Predictive Accuracy of Wideband Absorbance at Ambient and Tympanometric Peak Pressure Conditions in Identifying Children with Surgically Confirmed Otitis Media with Effusion

Background: Wideband absorbance (WBA) measured at ambient pressure (WBA_A) does not directly account for middle ear pressure effects. On the other hand, WBA measured at tympanometric peak pressure (TPP) (WBA_TPP) may compensate for the middle ear pressure effects. To date, there are no studies that have compared WBA_A and WBA_TPP in ears with surgically confirmed otitis media with effusion (OME).

Purpose: The purpose of this study was to compare the predictive accuracy of WBA_A and WBA_TPP in ears with OME.

Research design: Prospective cross-sectional study.

Study sample: A total of 60 ears from 38 healthy children (mean age = 6.5 years, SD = 1.84 years) and 60 ears from 38 children (mean age = 5.5 years, SD = 3.3 years) with confirmed OME during myringotomy were included in this study.

Data collection and analysis: Results were analyzed using descriptive statistics and analysis of variance. The predictive accuracy of WBA_A and WBA_TPP was determined using receiver operating characteristics (ROC) analyses.

Results: Both WBA_A and WBA_TPP were reduced in ears with OME compared with that in healthy ears. The area under the ROC (AROC) curve was 0.92 for WBA_A at 1.5 kHz, whereas that for WBA_TPP at 1.25 kHz was 0.91. In comparison, the AROC for 226-Hz tympanometry based on the static acoustic admittance (Y_tm) measure was 0.93.

Conclusions: Both WBA_A and WBA_TPP showed high and similar test performance, but neither test performed significantly better than 226-Hz tympanometry for detection of surgically confirmed OME.