title: Ultrasonic detection of middle ear effusion: a preliminary study.
abstract: OBJECTIVE
  To assess the ability to detect and characterize middle ear effusion in children using A-mode ultrasonography.
  
  
  METHODS
  Prospective nonblinded comparison study.
  
  
  METHODS
  Tertiary children's hospital.
  
  
  METHODS
  Forty children (74 ears) scheduled to undergo bilateral myringotomy with pressure equalization tube placement.
  
  
  METHODS
  Before myringotomy, ultrasound examination of the tympanic membrane and middle ear space was performed on each ear. Afterward, myringotomy was performed and the type of effusion (serous, mucoid, or purulent) was recorded. Pressure equalization tubes were then placed.
  
  
  METHODS
  Comparison of ultrasound findings with the visual assessment of the type of middle ear effusion present.
  
  
  RESULTS
  Of the 74 ears tested, 45 (61%) had effusion on direct inspection. The effusion was purulent in 8 ears (18%), serous in 9 ears (20%), and mucoid in 28 ears (62%). Ultrasound identified the presence or absence of effusion in 71 cases (96%) (P = .04). Ultrasound distinguished between serous and mucoid effusion with 100% accuracy (P = .04). The probe did not distinguish between mucoid and purulent effusion.
  
  
  CONCLUSIONS
  Ultrasonography is an accurate method of diagnosing middle ear effusion in children. Moreover, it can distinguish thin from mucoid fluid. Further refinements in probe design may further improve the sensitivity of fluid detection and allow differentiation of sterile vs infectious effusion.
authors.affiliation: Section of Pediatric Otolaryngology, Head and Neck Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Discolo
authors.forename: Michael C
authors.initials: MC
authors.lastname: Byrd
authors.forename: Teresa
authors.initials: T
authors.lastname: Bates
authors.forename: Dov
authors.initials: D
authors.lastname: Hazony
authors.forename: Jan
authors.initials: J
authors.lastname: Lewandowski
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koltai
mesh_terms: D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010034:Otitis Media with Effusion / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D013492:Suppuration; D014432:Tympanic Membrane / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography