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Two methods for estimating the odds of middle ear effusion were confirmed in a review of tympanometric and otoscopic data from children younger than 3 years conducted by Clyde G. Smith, M.S., an audiologist at Children's Hospital of Pittsburgh, and his colleagues.
A total of 6,350 children were enrolled as healthy infants when they were 2–6 days old, between June 1991 and December 1995. They had monthly otoscopic evaluations until 3 years of age, at which point 3,427 children had at least one tympanogram suitable for evaluation.
The overall likelihood of middle ear effusion (MEE) increased with tympanometric measures of lower height, greater width, and negative pressure among children aged 6–35 months. Middle ear effusion in cases with flat tympanograms was diagnosed in 174 of 217 (80%) ears in children aged 6–35 months, compared with 20 of 35 (57%) ears in children younger than 6 months.
The tympanograms from most healthy children older than 6 months are at least 0.3 mL high and 200 decaPascals, or daPa, wide, and they are rarely associated with MEE, but a flat tympanogram may raise the index of suspicion, the researchers explained (Pediatrics 2006;118:1–13).
As an alternative to comparing the tympanometric findings with age-based values, the researchers created a mathematical algorithm that combined the tympanometric variables of height, pressure, and width, and applied it to the 4,761 ears for which all three of these values were available.
For example, in children aged 6–35 months, MEE was present in 1.9% of ears with a tympanometric height of 0.6 mL or higher and 0–200 daPa width and 6.3% of ears with a tympanometric height of 0.6 mL or higher and a 201–300 width. No effusion was found in ears with a tympanometric height of 0.6 mL and a width of at least 301 daPa. Based on the algorithm, the area under the curve was 0.84; values from 0.80–0.90 tend to be accurate predictors.
There were no clinically significant differences between the empirical and algorithmic methods in terms of ability to predict MEE. The study was supported in part by donations from GlaxoSmithKline and Pfizer, Inc.
Two methods for estimating the odds of middle ear effusion were confirmed in a review of tympanometric and otoscopic data from children younger than 3 years conducted by Clyde G. Smith, M.S., an audiologist at Children's Hospital of Pittsburgh, and his colleagues.
A total of 6,350 children were enrolled as healthy infants when they were 2–6 days old, between June 1991 and December 1995. They had monthly otoscopic evaluations until 3 years of age, at which point 3,427 children had at least one tympanogram suitable for evaluation.
The overall likelihood of middle ear effusion (MEE) increased with tympanometric measures of lower height, greater width, and negative pressure among children aged 6–35 months. Middle ear effusion in cases with flat tympanograms was diagnosed in 174 of 217 (80%) ears in children aged 6–35 months, compared with 20 of 35 (57%) ears in children younger than 6 months.
The tympanograms from most healthy children older than 6 months are at least 0.3 mL high and 200 decaPascals, or daPa, wide, and they are rarely associated with MEE, but a flat tympanogram may raise the index of suspicion, the researchers explained (Pediatrics 2006;118:1–13).
As an alternative to comparing the tympanometric findings with age-based values, the researchers created a mathematical algorithm that combined the tympanometric variables of height, pressure, and width, and applied it to the 4,761 ears for which all three of these values were available.
For example, in children aged 6–35 months, MEE was present in 1.9% of ears with a tympanometric height of 0.6 mL or higher and 0–200 daPa width and 6.3% of ears with a tympanometric height of 0.6 mL or higher and a 201–300 width. No effusion was found in ears with a tympanometric height of 0.6 mL and a width of at least 301 daPa. Based on the algorithm, the area under the curve was 0.84; values from 0.80–0.90 tend to be accurate predictors.
There were no clinically significant differences between the empirical and algorithmic methods in terms of ability to predict MEE. The study was supported in part by donations from GlaxoSmithKline and Pfizer, Inc.
Two methods for estimating the odds of middle ear effusion were confirmed in a review of tympanometric and otoscopic data from children younger than 3 years conducted by Clyde G. Smith, M.S., an audiologist at Children's Hospital of Pittsburgh, and his colleagues.
A total of 6,350 children were enrolled as healthy infants when they were 2–6 days old, between June 1991 and December 1995. They had monthly otoscopic evaluations until 3 years of age, at which point 3,427 children had at least one tympanogram suitable for evaluation.
The overall likelihood of middle ear effusion (MEE) increased with tympanometric measures of lower height, greater width, and negative pressure among children aged 6–35 months. Middle ear effusion in cases with flat tympanograms was diagnosed in 174 of 217 (80%) ears in children aged 6–35 months, compared with 20 of 35 (57%) ears in children younger than 6 months.
The tympanograms from most healthy children older than 6 months are at least 0.3 mL high and 200 decaPascals, or daPa, wide, and they are rarely associated with MEE, but a flat tympanogram may raise the index of suspicion, the researchers explained (Pediatrics 2006;118:1–13).
As an alternative to comparing the tympanometric findings with age-based values, the researchers created a mathematical algorithm that combined the tympanometric variables of height, pressure, and width, and applied it to the 4,761 ears for which all three of these values were available.
For example, in children aged 6–35 months, MEE was present in 1.9% of ears with a tympanometric height of 0.6 mL or higher and 0–200 daPa width and 6.3% of ears with a tympanometric height of 0.6 mL or higher and a 201–300 width. No effusion was found in ears with a tympanometric height of 0.6 mL and a width of at least 301 daPa. Based on the algorithm, the area under the curve was 0.84; values from 0.80–0.90 tend to be accurate predictors.
There were no clinically significant differences between the empirical and algorithmic methods in terms of ability to predict MEE. The study was supported in part by donations from GlaxoSmithKline and Pfizer, Inc.