Incidence and Progress of Middle Ear Effusion in Allergy Practice as Detected by Acoustic Otoscope Reflectometry
The incidence and progress of middle ear effusion (MEE) in allergy practice is not well established in prospective studies. A total of 393 patients were screened for MEE by history and physical including pneumatic otoscopy, prick and intradermal skin tests, acoustic otoscope reflectometry (AOR), impedance tympanometry (IT), and audiometry for those with established MEE. The primary diagnosis of the screened patients was intrinsic asthma in 70 or 18%, allergic rhinitis in 134 or 34%, allergic rhinitis and asthma in 80 or 21%, miscellaneous in 103 or 26%. Twenty patients were receiving immunotherapy (5%), and 89 (23%) had middle ear effusion (MEE). Among the MEE group were 52 males (58%), 37 females (42%), with an average age of 13 years, median of 8 years, and range of 6 months to 13 years. The MEE group was statistically different demographically from the initial group (P < .05) for age and history of recurrent otitis. The MEE group's primary diagnosis was similar to that of the initial group, except that there was a statistically significant difference in the number of patients on immunotherapy (P < .05) and those in the MEE group, with 11 (12%) versus 20 or 5% in the initial group. MEE resolved in 91% of cases which could be followed to resolution, with average duration of nasal steroid of 4 weeks, average duration of effusion 8 weeks, median 4 weeks, range 1 week to 6 months. Effusions in 8 patients (9%) were intractable with duration greater than 3 months. Sensitivity of reflectometry was 79%, speificity 81%, with a positive predictive value (PPV) of 65%, and negative PV of 90% in comparison with tympanometry.
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Document Type: Research Article
Publication date: May 1, 1994
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