title: Applicability of spectral gradient acoustic reflectometry (EarCheck): screening patients who need surgical treatment for chronic otitis media with effusion.
abstract: OBJECTIVE
  We aimed to conduct a prospective, observational study of the applicability of EarCheck (Innovia Medical LLC, Omaha, NE) in the surgical management of chronic otitis media with effusion (COME).
  
  
  METHODS
  Between February 2013 and July 2013, 84 patients (165 ears) who had been diagnosed with COME and underwent surgical management were recruited. Information concerning patient sex, age, body mass index, EarCheck score, pure-tone averages (PTAs), speech reception thresholds (SRTs), and characteristics of middle ear fluid (MEF) were documented and statistically analyzed.
  
  
  RESULTS
  MEF was detected in 87.3% (n=144/165) of the 165 ears. Based on EarCheck scores ≥ 3 (as a criterion for abnormal findings), the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EarCheck were 56.9%, 90.5%, 82%, 23.5%, and 61.2%, respectively. Significant positive correlation was found between EarCheck, both pure-tone thresholds at all frequencies and mean PTAs, and SRTs. The mean PTAs and SRTs of the patients with EarCheck scores ≥ 3 was 37.79 dB and 33.26 dB, respectively; these scores were significantly higher than the mean PTAs and SRTs (30.56 dB and 25.88 dB, respectively) of the patients with EarCheck scores <3 (p<0.05).
  
  
  CONCLUSIONS
  Although it is not preferable to conduct the EarCheck test alone when diagnosing COME because of its low accuracy, because of its additional hearing level clues, EarCheck can be used in deciding whether to perform tympanostomy tube insertion when conventional audiometry is not possible.
authors.affiliation: Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University, Daejeon, Republic of Korea. Electronic address: hoyun1004@gmail.com.
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University, Daejeon, Republic of Korea.
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University, Daejeon, Republic of Korea.
authors.forename: No Seon
authors.initials: NS
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University, Daejeon, Republic of Korea.
authors.forename: Chin Saeng
authors.initials: CS
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery
keywords: Acoustic reflectometry; Chronic otitis media with effusion; EarCheck; Tympanostomy tube