A comparison between penlight and otoscopic examination of the ear canal and tympanic membrane among grade 1 students

ABSTRACT

BACKGROUND@#In the Philippines, screening for ear problems especially in children at entry to school is usually undertaken by school nurses and teachers who typically do not have specialized instrumentation. The penlight has recently been employed as screening method in determing the possibilities of ear problems in public school communities. This study attempts to determine the accuracy of the penlight as an alternative method for screening to assess the common external ear abnormalities among Grade 1 students in an elementary school.@*OBJECTIVES@#1. To compare the result of otologic examination using the penlight versus otoscopy in determining of common pediatric ear problems. 2. To determine the sensitivity, specificity and predictive values of penlight examination in the screening of ear canal and tympanic membrane for abnormal conditions among Grade 1 students.@*METHODS@#Otologic examination with the use of a penlight was carried out by the tranined nurse in ears of Grade 1 students and the results compared with those obtained from otoscopy done by an otolaryngologist. Presence of ear conditions such as cerumen, discharge, foreign body, tympanic membrane visualization, and an overall assessment were recorded in an Excel file. The examiners were both blinded with the findings.@*RESULTS@#Ninety-four students (188 test ears) with a median age of 6 years, ranging from 5 to 10 years, and a 11 sex distribution were included in the study. The result showed an excellent agreement (P<.001) between the penlight and otoscopic examination. The sensitivity and specificity were of 98.6% and 100%, respectively. The PPV is nearly 100% and NPV of 95.2% and and overall accuracy of 98.94%.@*CONCLUSIONS@#There is an excellent agreement between the nurse‘s findings and otolaryngologist‘s findings in examining the ear canal and tympanic membrane. The penlight has on overall accuracy of 98.94%, in identifying cerumen, discharge, foreign body and visualizing the tympanic membrane. Thus, this study shows that with trained nurse in otologic examination, the penlight is an effective screening in identifying common ear problem among children.