Screening for Otitis Media in Daycare-Attending Infants and Toddlers

The feasibility and effectiveness of using pneumatic otoscopy and tympanometry measurements to screen for otitis media (OM) in infants and toddlers attending daycare was evaluated. 10,245 weekly health screenings were attempted longitudinally on 132 children aged 6 months to just over 36 months. Complete pneumatic otoscopy examinations were rarely feasible (60%), while tympanometry was more readily obtained (84%). When a complete screening was obtained, the child was more likely to be diagnosed with OM, suggesting OM may be under diagnosed. Pneumatic otoscopy descriptors and tympanometry measures were different between health and OM ears, however, neither was an ideal tool to diagnose OM. Pneumatic otoscopy was often difficult to obtain and tympanometry did not clearly distinguish healthy ears from ears. Age was a significant factor in all measures. Further, these children were frequently ill (only 40% of screenings were classified as healthy). Ninety-nine percent (99%) of the children had at least one episode of OM, and the typical child had OM for 20 weeks before age 3 years.