A preliminary evaluation of the use of an automatic impedance tympanometer in the diagnosis of otitis media with effusion in children: a report from the Dunedin Multidisciplinary Health and Development Research Unit.

Microscopic examination by two trained examiners, conventional impedance tympanometry by a trained audiometrist, automatic impedance tympanometry by a person with minimal training and puretone audiometry by trained audiometrists were compared in 468 ears, studied blind. There was complete examiner agreement in microscopic examination in 465 (99.3%) ears, minor disagreement in three (0.7%) ears. There was a more complex relationship between examination methods, with microscopic evidence of effusion being present in 88.2% of ears showing B tympanograms to conventional tympanometry and in 66.7% of ears to automatic tympanometry. Automatic tympanometry provides a reasonably accurate method of detecting middle ear effusion, but tends to overdiagnose this condition compared to alternate methods.