Diagnosis of Middle Ear Disease using Tympanograms and Digital Imaging

Author:

Aronzon Anna1,Ross Adam T.1,Kazahaya Ken2,Ishii Masaru3

Affiliation:

1. Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, and Baltimore, Maryland

2. Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA

3. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institute, Baltimore, MD, Philadelphia, Pennsylvania, and Baltimore, Maryland

Abstract

OBJECTIVE: The study investigates the ability of physicians with different levels of training to accurately identify middle ear (ME) pathology using tympanograms and tympanic membrane (TM) digital photographs. STUDY DESIGN AND SETTING: Groups of medical students, internal medicine residents, and attending and resident otolaryngologists were presented with a set of 50 matched tympanograms and photographs of TMs. The physicians were asked to differentiate between a normal and an abnormal-appearing TM. The sensitivity and specificity of diagnosis of ME pathology by physicians were compared with the gold standard, examining the ME cavity for pathology during myringotomy. RESULTS: The sensitivity did not vary among physicians with different levels of training; however, specificity improved with an increase in physician experience. CONCLUSIONS AND SIGNIFICANCE: This study establishes a baseline for accuracy of diagnosis of ME pathology using tympanograms and photographs of TMs as compared with binocular otomicroscopy and the gold standard, myringotomy. EBM rating: B-2.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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