The most specific method to assess for MEE is pneumatic otoscopy. The NEJM video demonstrates the correct technique for the use of pneumatic otoscopy. An understanding of common tympanic membrane changes that are associated with OME is helpful in its diagnosis.
Tympanometry provides another an objective means of identifying a middle ear effusion (fluid in the middle ear space). It can be helpful to review tympanometry and practice reading tympanograms. Using tympanometry, the likelihood of a middle ear effusion is:
| Tympanometry | Likelihood of a Middle Ear Effusion |
|---|---|
| Compliance > 0.2 and Gradient < 150 daPa | Middle ear effusion is unlikely. |
| Compliance < 0.2 and Gradient < 150 daPa or Compliance > 0.2 and Gradient >150 daPa | 65% chance of a middle ear effusion. |
| Compliance < 0.2 and Gradient > 150 daPa | 95% chance of a middle ear effusion. |