Video Pneumatic Otoscopy for the Diagnosis of Conductive Hearing Loss With Normal Tympanic Membranes

Objective. To evaluate the usefulness of video pneumatic otoscopy (VPO) for the diagnosis of conductive hearing loss (CHL) with normal tympanic membranes (TM).Study Design. Prospective study.Setting. Tertiary care hospital.Subjects and Methods. Thirty-seven ears with CHL and 9 control ears with normal TMs were included. The VPO was performed preoperatively in all patients. The authors captured TM images in 3 stages of the VPO (static, positive, and negative pressure stage) in all subjects and measured the amount of relative position differences of the umbo. Pure-tone audiometry and temporal bone computed tomography (TBCT) were performed preoperatively. The possible causes of hearing loss were evaluated during exploratory tympanotomy in the patients with CHL.Results. Fifteen patients had stapedial fixation, 10 had fixation of the malleus or incus (MIF), and 12 had ossicular discontinuity. The positional differences between the negative and positive pressure stage of the MIF group were significantly smaller...