The Comparison of Otoscopic Findings and Impedance Measurements

Otomicroscopic visual observations including the use of the pneumatic otoscope were compared with impedance measurements: middle ear pressure, compliance, and stapedius reflex threshold. The tympanic membrane position, appearance, and mobility were used for an attempt to suggest an actual middle ear pressure in otomicroscopy. This was achieved by prior exercises connecting the pneumatic otoscope to the impedance bridge and monitoring different pressures. Audiological findings were in good agreement with previous similar investigations in the same age groups. A retracted ear drum always correlated with a negative middle ear pressure. Contrarily, bulging ear drums did not deviate from normal findings. Tympanic membranes with decreased motion correlated with a negative middle ear pressure. Flaccid ear drums demonstrated a considerable increase in compliance. The suggested middle ear pressure in otomicroscopy showed high agreement with subsequent impedance measurements. There was a marked tendency to higher negative values of middle ear pressure in ears with elevated elicitation levels for the stapedius reflex and still more in ears in which the stapedius reflex could not be elicited. It is suggested that the use of the pneumatic otoscope gives valuable information about middle ear function and could be adopted when audiological services are not available. As demonstrated previously, there is an increased number of children with an elevated elicitation level for the stapedius reflex.