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In Reply.—We thank Dr Schwartz for his comments and his reference, which was published after we submitted our manuscript. His observation that patients with peak-positive-pressure tympanograms at myringotomy often show group A Streptococcus or pneumococcus on culture is consistent with the excellent outcome we observed among patients with positive tympanograms after treatment with antibiotics. Dr Schwartz's finding that patients with acute otitis media and a normal or negative pressure tympanogram often have loculated or segmental middle-ear fluid underscores the importance of careful pneumo-otoscopy. Tympanometry did, however, identify patients who need particularly careful follow-up, ie, patients with flat or type-B tympanograms.
LAMPE RM, WEIR MR. Tympanometry and Otitis Media-Reply. Am J Dis Child. 1981;135(9):864. doi:10.1001/archpedi.1981.02130330074026