Abstract
Young infants with OM are at high risk for the development of prolonged middle ear effusion (MEE) and recurrent OM. Objective, non-invasive diagnostic methods are needed for this age group. We determined the diagnostic efficacy of ipsilateral acoustic reflexes (IAR) detected with a 1000Hz stimulus and susceptance (B) tympanograms (660Hz)(NEJM 296:412,1977). Seventy-two infants < 4m. of age who presented at well child and illness visits were studied prospectively. Quantitative measures examined were: 1) peak B, 2)mean B between +300 and -400 mm H2) and 3)IAR threshold in decibels (dbHL). These measures were compared to independent pneumatic otoscopic findings. Substantial agreement was achieved between independent otoscopists (Kappa =.73). Diagnoses were confirmed by tympanocentesis when clinically indicated.
Peak B in normal ears was related to age: the mean peak was 0.41 mmho in 47 infants <2m. and 0.68 mmho in 21 infants 2m. to 4m. (p < .005). Conclusions: Infants less than 4m. of age: 1)Tympanogram peak susceptance and ipsilateral acoustic reflexes are accurate, objective, quantitative diagnostic methods. 2)Developmental changes in peak susceptance may have obsured the value of tympanograms in previous studies.
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Marchant, C., McMillan, P., Shurin, P. et al. OBJECTIVE DIAGNOSIS OF OTITIS MEDIA (OM) IN EARLY INFANCY. Pediatr Res 18 (Suppl 4), 231 (1984). https://doi.org/10.1203/00006450-198404001-00826
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DOI: https://doi.org/10.1203/00006450-198404001-00826