Diagnostic instruments and methodologies have been sought for some time by investigators attempting to characterize the middle ear condition in the presence of an intact tympanic membrane. The presence of an acute serous effusion with air bubbles or an air-fluid meniscus makes the task relatively simple, but this condition is very uncommon in childhood chronic otitis media with effusion.
To our knowledge, Paradise et al1 were the first investigators to report a diagnostic paradigm for classifying tympanograms into a clinically useful scheme that would result in improved detection of middle ear effusion, the hallmark of chronic otitis media with effusion. They correlated their configurations with the presence of actual effusion at myringotomy. Cantekin et al2 combined the tympanometric paradigm by Paradise et al with otoscopy to further refine the algorithm for effusion detection. The article by Brostoff and Cantekin's3 further refined the original algorithm, a fluid-detection paradigm,
Le CT, Giebin GS. Otitis Media-Reply. Arch Otolaryngol Head Neck Surg. 1995;121(6):703–704. doi:10.1001/archotol.1995.01890060100024