Diagnosis and treatment of ear diseases in general practice. A controlled trial of the effect of the introduction of middle ear measurement (tympanometry)

: The diagnosis and treatment of diseases of the ear in general practice could be rendered optimal by employing tympanometry (measurement of the pressure in the middle ear) which is already known from specialist practice. This was investigated by means of a controlled investigation with cooperation between general practice, otologists and the health services in the County of Vejle. Following randomizing among 20 general practitioners, ten were trained in tympanometry (the test group) while ten did not change their principles for diagnosis and treatment (control group). The criteria for inclusion in the investigation were the findings of indications for otoscopy in children under the age of 16 years. During a period of 12 months, parallel registrations of the data were made in the two groups and 3,166 children with an average age of 3.4 years were included. The clinical course showed statistically significant differences (p less than 0.05) between the groups as regards diagnosis and treatment: acute otitis media was found in 8.4% in the control group and 2.6% in the test group. Secretory otitis media (glue ear) was found in 14.2% in the control group and in 25% in the test group. Correspondingly, penicillin was prescribed for 7.6% in the control group and 4.1% in the test group. The otologists performed tubulation of the tympanic membrane in 0.9% in the control group and 3.2% in the test group. Continued investigations are necessary to elucidate whether tympanometry should be part of the daily routine in general practice.