Home Forums Discussions General Discussion Pneumatic otoscopy survey

How many providers use pneumatic otoscopy to aid in the diagnosis of acute otitis media in children aged 15 months and younger? If so, how many providers feel it was accurate?

Pneumatic otoscopy requires a cooperative patient, which is why it is not very used in the the majority of small children. It requires a lot of practice which is another reason why it is not used much. Noting that small movement of the tympanic membrane with insufflation is very difficult to see in a child that is squirming and moving around. It is also not reimbursable. I prefer to use tympanometry which prints out the pressure differences and can be compared on the follow-up visit. The printed tympanometry is my documentation that the test was done.

Thanks for the reply. I agree. Plus it is difficult enough to have the parent hold the child (if they can't, I put them on the table), hold the bulb against the otoscope, hold the ear and still get a good seal. The reusable speculums are nearly impossible to get a good seal. When you read about the diagnosis of AOM, they make it sound like it is a routine thing.

Do you find that tympanostomy works well with a 6-month-old or 9-month-old? What brand do you use? Is it portable?

Yes, it is only reliable for kids greater than 6 months. I use the Microtymp3 and I also have the Otowave 102. I like the Microtymp 3 because it is fast. They do not make it anymore though. I only purchased the Otowave because I needed a backup in case the Microtymp does not work anymore.

I don't have to worry about getting the best one. My vendor guy always tells me this is the best. Actually, he always tells me something like TYMPANOWRONG is the best, then when it doesn't work, he says oh they do make TYMPANORIGHT but it is more expensive.

FYI: TYMPANORIGHT WAS FLAGGED AS A MISSPELLED WORD WHILE TYPANOWRONG WAS NOT. GO FIGURE.

I used to do more pneumotoscopy than I do now.
I was trained to do it with a straight tube that I blew or sucked in rather than a bulb. I've done it both ways and I prefer the straight tube.
On the other hand I don't do a lot with serous otitis anyway so......

Thanks Wendell. Yes, but everything I hear and read is that it isn't acute otitis media if the TM moves.

THIS COULD REALLY BE HELPFUL. Currently we are looking at a tympanometer that costs $4,000. Anyone know which one they use? Does it help with the diagnosis? I.E. You see a red inflamed ear that has a perfect tymp drawing showing good movement of the ear drum, do you not call it an OM?

This would be very helpful if a) you use it to make the diagnosis and you think it is worth the money.

The other issue is it would need to be moved from room to room unless done in triage but the triage MA wouldn't know when you needed it.