Rıfat KARLI, Arzu KARLI, AHMET AKSOY, Sevil AÇIKGÖZ, Emre AYHAN

Orta kulak efüzyonlarında timpanogram ile otoskopik bulguların karşılaştırılması

Amaç: Efüzyonlu otitis media şüpheli olgularda timpanogram bulgularının otoskopik muayene bulguları ile karşılaştırılarak timpanogram testinin rutin kullanımdaki yerinin sorgulanması.Gereç ve yöntem: Efüzyonlu otitis media şüphesi ile Ku- lak Burun Boğaz (KBB) polikliniğimize ayaktan başvuran 64 olgunun 128 kulağına otoskopik muayene ve sonrasında timpanometrik inceleme yapıldı. Otoskopik muayeneyi yapan hekimlerin timpanogramda çıkacak sonuç hakkında tahminleri ile gerçek timpanogram sonuçları karşılaştırıldı. Bulgular: İncelemeye dahil edilen toplam 128 otoskopik muayenenin 29’unda (%22,6) hekimin otoskopik muayene tahmini ile timpanogram sonucu aynı çıkmadı. Ancak bu otoskopik muayenelerin sadece dördünde hekim tarafından efüzyon olmadığını düşündüren Tip A timpanogram tahmini yapılırken, timpanogram işleminde efüzyon varlığını düşündüren Tip B veya Tip C sonuçları elde edil- miştir. Sonuç: Timpanogram testinin otolojik muayenenin bir parçası olarak rutin olarak her hastaya uygulanması zaman ve maddi kayıp sebebidir. Bu nedenle öncelikli seçeneğimiz otoskopik muayene olmalıdır.

Comparison of the tympanogram and otoscopic findings in effusions of middle ear

Objective: The aim of this study was to investigate the role of tympanogram test in routine use comparing the tympanogram findings and otoscopic examination find- ings in patients with suspicious otitis media with effusion. Materials and methods: 64 outpatients with suspicious otitis media with effusion presented at our Otorhinolar- yngology clinic and first otoscopic examination and then tympanometric examination was performed for their 128 ears. Predictions of the physicians who performed oto- scopic examination for outcomes from tympanogram and actual tympanogram outcomes were compared. Results: Predictions of the physician for otoscopic ex- amination were different from tympanogram outcomes in 22.6 percent (n=29) of 128 otoscopic examinations in total. However, the physician predicted Type A tym- panogram suggesting no effusion in only four of these otoscopic examinations yet Type B or Type C outcomes suggesting existence of effusion were obtained from tym- panogram. Conclusion: Application of tympanogram test routinely as part of otologic examination to each patient is a cause of material loss. Our first choice should be otoscopic ex- amination.

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