Applicability of spectral gradient acoustic reflectometry (EarCheck): Screening patients who need surgical treatment for chronic otitis media with effusion

Objectives: We aimed to conduct a prospective, observational study of the applicability of EarCheck (Innovia Medical LLC, Omaha, NE) in the surgical management of chronic otitis media with effusion (COME). Materials and methods: Between February 2013 and July 2013, 84 patients (165 ears) who had been diagnosed with COME and underwent surgical management were recruited. Information concerning patient sex, age, body mass index, EarCheck score, pure-tone averages (PTAs), speech reception thresholds (SRTs), and characteristics of middle ear fluid (MEF) were documented and statistically analyzed. Results: MEF was detected in 87.3% (n= 144/165) of the 165 ears. Based on EarCheck scores ≥3 (as a criterion for abnormal findings), the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EarCheck were 56.9%, 90.5%, 82%, 23.5%, and 61.2%, respectively. Significant positive correlation was found between EarCheck, both pure-tone thresholds at all frequencies and mean PTAs, and SRTs. The mean PTAs and SRTs of the patients with EarCheck scores ≥3 was 37.79. dB and 33.26. dB, respectively; these scores were significantly higher than the mean PTAs and SRTs (30.56. dB and 25.88. dB, respectively) of the patients with EarCheck scores <3 (p < 0.05). Conclusion: Although it is not preferable to conduct the EarCheck test alone when diagnosing COME because of its low accuracy, because of its additional hearing level clues, EarCheck can be used in deciding whether to perform tympanostomy tube insertion when conventional audiometry is not possible.