Year: 1999 Vol. 65 Ed. 2 - (3º)
Artigos Originais
Pages: 122 to 127
Importance of Otomicroscopy and Acoustic Imittance Measurements for the Early Detection of Effusion in the Middle Ear of Asymptomatic Children in a Pediatric Outpatient Clinic.
Author(s):
Myríam L. Isaac**,
José Antônio A. Oliveira**,
Francisco Holanda***
Keywords: otomicroscopy, acoustic imittance tests, serous otitis media
Abstract:
A study was conducted on 36 infants (72 ears) aged 5 to 29 months with no risk factors for hearing disorders or upper respiratory diseases at the time of study. The infants were submitted to otomicroscopy and acoustic imittance measurements and the results of the two procederes were compared. The results showed predominante of type A Jerger's tympanogram among normal ears, which increased with age, a high incidente of type B Jerger's tympanogram related to serous otitis media among infants aged 11 to 17 months, and a low incidente of rype C Jerger's tympanogram. Normal middle-ear pressure with horizontal location in the tympanogram was observed, mostly in the 0 to - 50 mmH20 range. Median static compliance was 0,45 cm³ for the rype A tympanogram, with the value increasing with age.The median contralateral acoustic reflex was 100 dB HL and was absent in the presente of unilateral or bilateral serous otitis media. The threshold did not decrease with age and there was an increase in number of responses with age for the 4.000 Hz frequency. The comparison of Otomicroscopy and Acoustic Immittance demonstrated 98,2% specificity and 100% sensitivity for the former and 100% and 98% for the latter confirming the clinical value of this diagnostic test.The combination of the two tests proved to be important for the otologic evaluation of small patients because it detected changes in the middle ear of asymptomatic normal children that may have gone undetected in a common otoscopic examination, showing that the combination of the two methods should reduce the possibility of diagnostic errors.
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