Details

  • 4-17 years
  • 30 Minutes
  • $80.00

Otitis media (infection of the middle ear) is one of the most commonly diagnosed childhood illnesses in New Zealand. The middle ear space, (the space behind the ear drum) is generally well ventilated by the Eustachian tube, a narrow tube that runs to the back of the nose and throat. When the Eustachian tube becomes swollen, it can prevent sufficient air flow and lead to fluid build-up. Children are more likely to develop ear infections due to their Eustachian tubes being narrower and more horizontal, making it more difficult to drain and more likely to clog up.

Otitis media with effusion, commonly known as “glue ear”, can occur when the fluid build-up gets infected by viruses, bacteria or because of allergies. An ear infection can lead to pain, fever, irritability, difficulty sleeping at night, an even temporary hearing loss. Middle ear effusions persisting longer than three months may need grommets (ventilation tubes), inserted by an Ear Nose and Throat specialist, to help fluid drain.

This assessment does not require any response from your child (other than sitting quietly) and will include video otoscopy, tympanometry/pressure test, acoustic reflex testing and DPOAE testing to determine whether glue ear is present and if ongoing referral to an Ear, Nose and Throat specialist is necessary. This appointment is available strictly to children who have been referred by their General Practitioner or Ear Nose and Throat Specialist.

What’s Involved

Video Otoscopy

During this part of the test, we will use an Otoscope to primarily assess the outer ear/lobe, the ear canal, and the ear drum. We will be paying attention to the outer ear anatomy, possible obstruction in the canal, possible infections in the canal, perforations/holes in the eardrum, fluid build-up behind the eardrum, and/or any other unusual findings. With Video Otoscopy we can take and store an image of the canal and eardrum. This can be very useful as a reference further down the track, and by sharing it with you and/or other medical professionals such as an Ear Nose and Throat specialist. This part of the test takes only a couple of minutes.

We will put a soft silicon plug in your child’s ear. They will hear a low hum and will feel a pressure change, much like when you want to equalize your ears when you are flying in an aeroplane. This sensation will only last seconds. This test is useful in determining if there could be a perforation/hole in the drum or if there may be an outer ear- or middle ear infection. It may give us information on the integrity of the little hearing bones in the middle ear. It may even give us information about the Eustachian tube (the narrow tube which runs from the middle ear space to the back of the throat, responsible for equalizing the pressure behind the eardrum).

Immediately after the pressure test, your child will hear a series of louder sounds. The smallest muscle in your body (the Stapedial muscle) contracts when we hear loud sounds. By contracting, it prevents sounds that are too loud from causing damage to the hearing organ as not all of the sound energy gets transferred through. Our equipment will record the presence or absence of this reflex. This part of the test will take a couple of minutes.

Distortion Product Otoacoustic Emission (DPOAE) testing is a simple, fast, and objective way of evaluating the integrity and function of tiny hair cells in the hearing organ, the cochlea. A soft sponge tip will be placed in the ear canal. Apart from sending sounds to the inner ear, the probe tip also measures a tiny echo which comes BACK from the inner ear. DPOAE testing is not a test of hearing, but rather a tool used to tell the difference between types of hearing losses. It is safe to use on all age groups from infants to the elderly. This part of the test will take a couple of minutes.

Discussion of Results

During this final part of your appointment, we will explain your test results, and answer any questions you may have. We can instantly provide you with a copy of your test results and will, at your request and with your permission, write a report to any other professionals. We will give you clear direction on what the next steps would be if a referral is required for further investigation and management.