Othman Deema, Alashkar Masa, Bitar Mohamad A
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, ARE.
Pediatric Otolaryngology, Al Jalila Children's Specialty Hospital, Dubai Health, Dubai, ARE.
Cureus. 2024 Nov 5;16(11):e73098. doi: 10.7759/cureus.73098. eCollection 2024 Nov.
Middle ear effusion (MEE) is the primary cause of conductive hearing impairment among children, predominantly occurring up to the age of two years. The gold standard for detecting MEE is tympanometry (Grayson-Stadler, Eden Prairie, Minnesota). This study explores a less costly alternative, the video otoscope (Inventis S.R.L, Padova, Italy).
The primary objective is to compare video otoscopy with tympanometry in terms of its ability to diagnose MEE. The secondary objective is to explore the prevalence of MEE in special populations.
We conducted a retrospective diagnostic study that included patients aged 0-18 years who visited the pediatric otolaryngology clinic for suspected MEE over a two-year period. Clinical presentation, otoscopy findings, and tympanometry results were reviewed. The data were analyzed using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York). The significance of the results was assessed using the chi-squared test.
We included 337 patients with a mean age of 5.1 years (standard deviation = 2.68); 967 tympanometry tests were available for comparison with the corresponding ears. Validity tests showed that the sensitivity of video otoscopy was 79.5%, the specificity was 56.9%, the positive predictive value was 89.6%, and the negative predictive value was 37.4%. The overall accuracy was 75.5%. These results were statistically significant.
Video otoscopy was capable of diagnosing MEE in children 89.6% of the time. However, tympanometry is still needed in specific conditions, such as narrow ear canals, dull tympanic membranes, and clear tympanic membranes in patients with decreased hearing, a history of ear infections, or speech delay.
中耳积液（MEE）是儿童传导性听力障碍的主要原因，主要发生在两岁以下儿童中。检测MEE的金标准是鼓室图检查（Grayson-Stadler公司，明尼苏达州伊甸草原）。本研究探索了一种成本较低的替代方法，即视频耳镜检查（Inventis S.R.L公司，意大利帕多瓦）。
主要目的是比较视频耳镜检查和鼓室图检查在诊断MEE方面的能力。次要目的是探索特殊人群中MEE的患病率。
我们进行了一项回顾性诊断研究，纳入了在两年期间因疑似MEE前往儿科耳鼻喉科诊所就诊的0至18岁患者。回顾了临床表现、耳镜检查结果和鼓室图检查结果。使用IBM SPSS Statistics for Windows 24版（2016年发布；IBM公司，纽约州阿蒙克）对数据进行分析。使用卡方检验评估结果的显著性。
我们纳入了337例患者，平均年龄为5.1岁（标准差=2.68）；有967次鼓室图检查可用于与相应耳朵进行比较。效度检验显示，视频耳镜检查的灵敏度为79.5%，特异度为56.9%，阳性预测值为89.6%，阴性预测值为37.4%。总体准确率为75.5%。这些结果具有统计学显著性。
视频耳镜检查在89.6%的情况下能够诊断儿童的MEE。然而，在特定情况下，如耳道狭窄、鼓膜浑浊以及听力下降、有耳部感染史或语言发育迟缓患者的鼓膜清晰时，仍需要进行鼓室图检查。
