title: Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies.
abstract: OBJECTIVE
  (1) The diagnostic accuracy of tympanometry in detecting fluid in the middle ear space in children with otitis media with effusion by comparing its findings with those of myringotomies. (2) Identify the age group most commonly affected by OME.
  
  
  METHODS
  This prospective study was conducted at the Department of ENT& Head and Neck Surgery, Postgraduate Medical Institute Hayatabad Medical complex, Peshawar from July 1, 2012 to April 30, 2015. Patients with suspicion of OME underwent tympanometry and later myringotomies. Using Jerger's classification, Type B tympanogram with normal canal volume was considered as conclusive evidence of fluid in the middle ear space. Its findings were compared with those of the respective myringotomies. From the data collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive values were calculated.
  
  
  RESULTS
  A total 117 ears of 63 patients were operated. The age range was 3 to 12 years. The commonest age group (58.7%) affected by OME was 6-8 years. Type B tympanogram with flat curve and normal canal volume was obtained in 71.4% of the ears. Comparison with myringotomy findings showed TP 85, TN 13, FP 5 and FN 14. The diagnostic value of tympanometry was; Sensitivity 85.85%, Specificity 72.22%, PPV 94.44%, NPV 48.14% and Accuracy of 83.76%. P value calculated using chi square test showed that there was significant difference between tympanometry and myringotomy findings in OME (p < 0.05).
  
  
  CONCLUSIONS
  OME is common in age group 6-8 years. Tympanogram Type B with normal canal volume is fairly sensitive in diagnosing this condition. However for occurrence of false positive results, final decision regarding management should be made on clinical findings and other supportive audiological tests.
authors.affiliation: Khurshid Anwar, Senior Registrar, Department of ENT and Head & Neck Surgery, PGMI Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Anwar
authors.affiliation: Saeed Khan, Trainee Medical Officer, Department of ENT and Head & Neck Surgery, PGMI Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Saeed
authors.initials: S
authors.lastname: Khan
authors.affiliation: Habib ur Rehman, Assistant Professor, Department of ENT and Head & Neck Surgery, PGMI Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Habib Ur
authors.initials: HU
authors.lastname: Rehman
authors.affiliation: Mohammad Javaid, Associate Professor, Department of ENT and Head & Neck Surgery, PGMI Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Javaid
authors.affiliation: Isteraj Shahabi, Professor & Head, Department of ENT and Head & Neck Surgery, PGMI Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Isteraj
authors.initials: I
authors.lastname: Shahabi
keywords: Accuracy; Hearing impairment; Otitis Media with Effusion; Tympanometry