Validation of a portable tympanometer for use in primary care.
OBJECTIVE
to determine the accuracy of a handheld, portable tympanometer, the microtymp, in comparison with a reference instrument, the AR 85 tympanometer, and with the gold standard: presence or absence of middle-ear fluid.


METHODS
comparison of results from the microtymp with results from the reference tympanometer, the AR 85 and the gold standard.


METHODS
University Children's Hospital, Utrecht and the General Hospital, Overvecht, Utrecht.


METHODS
142 children (284 ears) aged between 6 months and 12 years, who were referred by their General Practitioner or Ear, Nose and Throat surgeon for myringotomy and/or tympanostomy tube insertion.


METHODS
tympanometry with the AR 85 and presence or absence of middle-ear fluid.


RESULTS
In 243 ears, of the included 284 ears, the test results of the microtymp were compared with those of the reference instrument, the AR 85 tympanometer. Sensitivity 0.96 (95% C.I.: 0.93, 0.99), Specificity 0.81 (95% C.I.: 0.71, 0.91). In 233 ears, of the included 284 ears, the test results of the microtymp were compared with the gold standard. Sensitivity 0.94 (95% C.I.: 0.90, 0.98), specificity 0.48 (95% C.I.: 0.37, 0.59).


CONCLUSIONS
The microtymp is a valid instrument for diagnosing middle-ear effusions. The results of the microtymp are highly comparable with traditional tympanometers: high sensitivity and much lower specificity. Use in primary care can increase diagnostic accuracy of otitis media with effusion (OME) and makes follow-up possible. This will help to discriminate between those OME cases who need further treatment and those who will resolve spontaneously.
van Balen
F A
FA
Department of General Practice, University of Utrecht, Netherlands.
de Melker
R A
RA
D000158:Acoustic Impedance Tests / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity