A comparison assessment of videotelescopy for diagnosis of pediatric otitis media with effusion

Objectives: A correct diagnosis of pediatric otitis media with effusion (OME) is imperative for instituting an appropriate treatment. The aim of this study was to compare the diagnostic efficacies of videotelescopy, pneumatic otoscopy, and tympanometry for detecting the presence or absence of pediatric OME, and thereby, to recommend a standardized procedure for assessing possible OME in the outpatient setting of a referral center. Study design: Prospective study. Methods: Between November 1999 and May 2002, 104 children were enrolled in this comparison study of diagnostic methods for OME. Based on a presumptive diagnosis of OME or atelectasis of the eardrum, patients under 12 years of age were admitted to the ward for ventilation-tube insertion. In the 2 days prior to surgery, videotelescopy, pneumatic otoscopy, and tympanometry were performed. Myringotomies were subsequently conducted under general anesthesia to confirm the presence or absence of OME. Type B tympanograms were accepted as positive results for ears with effusion. Results: Of the 201 ears assessed in the study, middle-ear effusion was detected in 179, while the remaining 22 ears were found to be dry on myringotomy. It was demonstrated that videotelescopy had the highest sensitivity (97.8%), specificity (100%), and accuracy (98.0%), reflecting significantly better results than those for pneumatic otoscopy and tympanometry. Conclusions: In our study, videotelescopy seemed to be better than pneumatic otoscopy and tympanometry for diagnosis of pediatric OME. It may be has the potential to become the standard diagnostic and teaching procedure for pediatric OME in the outpatient setting of a referral center, and for validation of pneumatic otoscopy. (c) 2005 Elsevier Ireland Ltd. All rights reserved.