Tympanometric screening for otitis media with effusion and Eustachian tube dysfunction in a pediatric population in Yaoundé: A cross-sectional study

Abstract

Background: Otitis media with effusion (OME) and Eustachian tube dysfunction (ETD) constitute significant causes of pediatric hearing impairment. This study aimed to determine the frequency of OME and ETD and to identify associated factors.

Methods: A cross-sectional study was conducted among 255 children (127 males; mean age 6.1 ± 3.8 years) attending Yaounde Gyneco-Obstetric and Pediatric Hospital between January 1st to June 30th 2025. Sociodemographic and clinical data were collected through structured questionnaires. Tympanometry was performed using a tympanometer with a 226-Hz probe tone. OME was defined by type B or C2 tympanograms, and ETD by type C1 tympanogram. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with OME and ETD.

Results: The frequency of OME was 20.0% (51/255) and ETD was 20.4% (52/255). Prevalence was significantly higher in children ≤5 years compared to older age groups (OME: 80.4% vs 19.6%, ETD: 63.5% vs 36.5%; p < 0.001). Only 10.7% (11/103) of affected children had parental hearing concerns, and 47.6% (49/103) had abnormal otoscopic findings. In multivariate analysis, age ≤5 years remained the only significant independent factor associated with OME and ETD (adjusted OR: 5.59, 95% CI: 2.29-13.64, p < 0.001). The final model explained 19% of outcome variance (Nagelkerke R² = 0.194) with good fit (Hosmer-Lemeshow test, p = 0.591).

Conclusion: OME and ETD represent substantial unrecognized issue in Children. The discordance between objective findings and clinical detection highlights symptom-based surveillance inadequacy.