Pneumatic otoscopy and tympanometry in the detection of middle ear effusion.

A prospective study was designed to assess the relative merits of pneumatic otoscopy and tympanometry in predicting the presence of a middle ear effusion, and to determine if both tests in conjunction provided any significant advantage. In 121 patients (222 ears) pneumatic otoscopy with a Seigles speculum and tympanometry were performed prior to myringotomy. An immobile tympanic membrane on otoscopy, or a Jerger type B curve on tympanometry were considered indicative of a middle ear effusion. There was no significant difference (P greater than 0.05) between the predictive value of pneumatic otoscopy (88%) and tympanometry (89%). When pneumatic otoscopy and tympanometry were used in conjunction, the predictive accuracy did not increase significantly. Pneumatic otoscopy and tympanometry are simple and reliable methods of predicting the presence or absence of a middle ear effusion. Their use together did not increase diagnostic accuracy.