Identification of middle ear disease.

Since impedance measurements were introduced as a mean of identifying ears affected by middle ear disease, efforts have been concentrated on the identifying of ears in which effusion is present. The shape of the tympanogram has been analysed and it has been proposed that ears producing a shallow tympanometric pattern are more likely to contain fluid in the middle ear, than are ears having a tympanogram with a large peak. In this communication and great individual variation of tympanograms is shown and it is suggested that two categories of tympanogram should be considered, namely 1) flat tympanogram, and 2) tympanograms in which the middle ear pressure can be determined.