Diagnostic Utility of Electrophysiological Testing in Pediatric Otitis Media with Effusion: A Retrospective Analysis

Otitis Media with Effusion (OME) is a major cause of hearing loss in early childhood. While tympanometry is a standard tool for identifying middle ear effusion, it does not reliably differentiate between types or severity of hearing loss. Electrophysiological testing, particularly auditory brainstem response (ABR), offers objective and detailed auditory profiling, especially in uncooperative pediatric patients. to highlight the importance of ABRs in cases of OME. This retrospective study included 40 children (60 ears), aged 1–4 years, with hearing loss lasting over 6 months. All had Type B tympanograms with zero compliance and underwent ABR testing with air and bone conduction. In this study, tympanometry alone was insufficient to differentiate between pure conductive and mixed hearing loss. Although all cases showed Type B tympanograms with zero compliance, this did not reveal the full nature of the hearing impairment. ABR testing was essential in identifying sensorineural components in cases previously assumed to be purely conductive. This reclassification was based on elevated bone conduction thresholds, which tympanometry could not detect. Additionally, disease severity was assessed using two ABR indicators: Air-bone gap size, with larger gaps suggesting more significant conductive involvement. Wave V delay, in air conduction responses, indicates more severe pathology even in early-stage OME. These results underscore the diagnostic value of ABR in both characterizing hearing loss and evaluating disease severity in pediatric OME. Electrophysiological assessment, especially ABR, is a critical diagnostic tool in the pediatric evaluation of OME.