Reliability of the otoscopic tympanic membrane findings in the diagnosis of middle ear effusion.

Objective: To estimate the reliability of otoscopic findings to predict the presence of middle ear effusion.

Methods: The cross-sectional study was conducted at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from April 1, 2019, to January 1, 2020, and comprised patients of either gender aged 3-70 years complaining of ear problems. The patients were randomly assigned to two specialist otolaryngologists who checked the presence of retraction of the tympanic membrane and other features suggesting middle ear effusion. All the patients underwent tympanometric impedance measurement to compare the results with the otoscopic findings. Data was analysed using SPSS 25.

Results: The study comprised 369 ears of 203 patients. There were 98(48.3%) male and 105(51.7%) female patients. The overall mean age was 19±17.45 years. In 141(38%) ears, middle ear effusion was confirmed by tympanometric finding type B flat impedance curve, while 187(51%) ears had impedance curve type C and 41(11%) ears had impedance curve type A. The positive predictive value of otoscopic appearance in the diagnosis of middle ear effusion was 38%. History of recent hearing loss or upper respiratory tract infection had no significant association with the condition (p>0.05).

Conclusions: Otoscopic tympanic membrane findings were found poor predictors of the existance of middle ear effusion.