Purpose: Middle ear disease (MED) is common among young children. Detection is difficult since symptoms may be absent and middle ear examinations are not routinely performed. Tympanometry is a simple and objective way to detect MED in children. This study was designed to investigate the incidence of tympanometric abnormalities in children classified as being “low risk” for MED.

Methods: We performed a prospective study of 57 outpatient children 1-10 years of age at Cabin Creek Health Center (CCHC) in Dawes, WV. An assessment of risk was performed with a questionnaire and a tympanogram was performed with a Welch Allyn MicroTymp model. Normative values were used as per manufacturer recommendation. We excluded patients who had tympanostomy tubes or active otitis media present. Data in percent ± SD.

Results: We tested a population of 57 children who visited CCHC between June 9 and July 6, 1994 and classified them into low and high risk groups. We considered the child high risk if: 1) the patient had an ear infection within the last 3 months, 2) had more than 3 ear infections within the last years or 3) came with a complaint that would normally warrant a tympanogram. When excluding the high risk children 41 children remained with 82 tympanograms. We found 56 (68 ± 7%) Type A (normal), 7 (9 ± 3%) Type B (Low Peak Ya), 4 (5 ± 2%) Type C (Negative TPP), 3 (4± 2%) Type D (Positive TPP), 7 (9 ± 3%) Type E (Large gradient), and 5 (6 ± 2%) Type F (High Peak Ya). We found then that 56 (68± 5%) tympanograms were normal and 26 (32 ± 5%) were abnormal with possible MED. A total of 23 (56 ± 8%) low risk patients had normal and 18 (44 ± 8%) had abnormal tympanograms in at least one ear.

Conclusions: Our results show that there is a significant incidence of abnormal tympanograms in low risk children. Tympanograms should be implemented on a regular basis in pediatric examinations.