Diagnostic Accuracy of Tympanometry in Pediatric Otitis Media with Effusion Compared to Myringotomy Findings

Abstract

Background: Otitis media with effusion (OME) is a frequent ear disease in children that may lead to conductive hearing loss and school problems if not detected.

Objective: To assess the diagnostic accuracy of tympanometry for OME in children as compared to the reference standard of myringotomy.

Methods: The study was a prospective diagnostic accuracy study carried out in the Department of ENT, Hayatabad Medical Complex, Peshawar, Pakistan for six months (January, 2026 to June 2026). One hundred children aged 2-12 years, who were clinically suspected of OME and were scheduled for myringotomy, were enrolled using non-probability consecutive sampling. Preoperative tympanometry results were compared to intraoperative myringotomy results using Jerger criteria to determine the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy.

Results: The effusion was confirmed by myringotomy in 62 of 100 children (mean age 6.8 ± 2.7 years, 57% male). The sensitivity, specificity, PPV, NPV, and overall accuracy of tympanometry were 88.7%, 92.1%, 94.8%, 83.3%, and 90.0%, respectively, with a positive likelihood ratio of 11.2 and a negative likelihood ratio of 0.12.

Conclusion: Although there are false-positive and false-negative results, tympanometry is a reliable, non-invasive preoperative test for the detection of pediatric OME, and should be used in conjunction with clinical and intraoperative evaluations.