title: Role of otoacoustic emission in children with middle-ear effusion and grommets.
abstract: OBJECTIVE
  To evaluate the role of otoacoustic emission in children with middle-ear effusion and grommets.
  
  
  METHODS
  A prospective study was carried out on a total of 90 ears. All children listed for grommet insertion had a pre-operative and post-operative (three to six months after grommet insertion) pure tone audiometry, tympanometry and otoacoustic emission recorded. A comparison was made between pure tone audiometry and otoacoustic emission both pre-operatively and post-operatively.
  
  
  RESULTS
  Pre-operatively, 63 ears had an abnormal pure tone audiometry of which 59 had absent otoacoustic emission. Therefore the sensitivity of otoacoustic emission in detecting a conductive loss was 59/63 = 94 per cent (95 per cent confidence interval 85 to 98 per cent). All 27 ears with normal hearing pre-operatively had normal otoacoustic emission. The specificity of otoacoustic emission was 27/27 = 100 per cent, (95 per cent confidence interval, 88 to 100 per cent). The positive predictive value was 59/59 = 100 per cent (95 per cent confidence interval, 94 to 100 per cent). After three to six months all post-operative patients with grommets had a normal pure tone audiometry and otoacoustic emission. So both pure tone audiometry and otoacoustic emission were strongly related both in patients with middle-ear effusion and in patients with grommets.
  
  
  CONCLUSIONS
  As the demonstration of hearing in young and difficult-to-test children can be problematic and time-consuming, we suggest that otoacoustic emission can be used as an alternative to pure tone audiometry in patients with middle-ear effusion and grommets.
authors.affiliation: Department of ENT, Stepping Hill Hospital, Stockport, Cheshire, UK. ysaleem@yahoo.com
authors.forename: Y
authors.initials: Y
authors.lastname: Saleem
authors.forename: S
authors.initials: S
authors.lastname: Ramachandran
authors.forename: L
authors.initials: L
authors.lastname: Ramamurthy
authors.forename: N J
authors.initials: NJ
authors.lastname: Kay
mesh_terms: D001301:Audiometry, Pure-Tone / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D010034:Otitis Media with Effusion / Q000503:physiopathology* / Q000628:therapy; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome