Pediatr Infect Dis J 31:565–569

    Article  PubMed  Google Scholar 

  19. Smith N, Greinwald J (2011) To tube or not to tube: indications for myringotomy with tube placement. Curr Opin Otolaryngol Head Neck Surg 19:363–366

    Article  CAS  PubMed  Google Scholar 

  20. McCormick DP, Baldwin CD, Klecan-Aker JS, Swank PR, Johnson DL (2001) Association of early bilateral middle ear effusion with language at age 5 years. Ambul Pediatr 1:87–90

    Article  CAS  PubMed  Google Scholar 

  21. Casselbrant ML, Mandel EM, Rockette HE, Kurs-Lasky M, Fall PA, Bluestone CD (2009) Adenoidectomy for otitis media with effusion in 2-3-year-old children. Int J Pediatr Otorhinolaryngol 73:1718–1724

    Article  PubMed Central  PubMed  Google Scholar 

  22. Florentzson R, Finizia C (2012) Transmyringeal ventilation tube treatment: a 10-year cohort study. Int J Pediatr Otorhinolaryngol 76:1117–1122

    Article  PubMed  Google Scholar 

  23. Hammarén-Malmi S, Saxen H, Tarkkanen J, Mattila PS (2005) Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics 116:185–189

    Article  PubMed  Google Scholar 

  24. Kujala T, Alho O-P, Kristo A, Uhari M, Renko M, Pokka T et al (2014) Quality of life after surgery for recurrent otitis media in a randomized controlled trial. Pediatr Infect Dis J 33(7):715–719

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors have no financial interest in companies or other entities that have an interest in the information in the Contribution. The authors got no financial or material support for this research and work.

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Correspondence to Florian Bast.

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Knopke, S., Irune, E., Olze, H. et al. The relationship between preoperative tympanograms and intraoperative ear examination results in children. Eur Arch Otorhinolaryngol 272, 3651–3654 (2015). https://doi.org/10.1007/s00405-014-3421-8

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  • DOI: https://doi.org/10.1007/s00405-014-3421-8

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