Diagnostic Agreement Study: Otoscopy vs Tympanometry in Otitis Media with Effusion

Abstract

Background: Otitis media with effusion is a common pediatric condition leading to hearing impairment. Accurate diagnosis is essential and relies primarily on otoscopy and tympanometry. Objective: To describe the diagnostic agreement between otoscopy and tympanometry in children with suspected otitis media with effusion. Methods: A prospective study was conducted on 45 children (90 Tympanic membranes) aged 3–11 years. Tympanic membranes over 15 days (1/9/2025–15/9/2025). Otoscopy was performed using an Omni 3000 otoscope and tympanometry with Interacoustics AT 235. Exclusion criteria were acute otitis media, tympanic membrane perforation, tympanic membrane perforation, ear discharge and children who are uncooperative. Findings were categorized and cross-tabulated descriptively. Results: out Of 90 Tympanic membranes, otoscopy identified normal (8), red (41), retracted (33), and air bubbles (8). Tympanometry showed Type A in 23 (25.6%), Type B in 55 (61.1%), and Type C in 15 (16.7%). Among normal Tympanic membranes, most showed Type A (6/8, 75%), while red Tympanic membranes showed predominantly Type B (25/41, 61%). Retracted Tympanic membranes correlated mainly with Type B (20/33, 60.6%), and air bubble Tympanic membranes were exclusively Type B (8/8, 100%). Conclusion: Tympanometry and otoscopy showed more than 60% agreement. Type B tympanograms correlated most strongly with abnormal otoscopic findings, particularly with presence of air bubbles behind tympanic membrane. However, some Tympanic membranes with red drum or retracted drum by otoscopy yielded Type A or Type C tympanograms, emphasizing the need for combined diagnostic use.