Head and Neck Exam
Tympanocentesis (needle aspiration through
the TM) and myringotomy (incision in the TM
to provide fl uid) are the only methods directly
demonstrating the presence or absence of
middle ear effusion (Rosenfeld 1999). These
methods also have an immediate and posi-
tive effect on conductive hearing loss, which
in AOM may be as signifi cant as 50 dB (Mar-
golis and Hunter 1991; Hunter et al. 1994).
Their role as diagnostic methods and treatment
modalities has changed completely during recent
decades. In 1991, Finnish medical students and
GPs were advised to perform myringotomy on
every patient with AOM (Palva 1991) and...
