Persistent effusion following acute otitis media: tympanometry and pneumatic otoscopy in diagnosis.

Children aged six months to 10 years in one practice who were diagnosed with acute otitis media were examined one, three, six and 12 months after diagnosis by a general practitioner and an otolaryngologist on the same day using pneumatic otoscopy. Tympanometry and pure tone audimetry were also carried out. Tympanograms were combined with the specialist's otoscopy findings to determine whether effusion was present. The outcome categories three months or longer after diagnosis were compared with the otoscopic findings up to that stage.The tympanometry results showed that of the 29 children (31 affected ears), five had evidence of middle ear effusion on all occasions tested, while six were normal throughout, 10 fluctuated and eight followed a resolving pattern. Examination 10-14 days or one month after diagnosis was 75% accurate in predicting effusion after three months. Recommendations are made for the use of the pneumatic otoscope in follow up by general practitioners.