Assessment of Pediatric Middle Ear Effusions With Wideband Tympanometry

Abstract

Objective To determine if wideband tympanometry (WBT) can differentiate types of middle ear effusion (MEE): serous, mucoid, and purulent. Study Design Prospective cohort study. Setting Tertiary care children’s hospital. Methods Children who met American Academy of Otolaryngology–Head and Neck Surgery’s guidelines for ventilation tube insertion had WBT after anesthesia induction but before tympanotomy. MEE was categorized into 1 of 4 comparison groups: serous effusion, mucoid effusion, purulent effusion, or no effusion. WBT measurements were averaged to 16 one-third octave frequency bands, and comparison of the absorbance patterns for each MEE type was performed through a linear mixed effects model. Results A total of 118 children (211 ears) were included: 47 females (39.8%) and 71 males (60.2%). The mean age was 2.73 years (95% CI, 2.25-3.22); mean weight, 14.35 kg (95% CI, 12.85-15.85); and mean Z score, 1.13 (95% CI, –0.64 to 2.33). Effusions included 61 mucoid (28.9%), 30 purulent (14.2%), and 14 serous (6.6%), with 106 (50.2%) having no effusion. No significant differences were found for sex, race, age, weight, or Z score among the 4 types of effusion ( P < .05). WBT showed a significant difference in median absorption among the effusion groups ( P < .001), with a medium effect size of 0.35. Conclusions WBT has potential use to differentiate types of MEE and should be studied further as a tool for investigating how the natural history and management of serous and mucoid effusions may differ.